Vaccines and starting aza/6mp

[lowone]

Friday morning I got a call from my gi saying I can start aza or 6mp. Don't know which yet as my gi doc kept talking about 6mp and the pa talked about aza. I get to pick it up Monday (pharmacy had to order it in and did not say which either. So that will be a surprise). I was supposed to start this last Saturday but it will be delayed cause of the above and below?!?

Friday afternoon I had an appointment with my regular gp to look at a funny bump on a bone... I caught him up on all my gi docs were saying. He questioned the use of aza/6mp vs low dose pred. He wants me to think and research them as he thinks the side effects from aza/6mp is too scary. Though he said I should try it and see if it is effective. However he also said to delay the start of aza/6mp by 1week (so next Friday??). Then he gave me a tdap vaccine in the right arm and a pneumococcal 13 vaccine in the left arm.

Is a week enough time to wait? I have had a light sore throat since about 2days before I started my present course of prednisone and it's still there. Guess I am a bit confused since I am about to kill my immune system, and can't find much info out there about this stuff but neither doctor seemed worried so maybe it's all ok to start this Friday??

Left arm sure hurts from the pneumococcal 13 vaccine.

 

[lowone]

no responses! lol
I picked it up, i have mercaptopurine version in hand now waiting for friday I guess.

 

[Mehita]

When my son's GI mentioned possibly starting 6mp in the future, he said we'd have to be sure he was up to date on his varicella vaccine (my son is only 12). I'm still not sure I understand why, but apparently once he starts 6mp, he would not be able to get a varicella booster ever again. Maybe the dTap and pneum are the same? Though the GI never said anything about any vaccines except varicella. Sorry, probably not much help.

How's the mercaptopurine going?

 

[Lisa]

When I was on 6-mp I got the annual flu shot - always the shot, never the modified live vaccine....

And as far as 'killing' you immune system - it really isn't that bad - in fact I was usually the healthiest person in my house while on meds - including since I started Remicade almost 7 years ago!!!

 

[Mehita]

Maybe pasobuff just hit it on the nose... maybe live vaccines are what need to be avoided? But dTap and pneum are dead vaccines.

 

[Lisa]

@ Mehita - yes - it is the live vaccine that is to be avoided - that is indicated if you are on any type of immunosuppressor.....

 

[lowone]

How's the mercaptopurine going?

Its been interesting! re-vaccines a week later and arms felt fine so i started it that saturday...

The first dose~ WOW!! took it when I first woke up at 6:30am.. around 10am UPS made a rush delivery of a pile of parts for some broken servers at work. I was feeling ok so at 11am figured I would drive them in and fix stuff.... I SHOULD NOT HAVE DRIVEN! wow wow get out on the road and my perception/focus was way way off I felt like I had drank both an expresso and 6~ beers at same time so weeeeird to go from lazying around the house to going "oh ***** i shouldn't be driving". scary scary drive! by 6pm I was ok...

The second dose~ I could feel the effects a little abit like the first day but much less so and successive doses I have not really felt any different then normal in the above regards.

I have had some interesting thought pattern changes for a while, but those too are gone, but I dont know if they are related to prednisone and tapering off it or to changes due to 6mp or the combination or what...

right now I am kind of worried as my stool is moving toward the softer end of the scale. Starting in the morning I am at my last taper level of pred (5mg) for 7 days and Its definitely been helping so i worry and dont want to relapse into a full flare. At the end of the week I go in for my 3rd round of cbc + metabolism tests and the first round of what ever magic they use to determine if I am approaching a therapeutic dose. though am guessing if no pred and soft bowl movements will are a good indication to increase the 6mp dose?! though its supposed to take 6ish weeks to build to full whatever? In last two or three days my guts have been feeling a bit unwell also.. no level of pain yet just some kind of uneasy feelings. so I don't know in the end!

Results of my first cbc/metabolic panel were everything looks good, but still a little bit anemic (have been for months now). Results of my last cbc/metabolic panel were looks all ok and still anemic. The nurse sounded surprised i was still anemic... doesn't seem too surprising to me given the nature of everything. I was more interested in the shift from "looks good" to "looks ok". will have to find out more after this friday's round and maybe get paper copies so I can actually have the numbers in hand.

I have been developing a few bits of red pimply like bumps with white puss/squishy stuff in them, though they are harder squishy stuffs not like normal acne so I dunno thats one of the many possible side effects.. probably should report that to the dr.

To help complicate things I also started a new pro-biotic with 14 kinds of live thingies in it over the yogurt i have been eating that only has 6... so maybe thats causing a change in stuff tooos.

so much confusing!!

 

[rygon]

never tried 6mp but the acne I had when tapering off pred. Its a good drug for short term use but it can have some nasty side effects. Definately not a long term drug.

With regards to anemia, is it due to Iron, B12 or folate? Are you taking anything for it? If not then I suggest you try and eat foods rich in iron/b12 if your stomach allows. You will be either losing blood or not absorbing enough to become anaemic. Your tests should tell you what you are lacking, although to me "good" and "ok" are exactly the same thing .. its within limits

 

[lowone]

I asked about anemia and got a folate and b12 test done on 2/22 which showed:
folate: 17.3ng/ml (>9.1 is normal)
b12: 848pg/ml (211-946 is normal)

so those values looked good and that was back during the worst part of my last flare. I don't have anything that shows iron level. So dunno if the present metabolite tests will show that or not?

I would guess i am bleeding.... but dont know for sure!