What is after 6mp

[lookame]

So after 2 weeks of bloody, mucousy stools I've determined that the 6mp which worked for 4 months has stopped working as well. It's unusual because it works and then it "doesn't". What I mean is I still have symptoms blood, mucous, fatique, ect but then I do have formed stools and go about 3-5 times a day. I'm just curious what the next step is. I don't feel he should raise the dose from 50-75mgs because I'm worried that it'll essentially kill me(I'm a moderate metabolizer and I also only weigh about 100lbs, if it's raised it probably suppress my immune system to much) so what is next?

 

[muppet]

Is your doctor using the Prometheus Labs test to check your metabolite levels? If your level of "good" metabolite isn't therapeutic then a dose increase may be exactly what you need. 75mg isn't that much for an adult dose. My daughter was on 50mg when she was only a little lighter than you.

If you're worried about hepatotoxicity talk to your doctor about moderating your metabolism of the 6mp with allopurinol. You'll likely have to reduce your 6mp dose if you go this route but you should end up producing more of the good metabolite and less of the dangerous one.

If Lialda + 6mp isn't working for you then your next steps depending upon the details and location of your disease might be a resection or a biological like Remicade/Humira or both. There's quite a few options, again depending on what is specifically is going on with you personally. Get your doctor in a room after doing some research on the options and grill him.

And, my standard one-note-horn advice: if your doc isn't responsive to your questions and willing to discuss the options at length until you're satisfied with the answers: fire him/her and find a new, better doc.

 

[lookame]

Last time I saw him he said it was in a theraputic range. I told him I was having cramps before using the bathroom and he had me lay down and palpated my stomache then told me everything looked good and didn't want to change anything. A week or two after my appointment with him diarreah decided to show up a couple of days later came the blood then mucous. Stools started going back to formed but blood and mucous stuck around. The worst part of my disease is in my descending colon but its spread thoughout my entire colon, my small intestine has never been tested/checked. I have a feeling he won't listen to me when I talk to him. I don't go back until november, I tried to call him but the nurse acted like blood wasn't anything of concern or that I wasn't taking my medicine or that I was around someone who had a stomache bug...*shrug*

 

[muppet]

If you call your specialist's office and you tell them you're bleeding and they shrug it off, my advice is to find a new specialist on the double. No kidding around.

It may be that your 6mp is therapeutic but you're having a flare. This is a normal thing to happen, even though it's unfortunate when it does. You may need to go on Prednisone for awhile to quiet your bowel down and allow the 6mp to work again.

Crohn's is a cyclical sort of illness for most people. What works will not ALWAYS work and you'll occasionally need to supplement with steroids/diet/etc.

 

[lookame]

Oh and when I saw him last month I had lost 10 lbs in 2 months. He was concerned and told me to eat more(try not to skip meals) I feel like perhaps he dropped the ball on the last visit.

 

[muppet]

DEFINITELY time for a new guy. Call your GP and ask for a referral or see if there's any local IBD clubs in your area. Google is decent for this. Call specialists out of the phone book if you have to. This guy you've got now is a dud.