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Suggest Treatment For Chron's Disease And Rheumatoid Arthritis
Question: hello my name is XXXXXXX iv had celiacs since age of twevle i am know 50 at 22 i develibed chrons had a hole in asscending colan and around appendects lost six feet in surgery at have been on steriods most of my life at 45 had another blow out lost ten feet mostly small intestines iv been on humira since 2010 but my chest and breast become so sore cant even stand having a shirt on been going to clev clinic last two years cant seem to beat c-diff infection puts me in hospital every few months even had four time blood transfusions from bowels bleeding pain meds are three vicadons a day cant handle pain any more they wont up my dose also have seven back fractures ostio and rometiod arthris recently started taking predision 20m a day my chest clearing up but my bones hurt humira 40 shot every ten days should i just get off humira im diabled from back problems since 2012 iv lost all hope of every being normal just want the pain to stop any suggestions
Brief Answer:
Continue Humira and in hospital treatment
Detailed Answer:
Hi, thanks for posting the concern in the HCM.
Firstly, let's summarize the health issues you are suffering from-
Chron's Disease, with complications
Celiac disease
Rheumatoid Arthritis (probably moderate to severe form)
Osteoarthritis
clostridium difficile enterocolitis
Vertabral # (multiple)
Anemia due to chronic blood loss, malabsorption and anemia of chronic disease
Post intestinal resection status after bowel perforation
On long-term steroid and opioid medications with adverse reaction of steroids
On Adalimumab
Now, let's come to your medication part-
Adalimumab (Humira) is a TNF alpha inhibitor, which is effective against both Chron's disease and Rheumatoid Arthritis. There is an important safety issue, i.e. chance of recurrent infection, particularly because you were also on prolonged steroid use. But, despite this additional risk, weighing the risk-benefit of this medicine in both the above mentioned diseases, I don't think it needs to be stopped at this point of time, particularly when you have recently diagnosed active RA.
Regarding the pain management, you are already on opioid analgesia. Along with that you are also having Acetaminophen in combination. Now, limitation of activity, increasing dose of opioids are the medical options to improve pain management. But, the best way out for pain management at this refractory stage will be regional nerve blocks. You may consult your local pain management clinic regarding the same. This not only has lesser side effects, but also reduce the necessity for more aggressive use of more risky medications.
Your pain is due to the complications of ongoing active inflammatory processes and recurrent fractures.
Therefore, bed rest in a in patient facility with regional nerve block would definitely help you out a lot.
During this period, the ongoing inflammatory processes may also be controlled with TNF inhibitor management. Therefore, I think this method I think would be at least a bit longer lasting pain solution for you.
If you find this answer helpful, please close the thread and rate my answer.
Regards.
Continue Humira and in hospital treatment
Detailed Answer:
Hi, thanks for posting the concern in the HCM.
Firstly, let's summarize the health issues you are suffering from-
Chron's Disease, with complications
Celiac disease
Rheumatoid Arthritis (probably moderate to severe form)
Osteoarthritis
clostridium difficile enterocolitis
Vertabral # (multiple)
Anemia due to chronic blood loss, malabsorption and anemia of chronic disease
Post intestinal resection status after bowel perforation
On long-term steroid and opioid medications with adverse reaction of steroids
On Adalimumab
Now, let's come to your medication part-
Adalimumab (Humira) is a TNF alpha inhibitor, which is effective against both Chron's disease and Rheumatoid Arthritis. There is an important safety issue, i.e. chance of recurrent infection, particularly because you were also on prolonged steroid use. But, despite this additional risk, weighing the risk-benefit of this medicine in both the above mentioned diseases, I don't think it needs to be stopped at this point of time, particularly when you have recently diagnosed active RA.
Regarding the pain management, you are already on opioid analgesia. Along with that you are also having Acetaminophen in combination. Now, limitation of activity, increasing dose of opioids are the medical options to improve pain management. But, the best way out for pain management at this refractory stage will be regional nerve blocks. You may consult your local pain management clinic regarding the same. This not only has lesser side effects, but also reduce the necessity for more aggressive use of more risky medications.
Your pain is due to the complications of ongoing active inflammatory processes and recurrent fractures.
Therefore, bed rest in a in patient facility with regional nerve block would definitely help you out a lot.
During this period, the ongoing inflammatory processes may also be controlled with TNF inhibitor management. Therefore, I think this method I think would be at least a bit longer lasting pain solution for you.
If you find this answer helpful, please close the thread and rate my answer.
Regards.
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Above answer was peer-reviewed by :
Dr. Shanthi.E
Answered by
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