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Treated with Remicade for Ulcerative Colitis. Developed cellulitis and discontinued treatment. Had colectomy, pain and irritation in neck

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Internal Medicine Specialist
Practicing since : 2001
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I was treated with Remicade in 2009-2010 for Ulcerative Colitis. 8-weekly infusions. I developed cellulitis summer2010, and, treatment was discontinued.

Have had total colectomy since. I suffer constantly from pain and severe irritation in the area of the infection (round my neck)....3 years later.

Any thoughts on relief please?
Posted Sat, 21 Sep 2013 in Infections
Answered by Dr. Ram Choudhary 19 hours later
Brief Answer:
physician review and neuropathic pain control

Detailed Answer:
Welcome to healthcare Magic!
Remicade is infliximab which is TNF antagonist.
The medicine is very useful in induxing remission in Crohn disease or Ulcerative or Rheumatoid or Ankylosing arthritis but it has got adverse effects like reactivation of serious infections or appearance of malignancies.
Unfortunately you have suffered the adverse effects if Remicade.
The pain in the neck area may be due to XXXXXXX scarification or neuropathy.
You should get a physical examination by a local physician and get prescribed the pain control medicine like Gabapentin or pregabalin.
Also use local painkiller spray as required.
I hope the advise would be informative and useful for you.
Take Care!
Above answer was peer-reviewed by
Follow-up: Treated with Remicade for Ulcerative Colitis. Developed cellulitis and discontinued treatment. Had colectomy, pain and irritation in neck 37 minutes later
Should have told you in initial text that as a result of years of drug therapy, I have become seriously intolerant of most medications, including even Paracetamol.
At present am post op for shoulder arthroscopy, and had to stop all pain med within 48 hours of surgery - my decision, as side effects unbearable.
Apart from analgesic med, also all benzodiazepines, and antibiotics, when necessary, are a nightmare.
So, what spray would you suggest?
Answered by Dr. Ram Choudhary 11 hours later
Brief Answer:
Try Nupatch/Pregabalin

Detailed Answer:
Welcome Back.
Thanks for the inputs.
You can not use the pain killer spray on post-operative area till the wound heals fully and scar matures to satisfaction of your surgeon.
For the pain control you can use Fentanyl patch which is well tolerated and can be stuck at a site away from the operated site still quite effective.
It is a prescription drug, the patch can be applied at thigh or front belly and one patch will be effective for 3-4days.
Some patients tolerate the pregabalin fantastically well, at least a trial should be given to this nice drug. It has a slow onset usually takes 7-10 days to control pain fully.
Above answer was peer-reviewed by
Follow-up: Treated with Remicade for Ulcerative Colitis. Developed cellulitis and discontinued treatment. Had colectomy, pain and irritation in neck 1 hour later
I have just read the information leaflet on Pregablin, and the list of possible issues is terrifying, particularly as, as I've mentioned, in the past, my mind and body have been affected by most listed side effects of any drug, excluding far. I have suffered "highs", steroid induced psychosis, lack of balance, or coordination, to name the ones that come to mind most quickly, and have HATED the lack of control.
My pharmacist tells me that the body never forgets a drug reaction, so that even after years of being drug free, anything that previously affected me, will do so again.
I'm sure you can understand my blanket fear of medication after that.
By the way, rashes, hives, fibromyalgia arthralgia myalgia are a more or less constant in my life; again, particularly with the skin, drug induced.
Not a great location...between a rock and a hard place!

Answered by Dr. Ram Choudhary 1 hour later
Brief Answer:
choose to start at low dose

Detailed Answer:
Welcome back.
You are right in saying that Pregabalin has a pack of adverse effects probability, but luckily the side effects occur in few patient but mostly they do not occur at all. The side effect lists are taken from studies in thousands of patients.Mostly side effects are fully reversible so a valid option of stopping the drug is always there.
You can start it at quarter the usual dose to avoid the hit of adverse effect if any.
Wisj you all the best.
Above answer was peer-reviewed by
Follow-up: Treated with Remicade for Ulcerative Colitis. Developed cellulitis and discontinued treatment. Had colectomy, pain and irritation in neck 23 hours later
Maybe you misunderstood my mention of recent surgery. I was just trying to indicate the degree to which pain med is more difficult for me to cope with than pain itself. I was not looking for suggestions in that regard.
No, my initial query re post cellulitis pain is the only one.
Upon checking my records, I have used patch before on a short-term basis. Morphine seriously upsets me,and I think, is inappropriate for chronic use anyway.
The other, Prgablin, I didn't initially recognise, but realised I had been prescribed it as Lyrica. Let me just observe that it was not a "nice" drug as you put it.

The fact that, after 3 years I'm still in pain and discomfort and drug free SHOULD make make it very clear how difficult my relationship is with drugs. Bear in mind I have a team of specialists here.....I just thought it was was worth a fresh look in case something new (maybe not even a drug) had arrived in the picture that might have been helpful. Hope XXXXXXX eternal.

It seems nothing has.

Answered by Dr. Ram Choudhary 47 hours later
Brief Answer:
try alternative therapies

Detailed Answer:
Welcome back.
Thanks for your feedback and concerns.
You have a prolonged history of poorrly tolerating the drugs. And tolerating too many drugs poorly is quite curious alarming and obviously troublesome.
You do not want medicines so you can try alternative therapies for pain like hydrotherapy, ultrasound therapy, Yoga if you have an inclination to.
May be you can find a solution to your long lasting pain in either of these options.
Wishing you a great health.
Above answer was peer-reviewed by
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