I ended my last post with something along the lines, medication can do wonders.  And that it can, well, until your body begins to act up.  How your body may react to a new medication is always an interesting battle to choose when going on medication.  Even the simplest of drugs to treat Chrohn’s can have some pretty nasty side effects. What is the line between benefit and risk?

Look at Prednisone as an example.   Prednisone is a drug that is commonly prescribed as a treatment for a flare-up of inflammatory bowel disease (IBD), as well as for many other conditions.   I would truly consider it the first line of defence, as it is very effective at calming inflammation in many people with IBD.    Some of the common side effects include increased appetite (my favourite); indigestion; and nervousness or restlessness (does that remind you of any recreation drugs people consume?), and with prolonged use: filling or rounding out of the face, muscle weakness, thin, shiny skin, bone density loss and osteoporosis.

No matter how well a medication is doing at treating our disease, we always have to weight the long term effects.  For me, I can honestly say that I have felt my best on Prednisone.  But is prednisone a viable long term solution? Absolutely not.

As an alternative to my Prednisone use. I spent a few years on Azathioprine (Imuran) and Infliximab (Remicade).  However, over time body began to reject both the drugs.  Initially, my routine blood work began to show increase liver readings, eventually, my dosage was reduced to the point that it was not a viable option.  Fortunately for me and my liver, we both rebounded after a few months being Imuran free.  Similarly, I began to experience weird facial infections — so off of the Remicade I want.  Even to today, it is not clear if it was the Remicade or simply emphysema but it is always good to be a precaution.  Heck, if you look at Remicade in particular, a recent Health Canada advisory sums up the battle between having a normal life and the what-if of drug reactions and interactions nicely:

Currently the labels for all TNF blockers include warnings and precautions on the risk of lymphomas and other cancers. The labels will be updated to highlight the risk of specific cancers, particularly in the younger patient groups. As well, the label updates will include other new safety information based on reviews conducted by Health Canada , including the risk of new-onset psoriasis in patients treated with TNF blockers. Health Canada will inform health care professionals and Canadians again once these updates are complete.  (August 20, 2009 – 2009-137)

The reality of the situation is that normal life in most cases will surpass the what it, or the 1 in a 1000 chance that you may experience complication X.  If we didn’t, leaving the house, if not the hospital will be a challenge.  Truthfully, if need be I would jump back onto the Remicade bandwagon as quickly as I could get it approved.  For myself, Remicade, Imuran, and Prednisone did wonders.  I would argue that 90% of my days were normal, I was back at work, I was enjoying being a new dad, and the bathroom was not my most frequented room in the house.  That certainly seems like a great trade-off to a “what if”, and I think most would agree.

Life after Rejection

Some doctors refer to my rejection of Imuran and Remicade as an allergy, but I usually refer to it as a “drug sensitivity after prolonged use”.  The larger question at hand, could be simply, “that my body was telling me that it was ready to battle the Crohn’s beast on it own?”  And honestly, that it did.  For about two years now, I have been living without drugs or medications.  Although, I have to be honest — I do not feel 100%, and now that I can put a label on the Crohn’s I can assure you that it is still lurking there in the shadows — but I am drug-free, and rarely if ever do I miss work due to my illness.  I am coping and very well in the grand scheme of things.  I may have the occasional day that blessed me with 6 – 10 trips to the washroom but generally, I am coping with one leg on each side of the fence.   I suppose only time will tell as to how long I can survive medication free.  I am hoping for years to come!