Current Maintenance Therapies

Throughout my time with Crohn’s Disease, I have tried every class of medication: 5-ASA agents, steroids, antibiotics, immunomodulators, and biologic therapies. When my disease was mild, I even went a year or so without any medication at all thanks to good health and diet habits. As much as I do not like being on medication, many of which come with extreme side effects, I have no other choice at this point. Because my disease is now categorized as severe (wow, sounds so serious), I have no other option but to take medication to achieve remission and avoid flare-ups.
            The last resort treatment regimen for a person with Crohn’s Disease is typically a biologic therapy. In June of 2015, I started Remicade infusions after a severe flare that resulted in a week-long hospitalization. I would go to the infusion center at the hospital every few weeks and sit as an IV pumped the drug into my body. This worked pretty well for a few months until my body became unresponsive. I was thrown back into a flare yet again, this time with even more severe symptoms, most noticeably a pretty bad case of Erythema Nodosum (a fancy way of saying that my legs swell from inflammation so badly that I cannot walk… very painful). I was given a double dose of Remicade during that hospital stay, to which my body did not respond.
Taking a nap during a Remicade infusion.
            Next up on the drug checklist was Humira, as featured on the television commercials I am sure you have seen advertised. I was excited about trying Humira because I would no longer need to spend a day at the infusion center as I did for my Remicade infusions. Instead, I could inject the shot in the comfort of my own home. I get the medication delivered right to my doorstep; the convenience factor is definitely a plus. Moreover, being the tech-savvy millennial that I am, I am also pretty thrilled that Humira even has an app for my iPhone that reminds me when to take my shot and where my last injection site was.
If there isn't a selfie, did it even happen?
After my initial loading doses, I was started on bi-weekly shots. I needed to do a larger loading dose than what is typically prescribed because my flare was so serious; this thankfully helped put me into a bit of a remission. My doctor wanted me on a weekly schedule right off the bat, but unfortunately this was denied by my insurance because there is a waiting period before they will approve an accelerated dosing regimen.
After a few months on Humira, my flare had never completely subsided. I had two surgeries due to abscesses and fistulas, the Erythema Nodosum was reappearing on my legs with a vengeance, and my overall health was not where it should have been for a patient on a biologic medication. Because of these factors, my doctors pushed for weekly Humira again and this time it was approved (which brings us to present day, June 2016).
Humira comes in pen form (which is what I have) or in syringe form (which is more complicated to administer but supposedly less painful). Much to my surprise, the shots are not even half as painful as some people claim they are; be careful reading forums online, it is easy to get yourself worked up over nothing. To someone like me who experiences pain on a daily basis, Humira shots are a walk in the park!
Pen form of Humira; always check the expiration date on the packaging!
When injecting Humira, you can choose to administer the shot in your stomach or in the top of either thigh. I have found that the stomach is less painful for me because I do not have enough fat on my thighs to inject the shot without it hitting muscle. I always make sure to take the shot out of the refrigerator at least one hour before I inject to let the medicine get to room temperature. Next, I log onto the Humira app, check my last injection site and choose the area of which I will inject the shot.

After cleaning my skin with an alcohol wipe, I squeeze my stomach, hold the pen firmly against my skin and press the injector button until all of the medicine is released. This normally takes about six seconds and the pen makes a fizzing sound as all of the medication is injected, also indicated by a yellow bubble that drops into the small window.
I normally use my other hand to pinch the skin, but I needed it to take this picture. 
See the yellow bubble?!
Sometimes the injection site will bleed for a few minutes, so I normally keep Band-Aids on hand just in case. After my shot I get a mild burning sensation at the injection area as the medication is disbursing into my body, but nothing too serious.
All done!
When I first started Humira injections, I needed to take a nap or go to bed very early that night because my body was so exhausted. I also experienced headaches after some shots, which I have found can be alleviated by drinking more water than usual on that day. Now, I experience no side effects from the shot (knock on wood) and can function normally throughout my entire injection day (Tuesdays, in case you are wondering) even if I do my shot in the morning.
In addition to Humira, I recently was started on an immunomodulator called Azathioprine to work in conjunction with the biologic. This decision was made after my most recent hospitalization in June with the intent of increasing the effectiveness of both medications from a combination therapy approach. I am hopeful that weekly Humira injections coupled with Azathioprine will work to induce remission.
While these medications are working to keep my body healthy, I make sure that I am helping in any way possible to assist my body with healing. I am passionate about maintaining a healthy and active lifestyle, as I truly believe that nutrition and exercise are crucial to overall wellbeing. Although my disease cannot be cured through nutrition, I have found that making smart and natural food choices assists in alleviating some of my symptoms.
For more pictures of my meals (and cute dogs) follow me on instagram: @ashleyesper

            

Comments

  1. How are you doing on the double meds? I was on Cimzia and Aza together for awhile until crazy things started happening. I took myself off meds (I know, I know) and now I have to go back on something. I'm choosing Stelera this time. Love reading your blog! Onward!!!!

    ReplyDelete
  2. How are you doing on the double meds? I was on Cimzia and Aza together for awhile until crazy things started happening. I took myself off meds (I know, I know) and now I have to go back on something. I'm choosing Stelera this time. Love reading your blog! Onward!!!!

    ReplyDelete

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