Friday, January 30, 2015

Immunosuppressant therapy, Fungal Pneumonia, and Second Thoughts

At my GI appointment on Tuesday (1/27) we decided to use combination therapy (Azathioprine + Remicade) to treat my Crohn's Disease.  The addition of Azathioprine to the Remicade boosts Remicade's effectiveness (by about 10%) and some doctors believe reduces the chances of developing antibodies to the therapy.

I originally agreed to this therapy.

However, after the appointment, I thought long and hard about it and the remnants of my fungal pneumonia.  Many medical professionals, including my GI doctor, told me that if I had started Remicade back in September with my fungal pneumonia, I would be dead by now.

That's a pretty scary thought.

So I called my GI back and told him, I would prefer to err on the side of caution.  I only want monotherapy with Remicade (no Azathioprine) until such time as I'm declared Cryptococcus free.  At that time we should reconsider the use of Azathioprine depending upon how I'm responding to the Remicade therapy.

After all, if the conservative approach is wrong, I'll still be around to try a different course of treatment. If we go too aggressive with treatment any corrective action or lawsuit won't help me much when I'm 6 feet underground.

My GI doctor agreed.  We'll stick with monotherapy, continue antifungal therapy, and keep close tabs on the fungal pneumonia

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