On to hospital matters. Tomorrow I have an appointment with my consultant rheumotologist. I have found him to be the best doctor I have dealt with. I have only recently been under his care, as I asked for a second opinion earlier this year, and was sent to him (due to the associated arthritic symptoms I suffer). I asked for this after repeatedly being at loggerheads with my gastro-consultant and his narrow-minded god complex. Below I have outlined a brief timeline of my colitis and the list of Q's I am planning to ask. I will report back tomorrow.
Timeline
2002 - symptoms begin
2003 - Largest flare-up (May), treated with Mesalazine, which probably made it worse. Hospitalised and treated with IV steroids. Discharged with Mesalazine and oral Prednisolone. Relapse, medication reduced to oral prednisolone. Flare-up ended.
2004/5 - Intermittent flare-ups of associated arthritic problems. Treated with Prednisolone
2005/07 - Management of illness through lifestyle changes (e.g. stopping drinking alcohol). Mild flare-ups. No drugs. Acupuncture.
2008 - February: hospitalised with pneumonia. Treated with high dose of antibiotics (IV in hospital, oral on discharge). UC flared up following end of antibiotic course, end of March. Prednisolone (30mgs tapering on a weekly basis). Flare-up while on 5mgs lead to extended course. Flare-up after completion (first in colon, then arthritic June 7th – 12th). Back on Prednisolone, tapering 15mgs to 10 after one week.
Questions:
- How likely is it that this flare-up has been caused by the Pneumonia Antibiotics?
- Would it be sensible to stay on a low dose of prednisolone for a while to attempt to get back to a stable situation (i.e. 2005 – 07)?
- If yes, what would be the recommended course of action? Can you prescribe me enough prednisolone?
- Gastroenterology want to discuss with me moving onto Azathioprine (essentially due to the recent flare-up following the prednisolone course in April/May) – what is your opinion on this?
- So, should I be considering immunosuppressant now?
- I believe Azathioprine has a maximum 5 year course – what happens if UC/Arthritis flare-up after that?
- Is Azathioprine useful in the treatment of the arthritic symptoms?
- Should it come to surgery, will this also end the arthritic symptoms?
- And my wife wants to know if there would be any benefit of moving to a warmer climate?!
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