Are hearts sank for a while when we were notified by Medicaid that we longer qualify and that after next month we will no longer get taxpayer sponsored insurance. A closer second look eased our initial reaction though, because we still qualify for CHIP coverage, which is still affordable for us now. In fact, as you can imagine, we're really happy to advance out of poverty if that's what you want to call it. But that first notice really caught us, since our budget stretches pretty thin. And we know that a) coverage for our family costs us more than $1000 per month more than what we currently pay, and b) with Isaac's health care, we'd definitely be paying a lot for doctor and pharmacy copays and I'm sure we would be maxing out deductibles each year. Well, as it is, we'll do our best to get to that bridge and cross it when we do.
Also, I am being a little pessimistic. If Isaac continues in remission for years, our extra costs would be limited by his medicine costs and routine visits only.
Tuesday, June 28, 2011
Monday, June 20, 2011
writing about writing
Weblogs are a good way to share experience. As for IBD in our home, I am encouraged by readers who write, readers who only read, and other writers who don't even read. Lately we were included in a list of IBD blogs and websites. Also, I am continually reading about old patients, new patients, stories new and old, and anything else IBD in forums and in other places which list randomly 40 at a time on the right side of my blog....
I definitely recommend blogging for the journal aspect, for connecting with others in similar situations, and for helping others down the road. As you share your experience, it can really help someone else in a similar situation.
We are still weaning Isaac off of the prednisolone. And everything seems to be going just fine as it has been for a while....
Last week was Vacation Bible School at our church, and Isaac and his brother had a good time each day. Yesterday, they helped lead some of their songs during church, and how delightful it was to see little Isaac doing his body movements and gestures for the songs... Actually I had quite a moment, since one of their songs (How Great Thou Art) was one of my late grandmother's favorites. I am a bridge between her and them, and maybe it is all but impossible to fully relate the connection, but how delightful to see her progeny celebrating the same song that moved her decades ago.
I definitely recommend blogging for the journal aspect, for connecting with others in similar situations, and for helping others down the road. As you share your experience, it can really help someone else in a similar situation.
We are still weaning Isaac off of the prednisolone. And everything seems to be going just fine as it has been for a while....
Last week was Vacation Bible School at our church, and Isaac and his brother had a good time each day. Yesterday, they helped lead some of their songs during church, and how delightful it was to see little Isaac doing his body movements and gestures for the songs... Actually I had quite a moment, since one of their songs (How Great Thou Art) was one of my late grandmother's favorites. I am a bridge between her and them, and maybe it is all but impossible to fully relate the connection, but how delightful to see her progeny celebrating the same song that moved her decades ago.
Thursday, June 9, 2011
Isaac and Imuran, so far so good
Isaac continues to do well. His latest bloodwork showed lower 6-TG levels than his doc wants to see, so we are slightly increasing his consumption of Azathioprine (Imuran). Instead of every other day doses he is now getting 5 doses a week. We continue to taper his prednisolone. We have another doctor's appointment tomorrow.
6-TG is a derivative of thiopurine. There is a lot to learn. If you're interested, you can start with this article which deals specifically with IBD. In that article, you, like me, might get a little excited about giving such a drug to a young'un. But having said that, our doctor understands and is concerned about the risks and we are monitoring Isaac closely while he is introduced to this drug (for the first several months) to make sure his body tolerates it just fine.
The poop scoop: We remain in a phase of normal poops.
6-TG is a derivative of thiopurine. There is a lot to learn. If you're interested, you can start with this article which deals specifically with IBD. In that article, you, like me, might get a little excited about giving such a drug to a young'un. But having said that, our doctor understands and is concerned about the risks and we are monitoring Isaac closely while he is introduced to this drug (for the first several months) to make sure his body tolerates it just fine.
The poop scoop: We remain in a phase of normal poops.
Friday, May 27, 2011
pharmacy fun
Today we drove around and around looking for our new pharmacy, the Inwood Pharmacy in north Houston. We had neglected to grab the phone before we left, so we were just going by our memory of where it appeared to be on google maps. But no pharmacy was evident. I stopped at a place which was part of a hospital campus in order to ask about where this pharmacy might be. And lo and behold, there was the Inwood Pharmacy tucked inside, with no signage whatsoever outside its doors.
But let me tell you--we are happy to have found it. The owner is the pharmacist, who will compound our special drugs, and he filled our first prescription in a timely manner. The place is small and exactly how a pharmacy should be, where you talk to the pharmacist and know who is filling your prescriptions.
We switched from chain pharmacies after having bad luck with the Walgreens near us. Not all Walgreens pharmacies compound drugs, first of all, there are only a few in Houston. One was pretty close to where we live, but we kept running into problems. First it was that they don't compound on the weekend, but they neglected to tell us. Next, when we called in our refill early so they could compound it before the weekend, it wasn't early enough. Finally, there was just no good reason, and they had our drugs ready a couple days later than we expected. In Isaac's case, we don't want to miss doses, especially multiple doses. And he runs out of the medicine pretty quick, because he has 7mL three times a day.
Our new pharmacist, Vince, gave us two nice sized bottles so that we won't have to keep coming back so often. And he was straightforward about when he could get the drug components and when we would have it completed. We like that. On a day like today, when we make sure to fill something before a long weekend, it is good to know that we have somebody reliable we can count on.
Having said all that, if Isaac starts to relapse again, Bonnie and I are on the same page about trying the more potent VSL probiotics and giving probiotics and diet a good long run before we resort to steroids. We didn't get too far in slowly introducing the SCD (Specific Carb Diet), where we decided to eliminate first sugar, then lactose completey (he already doesn't have much dairy at all), gluten. In fact, he's cleared up really well now and having good old regular poop and everything seems hunky dory. Of course we think, well, this is the good thing about the steroids, bad as I believe them to be... but of course, we don't really know that he wouldn't naturally get to this healed point without--or that anything else we might do might bring about a similar result.
We have these facts. Isaac was relapsed down to stools with blood (albeit small amounts) daily. (This started with the soy incident at the end of March. And even though we got back to our good soy free, vegetarian-no-dairy-milk diet). After 11 days he started daily doses of the steroid medication prednisolone. A couple days later he also got a water cleansing enema. After five days of the steroids we saw the last blood in his stool. But except for a few good starts (sometimes a bowel movement would start of like a "perfect 3" and then degrade to a watery 7) they remained smelly (We label the smell "UC smell" because it's become distinctive), and generally unhealthy for about 10 days after taking steroids. At that point, the good stools took over and have seemed to improve in consistency and regularity. So, anyway, 17 days of stool with blood.
My my, I've got to get less wordy.
But let me tell you--we are happy to have found it. The owner is the pharmacist, who will compound our special drugs, and he filled our first prescription in a timely manner. The place is small and exactly how a pharmacy should be, where you talk to the pharmacist and know who is filling your prescriptions.
We switched from chain pharmacies after having bad luck with the Walgreens near us. Not all Walgreens pharmacies compound drugs, first of all, there are only a few in Houston. One was pretty close to where we live, but we kept running into problems. First it was that they don't compound on the weekend, but they neglected to tell us. Next, when we called in our refill early so they could compound it before the weekend, it wasn't early enough. Finally, there was just no good reason, and they had our drugs ready a couple days later than we expected. In Isaac's case, we don't want to miss doses, especially multiple doses. And he runs out of the medicine pretty quick, because he has 7mL three times a day.
Our new pharmacist, Vince, gave us two nice sized bottles so that we won't have to keep coming back so often. And he was straightforward about when he could get the drug components and when we would have it completed. We like that. On a day like today, when we make sure to fill something before a long weekend, it is good to know that we have somebody reliable we can count on.
Having said all that, if Isaac starts to relapse again, Bonnie and I are on the same page about trying the more potent VSL probiotics and giving probiotics and diet a good long run before we resort to steroids. We didn't get too far in slowly introducing the SCD (Specific Carb Diet), where we decided to eliminate first sugar, then lactose completey (he already doesn't have much dairy at all), gluten. In fact, he's cleared up really well now and having good old regular poop and everything seems hunky dory. Of course we think, well, this is the good thing about the steroids, bad as I believe them to be... but of course, we don't really know that he wouldn't naturally get to this healed point without--or that anything else we might do might bring about a similar result.
We have these facts. Isaac was relapsed down to stools with blood (albeit small amounts) daily. (This started with the soy incident at the end of March. And even though we got back to our good soy free, vegetarian-no-dairy-milk diet). After 11 days he started daily doses of the steroid medication prednisolone. A couple days later he also got a water cleansing enema. After five days of the steroids we saw the last blood in his stool. But except for a few good starts (sometimes a bowel movement would start of like a "perfect 3" and then degrade to a watery 7) they remained smelly (We label the smell "UC smell" because it's become distinctive), and generally unhealthy for about 10 days after taking steroids. At that point, the good stools took over and have seemed to improve in consistency and regularity. So, anyway, 17 days of stool with blood.
My my, I've got to get less wordy.
Saturday, May 21, 2011
Isaac these days
Since I'm changing the website photo I thought I'd put up the old one, plus a bonus photo of little Isaac. He's turning 3 in 8 days!
The med situation is that we are tapering down the steroids (the rate will depend on analysis of his blood--to see how much the Imuran is affecting him by now). Isaac's response to steroids wasn't as responsive this time as before--as far as his mood changes and "wiredness". About affecting his bowels, let us give the poop scoop below. We haven't started the VSL#3s yet but it's in the plans. Since he's doing alright, we might just wait for another relapse or hint of relapse before we try that....
Poop scoop: All better as far as poop goes. We're seeing nice 3s and 4s every day or every other day, and there seems to be no other indication of inflammation as far as we can tell....
Monday, May 9, 2011
shocked in spite of myself
We are continuing meds, and I have to repeat what I mentioned to Bonnie the other day, which is that I'm really surprised--shocked even--that our entire response to Isaac's condition is going on the way it is. What I mean by this, mainly, is that I am generally so pro-natural if not anti-pharmaceutical when it comes to treatments. Yet here we are finishing our fourth week of our second (or third--if you count that one isolated week) round of steroids since October, and Isaac is now taking a second drug--this one suppresses the body's immune response.
What I wish? I think we could effectively test out a few treatments which involve mostly diet and probiotics. Actually, by doing this alongside of what the doctor orders, I think we have found some good information about some of what affects Isaac. We have thought, from time to time, that we're onto something with probiotics we give him, but we don't have good evidence of that. We are going to get some strong concentrated probiotics to help alter Isaac's natural intestinal microbiome, but as he seems to be in a more "healthier" stage now, it may only help loosely point to what is/isn't effective. There are also many things out there that our doctor is shy about. Like probiotic enemas, and bacteriotherapy (an infusion of a donor's healthy stool to help adjust the culture of Isaac's gut).
So why is our doctor about these treatments and not shy about pushing expensive carcinogenic drugs to our two year old, talking about them as a pathway to probable surgery? One reason, of course, is the trend of research and science behind health care. A lot of research gets funded for things that make money. And simultaneously, the trends of health care point to miracle pills or substances which can treat symptoms and/or fix conditions as opposed to more mysterious treatments which contain components which are difficult to isolate and control. And that's especially true if the treatment does nothing more than encourage a body's system to do its job even though modern medicine has deemed the body's system pathological. Then there's the actual money factor, which isn't just about the science of medicine, but the actual money driven aspect of what pays and what doesn't. These expensive medicines Isaac takes help, in a twisted short-term way, to drive our economy. A cheap fecal transplant only helps the economy in the long run. I really hate that analysis, but that's our health care system for you.
I got a good private response from a reader about a situation similar to ours, where this family's toddler was diagnosed at a similar time. Their response to the diagnosis has leaned toward the nonpharmeceutical. One difference that Bonnie points out is that Isaac's case seems more moderate-severe whereas the reader's child's situation may be more mild-moderate, but in both cases we have diarrhea and blood. And in both cases, honestly, it seems like the outcome has been about the same. Some improvement, but some "relapse" in our case with drugs, and the same to be said for the nonpharmaceutical approach. So I ask myself, what are we doing exposing Isaac to months and months of steroids, for the same results we can get by going with probiotics and dietary changes?!
Of course you may anticipate the answer. We don't want Isaac to miss out on growth spurts. we don't want scar tissue to develop in his guts which may lead to surgery sooner rather than later. And we don't know--maybe without drugs, he would have needed surgery by now.
Anyway, this is my struggle. We'll probably wrestle some more, see how the VSL#3 goes, continue little by little finding more out with our dietary/stool/symptom diary, and who knows. I would still be thrilled to work with a scientist/doctor who wants to investigate this bacteriotherapy (I realize now that I have yet to write a good entry for the fecal transplant).
The poop scoop: Isaac has continued to poop pretty well, going once a day or once in two days. His last stool was a 4-5, but he also had an ideal 3-4 the time before that.
What I wish? I think we could effectively test out a few treatments which involve mostly diet and probiotics. Actually, by doing this alongside of what the doctor orders, I think we have found some good information about some of what affects Isaac. We have thought, from time to time, that we're onto something with probiotics we give him, but we don't have good evidence of that. We are going to get some strong concentrated probiotics to help alter Isaac's natural intestinal microbiome, but as he seems to be in a more "healthier" stage now, it may only help loosely point to what is/isn't effective. There are also many things out there that our doctor is shy about. Like probiotic enemas, and bacteriotherapy (an infusion of a donor's healthy stool to help adjust the culture of Isaac's gut).
So why is our doctor about these treatments and not shy about pushing expensive carcinogenic drugs to our two year old, talking about them as a pathway to probable surgery? One reason, of course, is the trend of research and science behind health care. A lot of research gets funded for things that make money. And simultaneously, the trends of health care point to miracle pills or substances which can treat symptoms and/or fix conditions as opposed to more mysterious treatments which contain components which are difficult to isolate and control. And that's especially true if the treatment does nothing more than encourage a body's system to do its job even though modern medicine has deemed the body's system pathological. Then there's the actual money factor, which isn't just about the science of medicine, but the actual money driven aspect of what pays and what doesn't. These expensive medicines Isaac takes help, in a twisted short-term way, to drive our economy. A cheap fecal transplant only helps the economy in the long run. I really hate that analysis, but that's our health care system for you.
I got a good private response from a reader about a situation similar to ours, where this family's toddler was diagnosed at a similar time. Their response to the diagnosis has leaned toward the nonpharmeceutical. One difference that Bonnie points out is that Isaac's case seems more moderate-severe whereas the reader's child's situation may be more mild-moderate, but in both cases we have diarrhea and blood. And in both cases, honestly, it seems like the outcome has been about the same. Some improvement, but some "relapse" in our case with drugs, and the same to be said for the nonpharmaceutical approach. So I ask myself, what are we doing exposing Isaac to months and months of steroids, for the same results we can get by going with probiotics and dietary changes?!
Of course you may anticipate the answer. We don't want Isaac to miss out on growth spurts. we don't want scar tissue to develop in his guts which may lead to surgery sooner rather than later. And we don't know--maybe without drugs, he would have needed surgery by now.
Anyway, this is my struggle. We'll probably wrestle some more, see how the VSL#3 goes, continue little by little finding more out with our dietary/stool/symptom diary, and who knows. I would still be thrilled to work with a scientist/doctor who wants to investigate this bacteriotherapy (I realize now that I have yet to write a good entry for the fecal transplant).
The poop scoop: Isaac has continued to poop pretty well, going once a day or once in two days. His last stool was a 4-5, but he also had an ideal 3-4 the time before that.
Monday, April 25, 2011
Roadtrips & Snack Plans
First, the poop scoop:
Isaac's stool has continued to be pass inspection since our last post. These are not ideal stools, but no blood, and we're continuing to be hopeful that we are on the cusp of a good remission. Yesterday he had some snacks with soy, and we didn't have any problems last night. He even passed a #6 stool this morning that didn't seem problematic, so that seemed good.
Also, we have ventured on a roadtrip and a weekend "away", and we are pleased to report that it was a success. We have a new procedure on the books. And I don't mean medical procedure, good heavens, but rather, a
Procedure for Social Snacking
When a group of ten kiddos get Easter cupcakes, for example, and you don't know if the ingredients pass stringent criteria, and your little boy is part of that group, it is really difficult to say, "No, you can't have one," unless you have a plan. And so now our plan is going to include some sort of snack bag which we'll have with us at all time so that we can make a suitable substitute snack that Isaac will enjoy will everybody else is enjoying an Easter cupcake.
Isaac's stool has continued to be pass inspection since our last post. These are not ideal stools, but no blood, and we're continuing to be hopeful that we are on the cusp of a good remission. Yesterday he had some snacks with soy, and we didn't have any problems last night. He even passed a #6 stool this morning that didn't seem problematic, so that seemed good.
Also, we have ventured on a roadtrip and a weekend "away", and we are pleased to report that it was a success. We have a new procedure on the books. And I don't mean medical procedure, good heavens, but rather, a
When a group of ten kiddos get Easter cupcakes, for example, and you don't know if the ingredients pass stringent criteria, and your little boy is part of that group, it is really difficult to say, "No, you can't have one," unless you have a plan. And so now our plan is going to include some sort of snack bag which we'll have with us at all time so that we can make a suitable substitute snack that Isaac will enjoy will everybody else is enjoying an Easter cupcake.
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