My Next Step in UC Treatment

I saw my gastrointerologist this week. He said I've gone from what he considers mild to moderate UC.  =/
Since the 5-ASA drugs are not working for me (Asacol, Balsalazide, etc) I've moved on to the next step.

The good news is that the next step isn't as hard on the wallet as I feared it might be. It is just harder on the body apparently, with stronger side effects to go with the stronger medicine. He prescribed Azathioprine and Prednisone for me, the first to be taken indefinitely and the second for a month. I must take blood tests every 2 weeks and a followup visit with the doc in a month.

He told me Azathioprine could cause cancer, but of course the chances are much greater I'd have more problems with UC if I didn't take this medicine. Part of the doctors job is to weigh options and set out a plan, I have confidence in him. It only cost about $20! I started taking it today and feel nauseous... as I expected.

Prednisone is serious as well. At least this one only costs five bucks. I have to take it before 9AM each day so I will start it tomorrow. I'll post later about what kind of effects I feel from the new meds. I am kind of concerned about them but more concerned that my UC has become even more limiting to what I can do than before.

Interestingly, the doc said I should stay on the 5-ASA drug indefinitely as well. It helps control my symptoms a little, so it makes sense that I would stay on it. I just wish it wasn't so costly as my insurance Rx coverage is not the best. So this one has cost me thousands and will continue to do so. That brings the drugs I am on this month to 3.

The doctor said it was fine if I continued to take aloe vera gel pills and fish oil supplements in addition to these 3 meds. He did mention that the fish oil could cause loose stools... which is ironic since I think that is the least of my concerns right now, considering the kind of symptoms that are common with UC!   :p

What should I ask the doctor?

What questions should I ask my gastroenterologist? More important, I think, is to actually take a little notepad in with you into the doctor's office and have it at the ready when the two of you are having a discussion. A simple thing I know, but chances are it is a costly visit for you and we all want to know the best way to get a handle on UC. I know I would probably forget a few questions and kick myself afterwards for it without taking some prepared questions in with me.

I have some questions prepared for my doctor's visit next week. I'll need to know what meds he will Rx, they will be new this time since Balsalazide Disodium is not helping us (the doc and I) reach our goal of remission.

Not something I was dying to put in the search box on my browser for, but I've heard people had success with a fecal transplant so I will ask about that. I also need to know if some of the bleeding is due to hemmorrhoids and if so, what I can do about that. Also, LDN. LDN is Low Dose Naltrexone, and something I've read that is in general effective, quickly. Sometimes I am severely constipated. I can swing from one extreme to the other, but I thought most with UC just stayed at one extreme. I need to ask about that as well, even though both doctors have told me modifying my diet won't help get UC into remission.

I think the doctor has a certain plan laid out for me if things keep getting worse. But this is my second doctor and things are not progressing as they both were hoping. I've poured thousands of dollars in to this already. So I will be prepared this time with a notepad and questions, ready for action as it were.