Imuran & Swine Flu

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JimCroydon
New Member


Date Joined Jul 2009
Total Posts : 2
   Posted 7/17/2009 9:52 AM (GMT -7)   
My crohns was diagnosed in 1964 with an operation to take a look (those days were before soemof the modern radiology techniques). I am now well controlled on Pentasa, Azathioprine (150mg) and a small dose of prednisolone. My worry (as I am in my 50's) is that the Azathiorpine is a serious immunosuppresant and with Swine Flu - am I better to stop this.  I have flare-ups every couple of months - mainly chronic pain but I can contriol it within 24 hours by upping the steroids to 40+mg for a couple of days and then tapering off quickly and occasional bleeds which get me into hospital for a few days.  I agree with your comments on good dietry control but add that excercise is also very important - in fact I am a martial arts instructor and well used to being thrown around, so after I got over having a nuisance disease, I got on with my life and don't let it slow me down. tongue
 
 
*I added a title to your post*

Post Edited By Moderator (Nanners) : 7/17/2009 2:37:27 PM (GMT-6)


aoccc
Regular Member


Date Joined Feb 2005
Total Posts : 455
   Posted 7/17/2009 9:57 AM (GMT -7)   
I have no answers for you but that is really fascinating that you are an instructor. Kicks in the stomach are probably nothing to you then. I agree with the exercise. I force myself everyday to ride bike to work and it has definitely helped. Welcome to the board.
SCD since 01, remission since 01, occasional random junk food breaks :)
No meds ever.


Nanners
Elite Member


Date Joined Apr 2005
Total Posts : 14995
   Posted 7/17/2009 10:19 AM (GMT -7)   
No I would not stop the immune suppressants. This medication is keeping your Crohns in check. You go off of it you are sure to get ill with Crohns again and that would weaken your system even more. JMHO

Good luck!
Gail*Nanners* Co-Moderator for Crohns Disease and Anxiety/Panic Forum
Been living with Crohn's Disease for 33 years. Currently on Asacol, Prilosec, Estrace, Prinivil, Diltiazem, Percoset prn for pain, Zofran, Phenergan, Probiotics, Calcium  w/Vit D, and Xanax as needed for my anxiety.  Resections in 2002 and 2005. Also diagnosed with Fibromyalgia, Osteoarthritis, and Anxiety. Currently my Crohns is in remission, but my joints are going crazy!
*Every tomorrow has two handles.  We can take hold of it by the handle of anxiety, or by the handle of faith"*

Stasi
Regular Member


Date Joined Jul 2009
Total Posts : 36
   Posted 7/17/2009 12:59 PM (GMT -7)   
The NACC says:

"Patients on standard doses of immunosuppressant or anti-TNF therapy should not be exceptionally susceptible to Swine Flu, and are advised to continue with their treatment as the risk of active IBD and subsequent need for drugs such as steroids would carry a greater risk than that of contracting the infection. Anyone experiencing flu like symptoms should contact their GP. immediately stating that they are on an immunosuppressant.

Early doses of antiviral medicines such as Tamiflu are thought to be effective in treating people with Swine Flu. There is no known interaction between Tamiflu and standard IBD drugs, and it is not is not thought to have any harmful effects on IBD itself, so Tamiflu may be given on medical advice to IBD patients."

http://www.nacc.org.uk/content/home.asp

There's a quick link to it on their site just now.

kaiden
New Member


Date Joined Jul 2009
Total Posts : 5
   Posted 7/17/2009 7:33 PM (GMT -7)   
swine flu is most dangerous in people with an extremely good immune system as it is not the flue that kills you at the moment but your body putting your immune system into over drive and trying to cure things that are not there

that is what my gi told me anyway , i hope it helped

inflamed
Veteran Member


Date Joined Nov 2005
Total Posts : 1340
   Posted 7/17/2009 8:30 PM (GMT -7)   
My husband had the swine flu. I wasn't on imuran or anything like that at the time but they gave me Tamiflu right away because of the CD and I didn't get it. I think they would just be more cautious with you if you were exposed.

ExJohnson
Regular Member


Date Joined Feb 2009
Total Posts : 128
   Posted 7/17/2009 8:37 PM (GMT -7)   
I think Swine Flu actually isn't that big of a deal. about a hundred times more people have died this past season of regular flu than swine, so there's some conspiracy people out there saying it's just a media scare to push an expensive vaccine. Far be it from me to litter the forum with conspiracy theories, but it makes you think when you look at the numbers.

Deaths be swine flu this year: 165
Deaths by regular flu this year: over 13,000
I am a pre-30yr. old who has been diagnosed with Crohn's for 14 years.  Symptoms change from cramping and weight loss to severe anemia with fatigue and diarrhea. 
100mg mecaptopurine, 40mg Prednisone, Darvocet for dessert.  Starting Cimzia this week (fingers crossed).


ISF13+
Regular Member


Date Joined Jun 2009
Total Posts : 202
   Posted 7/17/2009 9:44 PM (GMT -7)   
I'm on Humira and Immuran (and at one time Prednisone along with both of those) which are both immunosuppressants AND I work in a health clinic. With all the strep and flu and other things that come through there, you'd think that I would get sick all the time but I don't. I think our immune systems work twice as hard with make us that much more resilient.
Crohn's Disease. 
Diagnosed 13+ years ago. 
Been in remission for short periods of time but each time I come out of remission my disease seems to have spread.  No longer isolated in my ileum, now from stomach down to rectum.  Currently have C-Diff.
Current Medications for the Crohns:  Humera 40mg injections every other week, Imuran 150mg, 3xday, Levsin, Welchol 625mg, Flagyl 250mg, 3xday, Calcium, Acidophilus & Potassium
Previous Medications I've been on:  Asocal, Pentasa, Cipro, Prednisone & Entocort


ozonehole
Veteran Member


Date Joined Dec 2006
Total Posts : 559
   Posted 7/18/2009 12:49 AM (GMT -7)   
ExJohnson said...
I think Swine Flu actually isn't that big of a deal. about a hundred times more people have died this past season of regular flu than swine, so there's some conspiracy people out there saying it's just a media scare to push an expensive vaccine. Far be it from me to litter the forum with conspiracy theories, but it makes you think when you look at the numbers.

Deaths be swine flu this year: 165
Deaths by regular flu this year: over 13,000


A word about your figures. They are for the USA only (and as of today, total reported swine flu deaths are 273). In the past 10 years, the average annual number of deaths in the USA from flu has been 36,000. Swine flu is hitting the southern hemisphere pretty hard right now because it's winter there. When the northern hemisphere winter arrives, it will be interesting to see what the figures are like.

A friend of mine (a doctor no less) was the first case of swine flu here in Taiwan, so I've got some useful feedback from him. For him, it was no worse than a bad cold, and he's age 53. We've had no deaths here yet, but then we've had very few reported cases. It's likely that the majority of the people who catch the flu don't report it - they stay home, and recover. That's probably even more so in the USA where health care is so expensive and many are uninsured.

The UK is reporting a very high number of cases, but that could just be the result of better detection and reporting. It's summer there, so it seems weird that they'd be having much problem.

Flu tends to grow more virulent as the pandemic progresses, so those who get it early are lucky - I actually wish I could catch swine flu now. Once you've had it, you gain some immunity, so even if you catch it a second time you aren't likely to suffer much - it's kind of like a stealth vaccination.

H1N1 (the official name for "swine flu") is distantly related to the 1918 flu that killed over 50 million people worldwide. Fortunately, it is VERY distantly related. No one is predicting it will be as bad as 1918. The US CDC (Center for Disease Control) has labeled H1N1 a "category 2" flu. A category 2 pandemic has the following characteristics:

* Case fatality ratio of 0.1 percent to less than 0.5 percent.
* Between 90,000 and 450,000 deaths in the U.S. (compared with estimated 36,000 deaths during a typical influenza season).
* Excess death rate of between 30 to less than 150 per 100,000 people.
* Illness rate of between 20 and 40 percent.
* Similar to 1957 pandemic.

By comparison, 1918 was category 5.

The one worrisome trait of H1N1 is that if you've got a very good and active immune system, you might be in greater danger of suffering from a cytokine storm:

http://en.wikipedia.org/wiki/Cytokine_storm

So ironically, those with a weakened immune system may be in less danger. But that's not guaranteed, and I certainly wouldn't recommend that anyone should take Immuran just to fight swine flu! Anti-inflammatory drugs, on the other hand, might actually help, since a cytokine storm creates severe inflammation in the lungs.

Hopefully, we will have a vaccine available before the northern hemisphere winter arrives.

In the meantime, it just might be useful to get vaccinated against pneumonia. The vaccine is called Pneumovax. It will not prevent swine flu, or even reduce the symptoms. It will reduce your chances of catching bacterial pneumonia as a complication (there is evidence that this happened in 1918). You can, however, still catch viral pneumonia. Three years ago I caught bacterial pneumonia while I was in the hospital recovering from a bowel resection - it was the pneumonia that nearly killed me. Since then, I've been vaccinated, and hopefully that will do me some good if/when I catch swine flu.

It's not good to be an alarmist about swine flu, but it's not totally wise to play it down either. We are in the very early stages of this pandemic. It could turn out to be much ado about nothing. Let us hope so. I am not particularly worried. Having survived three bowel resections and lots of Crohn's illness in between, swine flu looks like a piece of cake.

regards,
Robert
Crohn's since 1988
3 resections


ivy6
Elite Member


Date Joined Sep 2005
Total Posts : 10404
   Posted 7/18/2009 1:08 AM (GMT -7)   
You should also be aware that it can be dangerous to go off your Imuran, as this (I've been told) can put you at greater risk of having a reaction if you restart it.
Co-Moderator Crohn's Forum.

Medications for Crohn's ~~ Diet and Nutritional Therapy for Crohn's


JimCroydon
New Member


Date Joined Jul 2009
Total Posts : 2
   Posted 7/22/2009 1:27 AM (GMT -7)   

Great to hear that you are a biker (as I am on the weekends) - by the length of time in remission, it proves your point! I think excercise helps the mind and the body and wish other sufferers would push themselves - even if it is just walking.. I got one friend to start by just walking around the shops and build it up from there. I do avoid stomach kicks but also can use a thin protector if needed. 


ISF13+
Regular Member


Date Joined Jun 2009
Total Posts : 202
   Posted 7/22/2009 7:28 AM (GMT -7)   
I wouldn't adjust my medications because of the "H1N1 (Swine)" flu. Your medication beneftis far out weigh your chances of getting the flu.
Crohn's Disease. 
Diagnosed 13+ years ago. 
Been in remission for short periods of time but each time I come out of remission my disease seems to have spread.  No longer isolated in my ileum, now from stomach down to rectum.  Currently have C-Diff.
Current Medications for the Crohns:  Humera 40mg injections every other week, Imuran 150mg, 3xday, Hyomax, Welchol 625mg, Flagyl 250mg, 3xday, Calcium, Acidophilus & Potassium
Previous Medications I've been on:  Asocal, Pentasa, Cipro, Prednisone & Entocort


tsitodawg
Veteran Member


Date Joined Sep 2006
Total Posts : 845
   Posted 7/23/2009 12:46 AM (GMT -7)   
ExJohnson said...
I think Swine Flu actually isn't that big of a deal. about a hundred times more people have died this past season of regular flu than swine, so there's some conspiracy people out there saying it's just a media scare to push an expensive vaccine. Far be it from me to litter the forum with conspiracy theories, but it makes you think when you look at the numbers.

Deaths be swine flu this year: 165
Deaths by regular flu this year: over 13,000



EX-Johnson,
I too was under the impression that the H1N1 virus was just media scare. That was until yesterday when my sister who has Rheumatoid Arthritis died from complications from swine flu. It is not time to go hide in a bunker but it is time to take it seriously. There have been nearly 300 cases of it alone in my state and 16 have now died.(inlcuding my sister) sure there are a lot of people that die from the influenza every year, but there is a vaccination against it every year as the strain changes. This is not the case with H1N1 and that is what makes it more serious. That fact that it has not mutuated yet is what is scaring all of the doctors and professionals. I put my head in the sand for a little while, but let me tell you I am watching now. Even when my sister caught it about a month ago, I did not take is very seriously because they had released her from the hospital. The disease slowly weakened her until the point that she developed pneumonia and then blood clots in her lungs. It is a disease that works slowly and you usually don't have the most problems from the swine flu itself, but from the compications that come from it.
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