Thursday, March 23, 2017

Stelara Re-Match

Everything in my life seems to run in cycles.  Currently, I'm about to re-visit my relationship with Stelara.  Stelara is a treatment for psoriasis (it is an immuno-suppressant).  Psoriasis is an autoimmune disease, wherein your over-active immune system essentially starts attacking you (your skin regenerates every 30 days; however, in spots where I have psoriasis plaques, that is sped up to every three days).  Super short version and probably not completely accurate as the explanation of the disease has changed several times since I was diagnosed as a pre-teen.  Stress is, and always has been, blamed as a common trigger for an outbreak.

I first started Stelara in 2012.  I had tried other biologics (injections), however none worked like Stelara (maybe a post for another day is how this shot costs my insurance almost $20,000).  I enjoyed clear skin for about four years.  Then, as part of trying to heal my liver, I decided to stop taking Stelara.  I just decided I didn't want to take medications if I didn't have to.  Although Stelara specifically didn't include elevated liver enzymes as a potential side effect, other biologics did.  So, I went off Stelara in November 2015.  My skin has stayed fairly clear for the last year+ (you can see an old post with photos HERE).  I'm not sure what changed but suddenly my skin is breaking out again.

I am using topical medications and lotions twice a day.  They are barely doing anything for me.  I'm even using one medication on pole days, which doesn't help me stick to the pole well.  I have become extremely self-conscious about my skin. Normally, I could care less.  Lately, I care a lot.

So, back to Stelara I go.  I sometimes feel like I am choosing this medication to be vain, but these plaques really do affect my quality of life.  I am currently sitting on my couch and seeing pieces of skin all around me.  It's disgusting.  The topical medications leave greasy trails everywhere I have to put my arms down.  I do need to be more careful on this medication, as I am more prone to infection.  Last time my nurse told me her experience was that people didn't get sick more often, they just stay sick a little longer.  So I can do things to take care of myself and lessen the chances of getting sick in the first place.  I have to get a yearly tuberculosis test, as that is apparently easier to pick up.  One very rare, but scary, side effect is cancer.  I feel like I did well on the medication the first round, so hopefully the second round will be fine as well.  My doctor did warn me that some patients do not do as well the second time around, but I have decided that will not be the case for me.  My dermatologist has agreed to monitor my liver enzymes to make sure they don't go up during my time on the medication.

Speaking of my liver...let's re-visit that little gem too.

So last year, my regular doctor told me I was doing to die of fatty liver.  I found out he was full of shit and fired him.  You can read those posts HERE and HERE.  While I will agree that I should be careful with my diet to keep my entire body healthy, I took issue with him trying to push diet pills on me to lose weight.  My liver enzymes have been slightly high for...ever.  There was no proof that taking medication that is probably processed through the liver anyway was going to make me lose weight and guarantee lower liver panels.  Even at my lowest weight after gastric bypass, I was getting calls from my doctor about my high liver enzymes (apparently quick weight loss can actually cause fatty liver, so my surgeon told me not to be concerned).   And a specialist confirmed that I was not the only healthy patient sent to him by my previous doctor with an incorrect diagnosis.  Even without the diagnosis of "nonalcoholic fatty liver disease," I am still trying to be kind to my liver.  I haven't been good to my body in general.  I've spent years eating high sugar, (bad) fatty foods, and I was on the birth control pill for 24 years.

I got my new liver panel results today and was quite pleased to see that despite my recent bout with enjoying alcohol a little too much, my liver is doing quite well.

Date          Weight          AST (10-30)          ALT (6-29)
                                         (Ideal: 22)             (Ideal: 25)

5/03              330                   43                           36
3/13              257                   33                           21
6/14              257                   57                           37
9/14              246                   42                           29
12/14            244                   39                           29
6/15              255                   48                           30
9/15              255                   51                           46
1/16              242                   35                           26
6/16              245                   40                           26
3/17              238                   36                           16

So, as you can see, I will not be dying of fatty liver today. I will, however, continue to monitor my liver and try to take better care of myself so I can continue living the life I was meant to live -- without the annoyance and pain of these skin plaques. 

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