Infusions with Biologics: Tips to Make Crohn's Treatments Easier

B.S. Dietetics, Dietitian, Health Professional

Biologics are one of the new tools in the arsenal for fighting Crohn's disease.   These medications work in a targeted way to reduce the cause of inflammation in the GI tract.  Doctors who once reserved biologics for patients who failed other treatments are now using them sooner in the disease process because of their high success rates and potential to reduce permanent damage.  For Crohn's patients this is even more important as there is no cure or surgical fix for the disease.  Treatment focuses on achieving a remission of symptoms and preventing future flare ups.

Biologics are given through an infusion which means that the medication is delivered through an IV directly into your blood stream.  These are a few tips that will make the process as easy as possible.

First things first
Once your doctor prescribes a biologic you should discuss any vaccinations or tests that need to be done before the first infusion.  Tuberculosis and hepatitis B infection can both be activated if they are present in your body when you suppress the immune system with biologics.  Your physician will want to test for these conditions and monitor your symptoms to keep you healthy.

For female patients it is important to be sure that you are not pregnant before beginning treatments because they could have a negative impact on the developing baby.  There is not enough information on their safety during pregnancy to recommend them accross the board.  During treatments you will also need a reliable form of birth control for the same reason.

The doctor may also want to check other labs as indicated by your overall health.

Check with your insurance and plan for the payments
It is important to know if your insurance requires a precertification for any tests or treatments as well as how much your portion of the treatment will cost.  If you don't have insurance or you can't afford your portion it can help to contact the hospital or clinic.  Often times there are need based programs in place that can help.  The manufacturer's website may also have a copay card to help offset the cost of the medications.

Speak up and ask questions
If you have questions be sure to ask the person scheduling your appointment to set some time aside for those concerns to be addressed.  Your physician may not be the one doing the infusion.  In that instance you may want to write a list for your doctor and schedule a separate appointment to go over your concerns.  Should you have any questions during your infusion please be sure to speak up.

Know ahead of time where you will get your treatment
It is important to know ahead of time where you will have your infusions done.  Some of the places you may have as options for your infusion could be your doctor's office, home health nursing, infusion centers or even your local hospital.  Be sure to set your infusion schedule at the place that will be the most convenient in order to help you to keep all of your appointments.

Healthy steps to take before the infusions
It is very important to be as healthy as possible when undergoing treatments with biologics.  In the days prior to the treatment be sure to stay hydrated by drinking enough water.  Get a good night's sleep and eat a healthy meal before heading to the hospital.  If you have been sick or have been exposed to something like the flu be sure to let your physician know ahead of time.  They may wish to delay your appointment until you are well.

Bring a friend with you
It is not possible to predict exactly how you will react to the treatments.  While biologics tend to have fewer side effects than other medications they may make you tired, give you a headache or you may have a reaction to the medication.  The pre-medications may also cause unforeseen side effects.  Having a friend along can insure that you make it to and from your appointment safely.  In addition a friend can be an advocate, support or simply someone to pass the time with while you have the infusion done.

Set aside enough time for your appointment
You should expect to have some time waiting while the pre-medication and then the biologic is infused.  Depending on which medications are used you can expect to be there for two to three hours.  Being on time to your appointment can help avoid extra wait time in the lobby.

Make the appointment as comfy as possible
Some of the things you may want to have for your appointment are comfy clothing, a warm blanket, books or magazines, snacks, a drink and whatever electronic device that will help you pass the time.  Once you get used to having scheduled infusions you may want to stash a "go bag" in your vehicle so you don't forget any of the comforts from home.

Any new treatment or procedure can be a scary thing to face.  Fear of the unknown tends to be the biggest cause of anxiety so following these tips, asking as many questions as you need to, talking with someone else who has been there or joining a support group can help to put your mind at ease.  Hopefully in the days and weeks to come the treatments will become second nature and have you feeling your best in no time.

_Jennifer has a bachelor's degree in dietetics as well as graduate work in public health and nutrition.  She has worked with families dealing with digestive disease, asthma and food allergies for the past 12 years.  Jennifer also serves the Board of Directors for Pediatric Adolescent Gastroesophageal Reflux Association (PAGER). _

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