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Crohn's Disease Forum » General IBD Discussion » Argon plasma coagulation vs infusions


08-20-2017, 07:00 PM   #1
Malice67
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Argon plasma coagulation vs infusions

Have to make the decision AGAIN soon... my Crohn's is practically asymptomatic (a day of pain every couple of months - usually pin-pointed to food I didn't think hard enough about not eating) except for re-occurring anemia... roughly twice a year my iron levels drop low enough to require infusions. My hematologist - who is the one monitoring the levels - shrugs it off - "of course your get anemic, you have Crohn's - we will just infuse you and you will be fine for the next six months". My initial reaction to this was - shouldn't we STOP whatever causes me to get anemic - he has no concern about that since he can treat the anemia. But I also look at the mildness of my symptoms and think - this IS an easy fix and the insurance covers almost all of it (USA - unless insurance reform messes with that in the future)

My GI, however, wants me to have an Argon plasma coagulation (APC) procedure if the anemia returns, which is has again. APC is a fairly low risk procedure using argon gas and electrical current to cauterize internally. Again, another somewhat simple procedure but they do put you under completely and its a bit painful for about 24 hours afterwards. I have had the procedure done twice in the past 2.5 years - it is expected to need repeating up to 4 to 5 times until fully effective. Cost is not an issue - I am blessed with great insurance. Part of me says - RUN - get it done NOW before insurance changes. But part of me says - do I REALLY need this procedure if I can reverse the anemia with infusions?

I get my blood tested again tomorrow to see if it has dropped low enough for the next round of infusions (it is just hovering above the level the insurance allows the infusions.) I just CAN'T make up my mind which doctor to listen to.... any thoughts?
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Diagnosis: Crohns of terminal ileum, GAVE ("watermelon stomach")
Current medication:
daily: Pentasa (500mg, 4x/day), probiotics, calcium, vit D, sublingual B12

as needed to control anemia: iron infusions (using Venafer since I had allergic reaction to Injectafer)
08-20-2017, 09:04 PM   #2
ronroush7
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I am not familiar with argon plasma coagulation but I have had the iron infusions. You saud they were painful for about twebty four hours afterwards. I would probably go for the iron infusions.
08-20-2017, 09:19 PM   #3
Malice67
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I like how the iron infusions are a little less invasive - no need to knock me out which is another plus. Just hoping I don't develop an allergy to Venafer like I did the Injectafer....
08-21-2017, 02:30 PM   #4
Tuff
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From what I read, the APC treatment is a cure. It will stop the bleeding. Otherwise, you will have to keep getting infusions, and the condition could get worse. I would get the treatment.
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Inflammatory bowel disease may more than double the risk of a serious blood clot in the legs or lungs.
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Stelara, Warfarin, calcium, Vitamins B12, D.
Previously: 5-Asa, Cipro, Flagyl, Prednisone, Aza, Remicade.
Pulmonary Embolism, DVT's, osteopenia, Peripheral neuropathy.
08-21-2017, 08:36 PM   #5
Malice67
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Today's visit to hematologist solidified my agreement with you - I am still anemic but just not low enough they can infuse me -- but I have been this way for over a month so I wasted half my summer being exhausted.

But your signature also brings up another thing - I have had a pulmonary embolism in the past after a non-Crohn's related surgery. HATED Warafin- all the stupid blood work and being so careful with vitamin K rich foods. Never want to go through that again - which is also why I hesitate with any type of surgery. Since this one doesn't involve any actual incisions I guess it is safer, but it does still get me worried. But I am so sick and tired of being tired...
08-22-2017, 01:28 PM   #6
Tuff
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Join Date: Feb 2013
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Blood clots shouldn't be a problem, but you could check with your doctor. I've been on Warfarin for six years with no issues, you get used to it. They now have INR clinics where they do a finger poke, or you can get your own machine. I still have it done in a lab once a month, but get the results online. You should eat approximately the same amount of vitamin K foods each day to keep the INR stable. You can still eat them, just need to be consistent.
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