Resistance to Remicade
January 17, 2023
Although for a long time Remicade had lowered the Crohn’s symptoms that disrupted Rubinchik’s life, things began to shift in sixth grade.
Symptoms that had long been prevented by the medication began to arise, including some new, far more serious ones as well.
Symptoms like these occur when the body stops responding to therapy. Oftentimes, unpredictably, one’s body begins to reject long-used medication, enforcing doctors to intervene and prescribe a new medication.
“The only issue with the medicines for Crohn’s is that there are very few of them. There are only like, maybe eight or something different medications, so eventually what happens is that at some point your body rejects the medication, and then you can’t take it anymore. Your body begins to grow a resistance, or you start to get bad side effects from the medication—so bad, you have to stop and switch to another medication,” Rubinchik said.
It’s not uncommon for Crohn’s medication to eventually lose its effectiveness, and that’s exactly what happened to Rubinchik.
“I was feeling good, but then in sixth grade, I started to get seizures from the medicine and I was like ‘Okay, I have to get off the medicine because the side effects aren’t worth it if I keep getting seizures,’” Rubinchik said.
The decision to choose a medication for Crohn’s isn’t an easy one—all come with varying side effects and symptoms. Before choosing a new one to switch over to, Rubinchik was on no medication, leading her to the most unhealthy and vulnerable state she’d been in since being diagnosed.
“If I got sick, there was nothing protecting me. So I would just get really sick, which is when they decided to put me on Entyvio, but it took over six months for me to get used to it. I struggled to gain weight—I think I was 50 or 60 pounds at 13 years old, which is what a seven-year-old should weigh,” Rubinchik said.
In general, the gut is a key source of immunity throughout our body.
“The gut is the foundation of our overall health,” said Kelsey Russell-Murray. Russell-Murray is a clinical dietitian at St. Thomas Elgin General Hospital in Ontario, Canada, and owner of Gut Healthy Dietitian. “Over 70% of our immune system is actually contained within our GI tract, and we know that those healthy gut bacteria have a role in hormone production and vitamin synthesis. Overall digestive health can then translate over to better immunity in fighting diseases such as COVID-19.”
Rubinchik’s struggle to gain weight was primarily tied to the fact that her body rejected any food or drink she tried to eat.
“My mom and I went to the ER to try to get fluids because it was really hard for me to drink water and I was very dehydrated and malnourished. When I went to the ER and they gave me some water they just admitted me into the hospital then because they were like ‘Yeah, you’re very sick,’” Rubinchik said.
Though it took nine feeding tubes and transitioning to a wheelchair, Rubinchik’s body was finally able to react well to the Entyvio. Since leaving the hospital, she has felt physically and mentally better than ever before, only having to go in once a month for an infusion.
“I don’t really have any Crohn’s symptoms, which is awesome. I’m able to attend school every day. I do activities after school. I go out on the weekends and I have energy. I’m a normal weight now,” Rubinchik said.