Plan your health ahead when under DMT

[anaishunter]

Just sharing the need to plan healthcare needs (surgery, dental work, etc...) ahead once you get on a DMT. Don't delay any procedure...

I'm on Ocrevus. I had to delay the treatment to 10 months (instead of the typical 6 months) to get my hip replacement surgery. The oral surgeon is asking the same now in order to operate and remove a wisdom tooth.

My point is, as soon as you need some "surgical" procedure, get into planning mode to line up everything. I wish I had scheduled my dental work to be the same month as the hip surgery.

Between insurance coverage, infusions scheduling, and surgeon availability, it is like waiting for the planets to align.

Just wanted to share...

[twooldcrows]

yes indeed get it done when needed or you have a long awaited appointments that get all delayed with just one ....

[ahrogers]

Interesting they required the wait. I had a hysterectomy 3 weeks after an Ocrevus infusion. I know they recommend waiting until close to the next infusion for vaccines though.

[mrsmike9]

Hopefully you can be put on another DMT in the meantime to prevent progression while you get the other things done.

[Frances_B]

Have you asked the oral surgeon WHY they want you delay your infusion for the tooth removal? Or are they just being over cautious and not giving any thought to the risk of you suffering a relapse and additional disability as a result of not having your infusions on schedule? If they think you can just swap to another MS med for a couple of months in order to have the surgery they are barking completely up the wrong tree as MS meds are not ones you chop and change for minor reasons - like having a tooth removed.

Here is a link to the full prescribing info for Ocrevus - and there is not a single mention of delaying surgery while on Ocrevus.

chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/gene.com/download/pdf/ocrev...

I can understand the hip replacement surgery concerns because that is a major operation with a huge incision and thus a big potential for infection, but removal of a tooth??? If the oral surgeon is concerned about infection they should be able to prescribe prophylactic (preventative) antibiotics, which is quite common with oral surgery, so I really don't see what the problem is.

MS and MS meds do not generally cause any problems with anaesthetics unless there is a very high level of disability which requires special considerations.

nationalmssociety.org/Livin...

I think you need to ask your neuro for their opinion.

[anaishunter]

Many DMTs and Ocrevus in particular are immunodepressant therapy that weaken your immune system so you don't want to be facing an infection. Tooth removal involve the bone in your mouth so avoiding infection there is also pretty critical.

I'm not too worried about delaying my DMTs. Just wanted to warn others who might not have that flexibility.

[tompumo in reply to anaishunter]

I've been on ocrevus for nearly ten years. I've had some teeth pulled, had COVID, but no problems with infections or other side effects. MS progression is minimal. So, I would give ocrevus a thumbs up. 👍

[anaishunter in reply to tompumo]

good to know that you did not have to space your infusion because of teeth work.

I'm the same - on Ocrevus for 5 years. no flu, cold, infection or anything and no relapre. I thought it was fair to delay the infusion for a hip replacement. I'm annoyed to have to do it again for a tooth. I'll ask my neuro.

(note that I'm one case where Ocrevus destroy more than my B-cells. My T-cells are also depleted so my neuro follows me closely with blood test prior to ordering the infusion. I'm at 1/2 dose and often only every 8 months). We're all different!