Surgery and RA

[LivingWithHope]

Hello all, I’m relatively new here and really excited to find a lively and helpful community who know what it’s like to live with RA.

I’ve had RA since 2004 and my symptoms are mostly under control with a combination of Benepali and Methotrexate. That was until Jan when I had to come off for a mastectomy and reconstruction surgery.

I’ve had a dreadful flare up after my op and this brought back lots of horrid memories of what a struggle I had in the early years and what many are still having to live with. My surgeon was concerned about the risk of infection and rejection of the implant so I had to come off my meds 3 weeks before and stay off for quite a while.

Anyway my question is whether any of you have had complex surgery such as a hip replacement or something and what your experience has been in regards to your biologic meds or any post operative recovery and flare up. It’s a tricky balance as obviously we need to minimise the risk of infection but a fired up RA doesn’t help your recovery.

Nb hope you’re all holding up today

Thanks so much.

[charisma]

Welcome to the community! I like the name..

I have not had major surgery since pre RA (might be what triggered it along with huge amounts of stress). Just wishing you full recovery and return to controlled R and stable health.

[LivingWithHope in reply to charisma]

Thanks

[allanah]

Hiya , yes foot surgery , hand surgery , spinal surgery, stomach surgery and I actually was ok just on the routine post op drugs ! just felt I needed the ops so had no choice !

Hi welcome here, do look up nras.org.uk , loads of advice there x

[LivingWithHope in reply to allanah]

Ok I’ll look up the site

[Eiram50]

Hi and welcome!

Yes; both hips replaced, both knees replaced, foot surgery, gallbladder removal, pelvis and wrist surgery and 4 weeks ago, ankle replacement.

For all surgeries, I’ve come off all RA Meds three weeks before ( biologics, MTX and leflunomide) and had to wait three weeks after, before going back on. Since the ankle replacement and because I feel fine, I am not back in them yet but generally, I’ve had no hiccups and have been great I’m just painkillers.

Hope you begin to feel better soon x

[Eiram50 in reply to Eiram50]

On just pain killers rather

[LivingWithHope in reply to Eiram50]

Wow! That is a lot of surgery. Hope your ankle replacement is healing nicely.

6 weeks must be about the standard then for being off our meds.

I’ve just gone back on my meds and slowly getting the flare up under control. Wish I could get a steroid injection as that normally dampens things down whilst the meds get to work but I’m not sure how feasible or advisable that is at the moment.

[Eiram50 in reply to LivingWithHope]

Not finished yet! Still the other pelvis and wrist and the other ankle

To be replaced but understandably, these will not happen for a good while.

My experience had been 3 weeks either side but I know some rhuemys say 2 weeks. I guess it depends on the individual, the meds you take and we muSt always be guided by them.

Again, if struggling, the best person to talk to will be your rhuemy. It’s maybe not the best time for steroid injection but equally, it’s not the best time for an uncontrolled flare.

Wishing you the best. Stay safe

[oldtimer in reply to LivingWithHope]

LivingWithHope: You could have a course of steroid tablets instead of an injection - but that would not usually be advised after surgery when it might delay the healing process.

[Neverending63]

I have recently had my pre op for a total knee replacement which is on hold atm for obvious reasons. But Rheumy said to come off Benepali 2 weeks before op and I can resume once wound is healed. Hope this helps x

[Hidden]

I have had a complete shoulder replacement, toe joint replacement and removal of multiple cysts and a ganglion. I was about to have my toe nails removed but it has now been cancelled and my toe nails are digging into my others toes very painfully. I was also due to see a spinal consultant in May but that has also been cancelled and I can hardly walk, when I do walk, I am bent right over.

With each operation I have had to come off my methotrexate for two weeks before and two weeks after the op. However with my last op, I got a skin infection and had to be off the Mtx for four weeks after the op, making it six weeks altogether.