I am about to have surgery for my arthritic foot & have been told that I must stop my medication: methotrexate & salfasalozine, for 2 weeks prior to surgery.
I guessing other people have done this? What can I expect pain-wise & what have others done to relieve this?
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KayteP
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They say it’s stays in your system for a few weeks so you shouldn’t get any pain , I usually get two weeks off Christmas / new year that I don’t have mtx and I’m always fine
I wasn't on MTX but LEF when they did mine over 4 years ago and it was fine, but I was told stop a week before after doing the MRSA swab now I suppose its Covid and MRSA. It was restarted following the surgery which was great. My foot had turned over and was very painful so they straightened - A metal plate was screwed in the big bone to big toe and my toes were broken straightened then they relaxed the tendons and shaved off a bits of overgrown bones. My foot was in plaster for 2 weeks then they removed plaster and rebound it and protected it by a plastic guard for 6 weeks or so. It did not hurt but was a bit irritating. I did shower with my foot in a bin bag done up with gaffer tape and it was worth any amount of short term discomfort for a normal foot. It's still straight and painless only tell tale is I've a load of small scars by the toes, and a couple of lines along the side of my foot. I was given pain killers to take home and did take them them and paracetamol afterwards. I feel it was so worthwhile and I'm very, very glad I did have the operation and somewhere on here are pictures of my left foot all mended. I was asleep as they said the operation was noisy and I also had to do Fragamin injections but they don't hurt anyway. So best of luck and thinking back I know it made my hip ache a bit as the plaster boot makes people lopsided and I had to use a stick too. But the hospital supplied that and I returned it when signed off.
I have had 3 major surgeries when I thought I should stop for the actual surgery but the surgeons said it was ok to take 25 mg of Mx. However with an immune system that is over active I took it on myself to miss just the surgery week out without their advice . That was Ok but so was the Maj surgery when I kept taking it. I guess it's up to you how bad you feel without it. 2 weeks is a bit much. Incidentally after one of the ops I was awake and walking next morning (towing the drip on wheels) days faster than expected. I think we have to remember that our condition is an over active repair system. When there is something to repair it beats being normal and baffles surgeons after operations.
I saw the same resilience in my mother.
I also have very little respect for any common sense approach from the medical profession, not seen much evidence that they have very much of that.
I had a calcaneal osteotomy and mid-foot fusion last year. My surgeon and rheumatologist know each other well. The surgeon said to take advice about medication from my rheumatologist. I take leflunomide, sulphasalazine and Rituximab. My rheumatologist said there was no point stopping medication, her argument was that sulphasalazine wouldn’t cause any issues and it’s slight antibiotic property might be useful and leflunomide stays in your system so long stopping it for a few weeks would have little impact. She said ideally the surgery would be a couple of months after Rituximab. Her other reason for not stopping medication was that I would need to be well controlled to be able to cope with mobilising on crutches after the surgery. I was in plaster for 9 weeks and a moon boot for 5 weeks. I guess what I’m saying is, if you are worried about stopping medication discuss it with your rheumatologist because they know you and your medication better than the surgeon.
As an aside if you have to be non-weight bearing for any length of time I can highly recommend using a knee scooter, I think I would have gone crazy without it. You can either hire or buy them. I also bought myself a pair of smart crutches, again an investment I’m very glad I made.
I can manage just 2 weeks; how u feel or how quickly symptoms comes on can depend how active your disease is. MTX’s half life means that it can keep protecting you for about 2 weeks, looking it up.
I had emergency knee surgery last year, but went for spinal blocking, so I was awake throughout and meant no recovery from the anesthetic. I could also chat to the surgeon and get real time feedback, but I know that is not for everyone!
I hope it goes well, your are in good hands with the medical staff and they were so reassuring. All the best.
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