surgery and actemra

[mngirl]

I had a knee replacement 6 weeks ago. I discontinued my actemra for total of 5 weeks. Three weeks prior and 2 weeks after surgery. I had been on 6mg of prednisone for 3weeks prior to surgery and 2weeks after surgery. At 2weeks after surgery, My blood work sed 17 ( within normal) and crp was 1.05 ( slightly over the upper limit of.80). I resumed the actemra. After the second injection I dropped to 5.5mg ( I had been on 6mg for 64 days) . It seems to be working ok. I was wondering about others experience after surgery. It will be 2 weeks Monday since I changed to 5.5. The last 2 days I have had shoulder, neck ache, very tired, general feeling of not myself. I question if its relapse , recovery (surgery) or withdrawal. I would be very interested in others experiences. or any suggestions. Thank you I enjoy HealthUnlocked . It has been a life saver. Many times I have wondered about something, tuned in and there was my answer. Thank You to all

[PMRpro Ambassador]

Not everyone gets entirely off pred even with Actemra. And at this stage you must also be looking for a return of adrenal function - and Actemra has no role in that at all. Your blood work may be within the range of normal for a broad population - is it within normal for you personally? That is a different thing.

[mngirl in reply to PMRpro]

since I started actemra my blood has been on the low end of normal. The rheumatologist reaction was " if you feel ok stcik with what your on", I did and I think I am ok. I just don't want to go back so I may be over cautious. Thank you for your reply

[piglette]

After my hip op my CRP went up to 41.5 goodness knows why as I felt fine. Kept me in hospital for a couple of extra days though. I felt very tired after the op though.

[mngirl in reply to piglette]

Thank you for your reply. I still get tired and I am going to bed early. I do sleep well though. The physical therapy is partially to blame I'm sure.

[piglette in reply to mngirl]

I suppose the op itself probably affects us too.

[PMRpro Ambassador in reply to piglette]

The CRP rises in response to damaged muscle tissue and bone marrow too - and whatever else, hip replacement is an invasive procedure that mashes both, especially, arguably, bone in particular!

ncbi.nlm.nih.gov/pmc/articl...

[piglette in reply to PMRpro]

Mine shoots up with a cold or a fall or a cut .....

[PMRpro Ambassador in reply to piglette]

Yup - all factors that need considering.

[piglette in reply to PMRpro]

I should have added the shock of Federer being beaten by Nadal at the French Open!

[PMRpro Ambassador in reply to piglette]

Wasn't a shock - didn't really expect anything else. But Mr D is a bit of wimp - asking to stop now cos it's windy, less windy than Fed/Nad's first set. Couldn't have anything to do with Thiem winning the first set? No, surely not ....

[piglette in reply to PMRpro]

Mind you there are red dust clouds floating about the place. Also it does seem to be pretty wet. I wonder if Thiem will win. He is more exciting than Djokovic.

[PMRpro Ambassador in reply to piglette]

Anyone is more exciting than MrD. Not often I support Nadal - but always when he's playing MrD.

[piglette in reply to PMRpro]

Absolutely agree. He did play well against Federer today though.

[Mary63]

I have also had a knee replacement but felt really uneasy about reducing my pred dose since. I am on 7mg and have had 2 failed attempts to get to 6.5mg My knee replacement was 26th Feb and I only now feel I MIGHT start a slow taper again to 6.5.

I have never been on Actemra...obviously you are and have had to stop and start it around the op. But I would suggest you might be flaring. Knee replacement whether partial or worse total is a HUGE assault on your body. If I were you I would rest awhile on 6mg pred, Actemra or no.

Good luck.

[mngirl in reply to Mary63]

I really feel actemra has made it possible for me to continue to reduce pred. prior to actemra I was up and down. With the 2 injections of actemra since surgery I was hoping to be successful with the 5.5mg

[Mary63 in reply to mngirl]

Oh that’s really good. Nice to hear Actemra helps. Even so I would be really careful about reducing pred too soon after knee replacement in case it backfires on you and you need to yo yo up again. Good luck

[HeronNS]

Even if you didn't have a serious systemic disease which is being treated with powerful drugs you still have undergone significant surgery and it will take a while to feel really well again. Hopefully within a short time you will turn the corner. Be kind to yourself - but do the physio! You probably need a little more pred for the sake of your adrenals. If you don't want to increase the pred then perhaps you can rest more than you had planned to. Recognize that your inner body is really working very hard to heal and think kindly of yourself. Best wishes for a speedy recovery!

[mngirl in reply to HeronNS]

Thank you I have been kind to myself. I have a great help and cheerleader in my husband.

[suzy1959]

Agree with the above. I have had 2 joint replacements in the last year. Both times I stopped trying to reduce for a while. Had my knee done 1st March and am only just thinking of reducing. My body has been through a lot and this time I had a flare after the op. too as if to remind me! I have found that the healing process is a lot more obvious and difficult when you have PMR too.

[Jim-CJ]

Hi mngirl, My wife is on Actemra and she had back surgery last October. She stopped Actemra two weeks prior and one week after. Everything went fine.

Take Care,

Jim & CJ