When I peer into my crystal ball, I see sharp instruments and biologic drugs. (The long story is in my blog.)
When you’re on Enbrel or one of the bio-drugs, do they take you off it when you have surgery? Or do you just carry on?
Just curious. What experience do you have with this?
Thanks, folks!
Hows this for an answer? "Depends"
Me I'd do it period, there isn't a lot I fear but hospital produced infections is one of them. My cuter than Heck 2 year old granddaughter is another.
It's your rheummies decision. You have to ask them
Agree talk to your doctor but it is my understanding you go off x amount of time before and start back once you are clear of infection. But always check with your doctor.
The longer story is this. I anticipate being summoned to the rheumy’s once she gets the letter from my OS telling her that he thinks my PsA treatment needs to be stepped up. (Probably in January). The only alternative is a biological, as I have tried all the DMARDs. My hip replacement will probably be done in February. So potentially, I could be put on a bio-drug in January, but then have to pause it for surgery within a few weeks.
That’s all fine and well, but, because of travel plans, getting to the rheumy’s will be very difficult and expensive for me in January.
I’m wondering whether seeing the rheumy in January will be worth the trouble and the expense, if I’m just going to end up starting and then pausing the treatment after a short while. Or if she is likely to say “No point in starting now, let’s wait until March.” Maybe it would be better just to tell the rheumatologist that I’ll have an appointment sometime in February, when I’m back, and go from there. That’s why I wanted to know about peoples’ experiences with this.
Life with PsA is never dull. 
And rarely simple.
Why wouldn't your rheumy be willing to let you start shortly after your surgery?
Seenie, I am going through this right now , I am having shoulder and bicep tendon surgery tomorrow and am now off all my meds. The Enbrel, methotrexate, sulfasalazine and Celebrex had to be stopped 2 weeks pre-op and 2 weeks post-op because of the potential of bleeding( Celebrex) and increase chance of infection ( Enbrel and the rest of the gang !)
When the hospital called today to go over the instructions and medical history, they were very concerned about the meds until I told them I had stopped them x2 weeks. This will be my third surgery in 3 years and each time I had to put them on hold on the advice of the both the rheumatologist and surgeon.
My poor body is begging to go back on the meds, it's amazing how much you realize they are working when you are off them ! Hope this helps in your decision. In my opinion, I think I would wait to start. It's like giving a kid a lollipop and then taking it away !
Good luck in whatever is decided , take care :0]
Thanks, everyone, especially Babs, to whom I’m sending healing thoughts for her surgery. Your feedback has been very helpful. As much as I’d like that lollipop asap, I’ve decided that I’m not going to fly back to Snowsville from Florida to go to the rheumy to be put on a new med, which will be paused before the “break in” period is over. Just not worth the expense and effort. And I have a feeling that she might just say “let’s wait until after your surgery” anyway. Yes, I will stay in the warm until I have to come back for pre-op and surgery.
The wait begins. Thanks again, PsA buddies, for propping me up. 
It’s been a trying week.
Party hearty over the holidays, Seenie. You've got a lot on your plate in the New Year. All good wishes to you a you do the prescription drug polka!
I am sending you prayers and hugs Seenie!
Thank you Jane and MiV, for your good wishes.
Jane, I’m on leflunomide, so I have to invent my own definition of “party hearty”. Particularly difficult when I do so enjoy a glass of wine with dinner, and it’s just not allowed. Something really nice happened today, though. The doctor’s secretary called and said “I have two messages from Dr. M. One, your AST is down. Two, your ALT is down. I don’t know why she wants you to know, but she said to have a nice holiday.” I knew immediately that it was her way of saying that it would be OK to have a glass of wine with Christmas dinner. I thought that was really sweet of her (she loves food and wine, as I do).
I finally caved today. I got so tired of the constant pain that I had a meltdown. As much as I hate to do it, I reached for the tramadol in the back of the cabinet. I hate to resort to industrial strength painkillers, but I was at the end of my tether. I had a lie down, and felt much, much better an hour later. I think I’m going to do that more often.
Happy pain-free holidays, everybody!
My theory is if you need pain med you take pain med. I have taken meds in the past and have never had a problem with them. As the pain goes down so does my use. Usually quite precipitously! The same is true these days. Sometimes I take one vicodin a day, sometimes none, sometimes if I am flaring badly I might take four in a day. I get some rest and might only take one the next day. You are not less of a person in my eyes because you took a tramadol when you needed it. Sometimes it is the only way to get some rest. Be well my friend.
Seenie--I'm with Michael. Meds exist for a reason and if you are at the end of your tether and everything else has failed, you should not feel bad resorting to the prescription given you by your doctor. I'm not supposed to be drinking (much) either (mtx). My rheumy and his practice partner have slightly differing opinions about alcohol. Mine says keep it minimal (but he hasn't forbidden it as my levels were OK). His partner says telling people to NOT drink is pointless! So glad your doc could offer a little holiday cheer!
We got 6" of snow last night and I just cleared the front steps and the sidewalk. Hello heating pad.
Yes, you’re right about taking the pain drugs. The orthopedic surgeon did say that what I had was very painful. And orthopedic surgeons know pain. After feeling so much better yesterday after a few tramadol, I made the decision that I need to just say yes … The bottle says 1 to 2, 4 times a day (so, maximum 8 per day). I’m going to try taking one, four times a day, and see how I do on that. If I’m an addict by the time I get to surgery, I’m sure there are treatments for that too.
Jane, my doctor didn’t say anything about cheer. LOL. She gave me information, and I made my own decision. And she takes no responsibility for that. Gotta love it.
All the best to you and your family over the holiday season. We are definitely having a white Christmas here: 8 inches so far, and another 3-6 to come. Bing would be happy.
Seenie.... You FINALLY get the approval for some vino for Christmas and you start popping tramadol??? :-)
LOLl It’ll be one small glass, Lamb. But a bit is better than nothing.
Tramadol. Yes, the pain is terrible. If I could go under the OS’s knife tomorrow, I’d be so there!
Seenie
I can't imagine the pain OR the amount of flying you have done the last few months.
Flying? Huh? The tramadol must be doing something to my brain …
Well I guess on should never ASSume. I thought you were in England home to Toronto and now in or going to Fla. In my world that a lot of travel sitting in one spot......
Oh, OK! That … I took one six hour flight to the UK, but we came back on a transatlantic cruise. It was the perfect environment for poor ol’ (ha ha) me. Then a short hop back to the Great White North. Not leaving for FL until after Christmas, and we will drive. We’ve already decided that there won’t be any extremely long days, and lots of rest stops. Although I spend most of my time at home ASSuming the sitting position, so what’s the diff?
Looking forward to the warmth, and I’ve decided I am NOT flying from FL to Ottawa to see the rheumy in January, even if she invites me.
Keep well over the holidays, Lamb! All the best