Re: ??? about surgery and JRA meds

[Guest guest]

Hi e,

had his tonsils and adenoids out while being on the Enbrel and MTX we even took precaution due to it not being a year off the pred. had general anastesia so they took 4 xrays of his cervical spine,they took blood clotting tests,they gave IV antibiotics and 2 types of pred in his IV.

The only problems he had was in recovery. He was getting small amounts of fluid in his lungs,but he was able to cough it up.No flare of any kind and no infection.

Oral antibiotics wouldn't hurt and e will need some sort of increase in her steroid.Only the rheumy can tell you what or how.I take it Joe is having consious sedation.Thats how I had mine taken out.The oral surgeon hooked up an IV and had six differant big syringes filled with something.I have no memory of nothing other then comming to in another chair laughing my head off and making a total fool out of myself.

Wishing Joe an uneventful surgery.By the way if it's a upper that they don't stitch closed or a lower one ask the oral syrgan for the water pick syringe.If Joe gets food stuck in the hole it will cause a dry socket.I learned the hard way.Ouch!

Hugs

Becki and 5 systemic

PS) didn't stop any meds.We actualy gave the Enbrel before we lft for the hospital.

[Guest guest]

Hi e!

I work in an Oral Surgeons office so I hope I can be of some help. All of the meds should stay on schedule UNLESS she is on any blood thinners. Those must be stopped 3 days prior with a 24 hours before surgery PT done. The day of surgery she can take her dose of meds after the procedure is done. However, check with your rheumy doc on skipping the surgery day altogether. This is what my did (16) as she was flying on the IV drugs as well as the oral stuff. She started back the next day as usual. Antibiotics are not usually given unless for pre med (heart etc) or there is an infection present and the appointment is weeks away. If she has 4 teeth that need to come out IV understand that each time you sedate the body there are risks. We usually recommend all 4 with one IV. Ultimately it is your decision of course Another thing that could be helpful is 1 tsp salt to 8oz of very warm water could relieve that discomfort in the back. You could also try peroxyl which is a peroxide solution that the foaming properties could loosen any food that could be in there. Is this of any help?

Carol and 16 AS and ?

[Guest guest]

Carol,

Thank you for the response. That calms my nerves a bit. The oral

surgeon had never even heard of JRA or half of her meds so he did not

know what to advise. We are onlly doing two on his advice. The uppers

are so far up he doesn't even know if they will come down or not.

You're so right though that then she will need to be sedated again

and there are risks but he feels it would be too much trauma to take

them. I'll just have to keep praying that we made the right decision.

One of my biggest concerns is that his office is downstairs and there

is not ramp or elevator plus a walk to the car. Hope she is awake

enough afterwards to negotiate steps. I had all 4 of mine removed way

back and all I remember really was the friend who came to pick me up

saw the little bit of drainage I had and passed out cold, so back to

sleep for me while she got to sleep it off too! LOL. We go to the

rheumy Thursday so we will see what he says. I'll let you know. Oh,

what do you say for typical recovery time? She will have the

procedure on Friday and then has a 3 day weekend with school on

Tuesday. Does this sound reasonable? I can't remember from mine--too

mnay years ago!

e

> Hi e!

> I work in an Oral Surgeons office so I hope I can be of some

help. All of the meds should stay on schedule UNLESS she is on any

blood thinners. Those must be stopped 3 days prior with a 24 hours

before surgery PT done. The day of surgery she can take her dose of

meds after the procedure is done. However, check with your rheumy doc

on skipping the surgery day altogether. This is what my did

(16) as she was flying on the IV drugs as well as the oral stuff. She

started back the next day as usual. Antibiotics are not usually given

unless for pre med (heart etc) or there is an infection present and

the appointment is weeks away. If she has 4 teeth that need to come

out IV understand that each time you sedate the body there are risks.

We usually recommend all 4 with one IV. Ultimately it is your

decision of course Another thing that could be helpful is 1 tsp salt

to 8oz of very warm water could relieve that discomfort in the back.

You could also try peroxyl which is a peroxide solution that the

foaming properties could loosen any food that could be in there. Is

this of any help?

> Carol and 16 AS and ?

[Guest guest]

Becki,

Thanks for the insight. She is still at 12.5 on the pred, trying to

taper again because the weight gain puffy face acne thing is not a

desirable look when you are 17! LOL Hopefully this time we'll make

it! We usually give Enbrel on Wednesday and Enbrel and MTX on Sunday

so it won' be those days but it is all the others I wondered. I'll

let you know what the rheumy says on Thursday. She did well with the

sedation when they injected her joints, I just pray she does as well

this time. Nothing like being sick when you just had major mouth

work. Thanks for the idea about the syringe. I have to find something

she will eat. She has always despised softs, never would eat baby

food, mashed potatoes, applesauce etc.. This could be interesting. I

was thinking scrambled eggs, which she does like, because o the

protein. Her favorite ice crean is mint chocolate chip but I'm

thinking that is not the best choice because of the chocolate chunks.

Hmm. Maybe I can try to make some mint ice cream at home without the

chocolate. I'll have to experiment before then. Thank you for the

information and I'm so glad for you on how well is doing. Maybe

he can get on next years Enbrel calendar. They had quite a few JRA

kids in there. Wouldn't that be cool? He could be the July calendar

boy (I think that is when you said the magic day is). Go !

e

> Hi e,

> had his tonsils and adenoids out while being on the Enbrel

and MTX we

> even took precaution due to it not being a year off the pred.

had general

> anastesia so they took 4 xrays of his cervical spine,they took

blood clotting

> tests,they gave IV antibiotics and 2 types of pred in his IV.

> The only problems he had was in recovery. He was getting small

amounts of

> fluid in his lungs,but he was able to cough it up.No flare of any

kind and no

> infection.

> Oral antibiotics wouldn't hurt and e will need some sort of

increase

> in her steroid.Only the rheumy can tell you what or how.I take it

Joe is having

> consious sedation.Thats how I had mine taken out.The oral surgeon

hooked up

> an IV and had six differant big syringes filled with something.I

have no memory

> of nothing other then comming to in another chair laughing my head

off and

> making a total fool out of myself.

> Wishing Joe an uneventful surgery.By the way if it's a upper that

they don't

> stitch closed or a lower one ask the oral syrgan for the water pick

syringe.If

> Joe gets food stuck in the hole it will cause a dry socket.I

learned the hard

> way.Ouch!

> Hugs

> Becki and 5 systemic

> PS) didn't stop any meds.We actualy gave the Enbrel before we

lft for

> the hospital.

[Guest guest]

e~

The recovery time is really up to the patient. As you know our kids have a much higher pain threshold so they seem to bounce back quicker. I have had patients call and ask can I bowl tonight! You have a great scenario with a three day weekend! The main thing you need to realize is that the swelling will be the worst on the THIRD day. If sutures are placed it is even more pronounced. So pain will be manageable or none but chipmunk cheeks will be really there. Keep the surgical sites clean with warm salt water rinses 3 times a day. No straws for a week to 10 days. I would encourage you to walk him into the house with one hand on each of your shoulders as YOU walk BACKWARDS for maximum support and control of him. He should be able to walk on his own but it is harder to catch or control a patient under the influence from the side or back.

Carol