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Re: MTX and surgery

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Hello Group,

Does anyone know the facts about being on mtx and pred and having surgery? I

was told by a surgeon to stop taking both prior to surgery. My rheumy says

stay on the meds. I was on prednisone for a prior surgery. I've tried to

find some info on the net, no luck though.

Thanks for any input!

Trish

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dEAR tRISH,

I have personal experience with both drugs and surgery.

The reason to stop the MTX is simple. You are much more prone to infection

when you take it. Your rheumatologist should start you back on it after a

couple of weeks post op.

With the predisone, you can have respiratory problems with the anesthesia, in

addition it slows the healing process.

In my case, the years of predisone use-

even creams, inhalers, and medrol packs

since the age of ten have caused a sufficient adrenal insufficiency that I had

pulmonary problems and had a respiratory arrest during abdominal surgery this

past

April. It was very scary. I would definitely mention to the surgeon and the

anesthesia people prior to surgery of your steroid and mtx use. I don't

understand why your rheumatologist seems to be so cavalier about it.

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Trish,

I have had 4 surgeries while on Mtx. and Pred. and was not told to stay

off before the surgeries.

The only time I was taken off of all meds was when I had a heart attack

and they wanted me off of everything because they did not want it to

mask any symptoms I was having, such as pain, nausea, swelling, etc.

Let me tell you that the 2 weeks in the hospital were torture. They put

a 4 " foam mattress on top of the hospital bed to ease the soarness until

I was able to get back on the meds. After the angioplasty and

disconnection from all IVs they let me start taking everything again

(which was approx. 2 weeks after the heart attack and when I was at

home).

If you are going to be in the hospital for an extended period of time

and off of meds, why don't you ask your Dr. to prescribe the mattress.

It really was a great help. I probably would have been a much worse

patient if I had not had it. I still had pain, but it helped.

I would also ask the surgeon for his reasoning on why he wants you off.

There may be a good reason why he is doing it.

Hope this helps with your question.

Angera

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Hi Folks

While we all should (and need ) to learn from the experience of others, I

really caution agains taking advice on line from anyone, even those who have

had 30 surgeries.

If you have questions about surgery that is not really satisfied by your doc,

I think you should go to for another opinion.

I am really nervous when I read that some people ask what to do about meds

before surgery.

We are all so different and so much can go wrong that taking any advice about

surgery from anyone on line is risky at best .

I too have read about the multi porblems with Derkel on BBS but I do hope that

if surgery is really necessary then the best thing to do is get it from a good

doctor.

And I stress the word good.

Hope everyone is well today and enjoying life.

Kit

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Angera,

Thanks for sharing your experience. The surgeon mentioned, as did,

the risk of infection, and a slower healing process. I should only be in for

a day or two.....it's for a tummy tuck! Pretty vain, I know. But, after

losing 75lbs and moving to Hawaii......I feel the need! :)

Thanks again,

Trish

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In a message dated 2/15/99 5:23:22 PM Hawaiian Standard Time, PBias@...

writes:

<< She has been thru over 30

surgeries and give you some hints and reasons etc... >>

Wow, that's a few more than I'd like to go through, cosmetic or otherwise!

Thanks for the link, I'll check it out.

Trish

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Dear Trish,

I defer to your doctors on when to stop the methotrexate. The bad news is, I

got a severe flare post-operatively, which I believe was due to the

methotrexate withdrawal. My docs had me stop it one week before, and not

start until six weeks post op. Let us know what your docs say.

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Trish,

WOW!!!!!! Congratulations on the weight loss and in my opinion, you are

not being vain (I've been there and lost 60 lbs. about 10 years ago). I

see it as feeling good about yourself. I think it is great!!!!!

Good luck, feel better quick and get out and enjoy those Hawaiian

beaches.

Angera

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As someone who also has PA and in the medical profession that statement needed

to be said. This msg. board is just great for all of us, because we don't

meet others with our PA. Chatting back and forth on symptoms, treatment and

other methods we use to make life more palatable is beneficial to all. We

just have to look at how different ways PA afflicts different people. It

helped me knowing from this board side effects from different meds. Some said

they lose their hair, can't have a perm andcan't color. I do all three and

have no problem, and am on plaquinel, pred 13mg., folic acid, mtx 17.5mg.

That is just one example. No one can take the place of our RMD and we should

follow his or her instructions, only. The combination of meds that we take

can be deadly if not taken properly. They also can restore our life to almost

" NORMAL " also when taken properly. I can't praise the PA members for the

info, encouragement, time given in listening, and follow thru with

communication. I am just going through my husband having surgery for colon

cancer, with chemo to follow. I have received kind inquiries from some

members. That means a lot. Thankso much. I didn't intend to give a sermon,

really. We all serve each other to feel the best we can. Keep contributing.

Betty

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In a message dated 2/16/99 9:03:10 AM Hawaiian Standard Time, Kitzel47@...

writes:

<< I am really nervous when I read that some people ask what to do about meds

before surgery.

We are all so different and so much can go wrong that taking any advice about

surgery from anyone on line is risky at best . >>

Dear Kit,

I would certainly not follow anyone's advice, other than that of my doctor. I

simply wanted to hear what others had experienced, since I had conflicting

instructions from my doctors. I would prefer not to stop my meds and was

hoping to find some information to present to my surgeon, supporting this.

Thanks for looking out for me though! :)

Take Care,

Trish

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Hi Trish

Glad you are looking gorgeous and even more so after the surgery.

One sign that you are feeling better is that you are paying attention to your

" bod " and not your pain.

Hawaii beaches will never be the same after you strut your bikini.

Kit

P.S

Glad all that other " stuff " is now in the past as well.

Nothing but blue skies from now on as the song says.

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Trish,

And the even bigger battle is keeping it off. I have found with all the

medication I am on, especially the Pred., can be really discouraging at

times, but I don't let it get me down. If I slip and put on a few

pounds one month, I take it in stride and set a goal to lose it the next

month, which is a lot easier to lose 3 to 5 lbs. than 60 all over again.

Just keep up the good work, just keep saying to yourself, " I am worth

it " .

Keep us informed how you fare through the surgery. Good thoughts and

prayers are with you.

Angera

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Angera, were you on a special diet to lose the weight. I am on all the usual

meds, but the side effect of weight gain and puffed moon shape face is

horrible. I have trouble putting my contacts in. I'm taking pred. 13mg daily

plus mtx17.5mg. per wk. I know if you can get below pred 5mg. that

disappears. Too bad, because this dose I,m doing great. Any helpful hints

would be greatly appreciated. Thanks Betty

BCLEARY2@...

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Betty,

I started with going to Craig (this is not an advertisement) and

lost the first 45 lbs. by following their plan. I learned how to eat

through behavioral modification classes and tapes. I then switched to

Weight Watchers(this also is not an advertisement) and lost another 15

lbs. with them. It was a long hard battle and still is. It took me

over a year to lose the weight. I now know what to eat (actually I

always knew what was the right food), but I don't beat myself up over it

anymore if I slip and fall.I still need to lose at least 30 more pounds

but it just isn't happening. I now realize that my body is comfortable

at this weight and have finally accepted that. It has been a long hard

struggle.

I understand how you feel about the side effects of the prednisone (moon

face, etc.). I feel that if it is helping me with the pain, I can deal

with it.

My suggestion to you is research some of the diet plans out there and

find one that fits your lifestyle. It took me 35 years before I found

one.

Another reason it took me so long to lose the weight was that I cannot

exercise. What I do now is water aerobics, which is very low impact.

The local YMCA has a swim program for people with Arthritis.

Hope this helps you.

Angera

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I have been active in water aerobics here in Va. and it was a workout. We had

3 diff. instructors, and each had her own method. It was outside pool at the

club. The problem was that we would eat at the club after. In Oct. we went

to Fl. where we have a condo and a small group of women had a tape of

exercises. We would meet at 8A and play the tape and do the exercises which

was good. Came home for holidays and my husband ended up being operated on

for colon cancer. Everything stopped for a while 'till we get chemo behind

us. I may try to go to the rec center and go on a day to day basis. In Fl.

we were great about walking at least 2mi. every day. I also know what I should

and shouldn't eat. I just have this dumb craving for something cold like

sherbert or ice cr. I have just started getting sores in my mouth which may

be from mtx. or cold I've been carrying around. The only way to gain wt. is

through the mouth, and way to lose is also through the mouth and exercise. I

must talk to myself and get with it. Thanks for your encouragement. Betty

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