Re: Methotrexate and Enbrel Surgery ? Responce

July 14, 2003

In a message dated 7/14/03 8:47:26 PM Eastern Daylight Time,

goodman156@... writes:

> Why don't you try Enbrel first. If it appears to work, taper off MTX and

> see. If the Enbrel is as good/better than MTX, you might be able to have the

> surgery.

>

> claire

>

-----

From:

Sent: Monday, July 14, 2003 11:18 AM

Subject: Re: [ ] Methotrexate and Enbrel

>I have PA along with other morbidities but my Question to anyone who will

answer

>me.. I am going to have Roux-en Y gastric bypass surgery in sept. My

>I have to make a decission to

>stay on it or go off it and take the chance that Enbrel will not be

>enough. I understand that bottom line it is my decission but I would

>like oppinions....Please HELP!

This is in response to 's response to I believe it was 's post (If that

isn't right, then to whom every made the initial question about surgery

meds.),

First and fore most it is advisable to be off of any NSAID, MTX, and Enbrel

prior to any surgery for at least 2 weeks. These Particular types of meds can

caused excessive bleeding and MTX and the Enbrel suppress the immune system

thus can lead to an infection following surgery. This is my experience (sorry

if I have already shared this but this and another thing in this post I feel

are extremely important to know). Most know that in May (2 months ago today) I

had the BIG back surgery. My neuro stopped all meds 2 weeks pre-op except

meds for HTN and mentioned nothing about holding my Enbrel injection. My

surgery

was on a Wednesday and my injections were scheduled for Wednesdays and

Thursdays. So the 2 weeks prior I still administered my injections. Monday

prior

to surgery I had the usual pre-op and the anesthesiologist questioned as why I

had not DC the Enbrel and I told him that my neuro didn't tell me not to. He

said not to take my Monday injection and that I could possibly have to

reschedule the surgery. But, I had the surgery. I have had too many surgeries

to

count since 1999 and all without complication. Well, I lost lots of blood and

the day after surgery had to have 2 pints of blood and my BP bottomed. SCARY

THING! Got home called the Enbrel people and they noted the incident and told

me that there was little data on surgeries that were emergency or prescheduled

and it was there advice to stop the med prior because it will increase the

chance of infection. I cannot begin it again until November so it doesn't slow

the fusion and rods from taking. Joy, joy. I will restart it The risk is not

worth the pain and irreversible damage PA can cause.

Second scary Enbrel fact. Recently a longtime family friend who had suffered

with RA for all her life began Enbrel about January. The Enbrel gave her her

life back and was more active than ever and she had basically become

nonfctional. In April she needed emergency surgery for a bowel blockage. So

she went

in a day after they DX the problem and had the surgery. Next day she was up

and ready to go home and feeling well, by that afternoon things tool a turn

for the worst and she ended up with pneumonia in ICU and on life support and

died that night. The obtopsy report stated death by pneumonia caused by taking

biologic drug, Enbrel. Her husband is deciding how to proceed.

I know this is long winded and scary. I know that some people are on the

fence about Enbrel HUMARA, Remicade and other biologics. I had been torn for

some time about posting this. As I stated I will start my Enbrel as soon as I

can, because it is a wonderful and has soon wonders for my PA and have being off

of it for 2 months now I know how bad I need it and how great it si. But, I

have also learned so hard facts. I guess my point is just be careful and if

it is an elective surgery, go off of it and remain off until your doctor says

OK, even if you think you feel well enough to take it. Too many people die in

hospitals of infections after surgeries that were healthy to start with so we,

that are not blessed with great immune systems, must be extra careful. And

please, I pray that this doesn't scary anyone off of this med or close their

mind to try it. Just know what you are dealing with. Take care!

July 15, 2003

,

How old was this person? I know bowel blockages usually happen in the

elderly, so just wondering. I know Enbrel has a higher rate of infection in the

elderly.

In a message dated 7/15/03 8:28:09 AM Eastern Daylight Time,

CND110370@... writes:

<< Second scary Enbrel fact. Recently a longtime family friend who had

suffered

with RA for all her life began Enbrel about January. The Enbrel gave her

her

life back and was more active than ever and she had basically become

nonfctional. In April she needed emergency surgery for a bowel blockage.

So she went

in a day after they DX the problem and had the surgery. Next day she was up

and ready to go home and feeling well, by that afternoon things tool a turn

for the worst and she ended up with pneumonia in ICU and on life support and

died that night. The obtopsy report stated death by pneumonia caused by

taking

biologic drug, Enbrel. Her husband is deciding how to proceed. >>

July 15, 2003

Thanks for the post, . I certainly can understand why one would need

to stop Enbrel before a scheduled surgery. I got two skin infections (from

surgery the same day) immediately after taking my first shot of Enbrel, so had

to discontinue it for 3 weeks. I saw first hand how careful one has to be about

having any kind of surgery, even minor, while taking Enbrel, due to the

increased risk of infection from Enbrel.

I was suggesting that try Enbrel to see if it was going to work for her,

then STOP IT BEFORE THE SURGERY. Guess I didn't make this clear. It only takes

a couple of months for Enbrel to show you whether or not it is going to work. I

figured the kind of surgery she was having could be postponed for a few months,

in order to give Enbrel a try to test its efficacy. Of course, then she would

schedule her surgery and stop the Enbrel for the appropriate period of time

beforehand, and after the surgery for quite a while. When she was completely

healed, she could then go back on the Enbrel, knowing it was going to be a

workable substitute for MTX, which she could no longer take.

I called the Enbrel support folks and they told me that Enbrel stays in the

bloodstream for approx. 100 hours after the shot. So if one takes a shot, then

within the next 100 hours, has to have emergency surgery, extra precautions must

be taken by the medical team to insure that infection is caught and treated

swiftly. In the case of your friend who died, I wonder if the surgeon etc. knew

about the threat of infection from the recent dose of Enbrel?? One would have

to assume the docs knew she had taken Enbrel recently, and that they took extra

precautions (IV antibiotics before/during/after the surgery!), and that she

STILL got fatal pneumonia??

claire

Re: [ ] Methotrexate and Enbrel

>I have PA along with other morbidities but my Question to anyone who will

answer

>me.. I am going to have Roux-en Y gastric bypass surgery in sept. My

>I have to make a decission to

>stay on it or go off it and take the chance that Enbrel will not be

>enough. I understand that bottom line it is my decission but I would

>like oppinions....Please HELP!

This is in response to 's response to I believe it was 's post (If that

isn't right, then to whom every made the initial question about surgery

meds.),

First and fore most it is advisable to be off of any NSAID, MTX, and Enbrel

prior to any surgery for at least 2 weeks. These Particular types of meds can

caused excessive bleeding and MTX and the Enbrel suppress the immune system

thus can lead to an infection following surgery. This is my experience (sorry

if I have already shared this but this and another thing in this post I feel

are extremely important to know). Most know that in May (2 months ago today)

I

had the BIG back surgery. My neuro stopped all meds 2 weeks pre-op except

meds for HTN and mentioned nothing about holding my Enbrel injection. My

surgery

was on a Wednesday and my injections were scheduled for Wednesdays and

Thursdays. So the 2 weeks prior I still administered my injections. Monday

prior

to surgery I had the usual pre-op and the anesthesiologist questioned as why I

had not DC the Enbrel and I told him that my neuro didn't tell me not to. He

said not to take my Monday injection and that I could possibly have to

reschedule the surgery. But, I had the surgery. I have had too many

surgeries to

count since 1999 and all without complication. Well, I lost lots of blood and

the day after surgery had to have 2 pints of blood and my BP bottomed. SCARY

THING! Got home called the Enbrel people and they noted the incident and told

me that there was little data on surgeries that were emergency or prescheduled

and it was there advice to stop the med prior because it will increase the

chance of infection. I cannot begin it again until November so it doesn't

slow

the fusion and rods from taking. Joy, joy. I will restart it The risk is not

worth the pain and irreversible damage PA can cause.

Second scary Enbrel fact. Recently a longtime family friend who had suffered

with RA for all her life began Enbrel about January. The Enbrel gave her her

life back and was more active than ever and she had basically become

nonfctional. In April she needed emergency surgery for a bowel blockage. So

she went

in a day after they DX the problem and had the surgery. Next day she was up

and ready to go home and feeling well, by that afternoon things tool a turn

for the worst and she ended up with pneumonia in ICU and on life support and

died that night. The obtopsy report stated death by pneumonia caused by

taking

biologic drug, Enbrel. Her husband is deciding how to proceed.

I know this is long winded and scary. I know that some people are on the

fence about Enbrel HUMARA, Remicade and other biologics. I had been torn for

some time about posting this. As I stated I will start my Enbrel as soon as I

can, because it is a wonderful and has soon wonders for my PA and have being

off