A question or maybe two...Surgery. | Arthritis Information

I am sheduled to have a second carpal tunnel decompression on Feb 23rd, not long from now.

I know it's a small  procedure. I had my other hand fixed Years ago. Works good.

This time Its different because of the RA , I am told that I am to abstain from both MTX and naproxen for a week before, and MTX (at least ) for a week after.

I am normally used to preparing for these things, should something unforseen come up. Knowing the risks? I have had enough op's to know the regular list of risks. It's the disease specific ones that I don't know about.

I am wondering about everything from instant flaring as soon as I stop the MTX to the hieghtened threat of infection.

It seems like I'm flaring instantly as it is whenever I taper down on prednisone anyway, and I am on a fairly low dose tapering down at the moment.

Does anyone have any advice?.....I am worried about being a painful swollen mess afterwords. I can accept that if I have to. I need my hand fixed. It's really contributing to my inactivity. I don't like to be completely inactive.

If any of you have some helpful hints I would sure appreciate them.

Any Ideas on what do you think I should know or do?...or maybe even not do? Any Advice would be appreciated...I'll talk everything over with my doc's before hand. I just thought you might have some Ideas?

(ok nervous rambling over..)

Thanks for reading this....

I don't have any advice for you, but I may be having the same surgery soon.  So I'll be looking forward to any advice you get here from the others.

I'm not yet sure what my problem is...it may be carpal tunnel...or may be neuropathy...I don't know anything about either, but I'll find out more after I have my emg next month.

Good luck with the surgery, Jen

Kelly

I have missed my meds for 3 days or so once, and didn't experience any swelling.  But, I did feel sicker that you know what.  Good luck with everything, sorry for posting a negative instead of something positive :)

-JON

I'm having knee surgery and the ortho said that he didn't want me tapering on the pred before and that he would give me a extra dose of pred during the surgery to make sure that I didn't go into a flare. So, that's what I would discuss especially since this is your concern.

I don't think there are extra risks other than of course infection from RA. They take you off anything else that might cause a problem.

Hope that helps.

OK thanks I was wondering If I was making more of a worry out of it than I should be. Old habits I guess... I'll call him about the prednisone regiment, but it sounds as if it shouldn't be a big deal...Thanks!

Deanna I'll be thinking about you on the 22nd. I hope everything goes without a hitch. Hope your back and feeling better soon after.

Thanks Kelstev, For the well wishes and the info with MTX, I hope it's the same here. It should be.

EODtech. /:O)  We can't live in fuzzy bunny land all the time. right?....It's alright..

Situation Normal.....I guess..

You are wise to get this important information to your surgeon and your Rheumatologist, be prepared. Please read RA & Surgery that I posted on the 9th. Although my surgeon knew about my medication (methotrexate) and because I had a valve repaired in my heart they didn't want me to take it until my chest healed.....I suffered and could have used some help (prednisone). I took pain meds like crazy (Ultram and Oxycoden), but I really needed my RA medication.  I'm just now feeling better with 15 mgs. of Prednisone. Remicade 2/2/07,

and methotrexate (worked the best). I don't ever want to go through 2 months like that again. Good luck, hurts

I had my carpal tunnel surgery post ra and had to be off my mtx and humira for a couple of weeks..had no problems with doing that but rheumy was prepared to give me dose pack of prednisone if i needed it. It healed well and I didn't even need any therapy after so there are good results to be had...hope you are one of them

ginger

I just had the second of 2 arthroscopic knee surgeries...the first one back in sept and then the second one on the 1st of this month. I stopped my MTX 2 doses before surgery b/c I take it on mondays and my surgery was on thurs. Both times I had a decrease in the overall activity that i could tolerate in a day but it wasnt like a sudden bang...just a gradual decrease in the tolerance over the course of days. The two differences were that back in sept I was on Humira and I had to stop that too..and then after surgery I wasnt going back on Humira so I had to wait for about 3 weeks post op to start back on a biologic. This time I have been on Remicade and I purposely scheduled the surgery exactly right in the middle of infusions so my infusion schedule was not interrupted. The other difference was that in sept I was not on pred and this time I had had some steroids, because of steroid injections in my neck. They administered steroids during surgery because of that and I think it helped to control some of the post op swelling.

All in all I can say that having RA certainly doesnt make it any easier..not so much because of the medication issue pre-op, but because that post op you are putting so much extra work on your good limb. That extra strain makes it difficult and you just cant do as much as you like...but, such is life with RA anyways.

Good luck..youll get through it. Just try to have things done as much as you can before your surgery so you can just take it easy when you get home. If it took you a week to recover from the first surgery of this kind before RA, plan on twice that time this time around.

Oh yeah..I wanted to add that both times..especially this last time I worked really hard to not take any narcotic pain pills for about 10 days before surgery. I did have to break down 2 or 3 times and take something..but my theory was that I didnt want to load up on them because after surgery I wanted to be sure that they worked and well. I generally take tylenol 4, but post op I go for darvocet. It works well but when I ran out the first time I didnt refill since I wasnt having surgical pain. They worked just as well the second time around too. I could take pain pills all day everyday, but I dont becuase I know I have a long long road to travel and not a lot of options for pain relief. I am trying to prolong building a tolerance for as long as I can.