RA and open RNY

Hi all~ I see not too many people post here regularly but hopefully someone can give me their experience. I am about to have an open rny, in June. My rhuematologist and pcp have agreed that the surgery is OK for me. My rhuemmy did send specific instructions to the surgeon since I have been on prednisone for a portion of the last 12 months...I'm off now though. I currently take Enbrel and that's it. I had a bleeding ulcer with anaprox so I stopped taking that type of drug (motrin, vioxx, etc.) years ago. I was wondering if anyone else had the same cir****tance as me - ra with open rny. E-mail me if you do. Thanks Sandra

Sandra - I am hoping to clear the insurance hurdles sometime by the end of this year 2005 and I too have RA, taking injectible Methotrexate and other immunosuppressive and NSAID drugs. My RA doc and an infectious disease doctor say that switching to the "biologicals" like Enbrel, Remicaid, Humira, is the right thing to do. I only take Prednisone when a flare-up hits......but both say that AFTER surgery, we might need and really require steroids to help the body cope with the trauma. Both say we'll wait till AFTER the surgery to determine that....be sure that you have preop labs for the RA, just to have a baseline. Check your RA and CRP levels for sure, and get a sed rate done. The surgeon's concern was for compromised healing, and I've tried to cut back or get off the arthritis meds because the surgeon's NURSE said to do that. I consulted with the rheummy and he agreed to try, and I had a terrible crisis. The rheumatologist has now said NOT to try to modify the meds until just at surgery, and he will call the surgeon and discuss directly the course needed. Lots of people have major surgery with arthritis drugs and do just fine, we just have to be more vigilant. I also take pain medicine regularly, and this is VERY important to tell the anesthesiologist, since we may require extra pain meds not because of the surgery but because of the RA. Things may hurt a lot because of the underlying disease, but it can be coped with effectively. Best wishes for your "event", and hope this info helps.