Needing support and experience (other surgery and medications, infection, etc.)...

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Veteran Member

Date Joined Jun 2008
Total Posts : 2865
   Posted 3/3/2009 5:57 PM (GMT -6)   
I don't expect anyone to really KNOW the answers - even my doctors don't.  But - I went to ortho knee replacement surgeon today.  He has no problem with surgery to replace my knee (ultimately both) taking prednisone BUT he was not sure about the 6 MP or other immune suppressant.  I started 6MP three days ago at 50 mg.   I have appointment with gastro doc March 16.  Surgeon would like letter to tell him I am on the 6MP, dose and what for with status of the UC.  He impressed upon me the "risk" of infection and "catching anything like viruses, etc. which I am aware of.  Of course, no one really know MY risk as it has not been tested.  I do know that normally I rarely have an infection or have to take antibiotics, etc.  I get maybe one or two colds a year.  Knee surgeon says both my knees are really getting worse and it will be harder surgery and rehab, etc. the longer I have to wait.  I walk with a cane or walker most of the time. I am extremely knock kneed from this!
Probably if my gastro doc says he thinks it will be ok - I will go for it - with every precaution they can give me.  It is a small hospital and very experience ortho group, etc.  Seeing surgeon March 23 for a decision.
Guess I have a lot to thnk about.
By the way, my gastro doc has never said anything about blood tests or anything in conjunction with prednisone or 6MP.  Hmmmmm?
Senior - New diagnosed with proctosigmoiditis - 6/2008
Tried all mesalamines and enemas, Canasa, etc.  Colonoscopy 10/28 showed only few cm. left to heal -hydrocortisone enemas 12 days - much worse. Cannot tolerate mesalamine!
2/3/2009 - sigmoidoscopy showed about 30 cm. involved but mild - starting on prednisone only 40 mg. taper on 2/7/2009.
 Feb. 21 - down to 20 mg. - no blood, no pain, no bad side effects so far. Starting 6-MP Feb. 28 along with 20 mg. prednisone.
Probiotic Align, Prilosec for GERD

Elite Member

Date Joined Mar 2003
Total Posts : 10407
   Posted 3/3/2009 6:30 PM (GMT -6)   
Elaine, I never had surgery while on immunosuppressants, but I have had two shoulder surgeries while on Remicade. My ortho doctor covered me with IV antibiotics - Ancef, I think - to help prevent infection. Ask your doctors about this.

Moderate to severe left-sided UC (21 cm) diagnosed 2001.
Avascular necrosis in both shoulders is my "forever" gift from Entocort.
Colazal,  Remicade, Nature's Way Primadophilus Reuteri. In remission since April, 2006.
"My life is an ongoing medical adventure"
Co-Moderator UC Forum
Please remember to consult your health care provider when making health-related decisions.

Mamas Boys
Veteran Member

Date Joined Oct 2005
Total Posts : 1460
   Posted 3/3/2009 9:09 PM (GMT -6)   
Don't know what to tell you. Never had surgery.  However - sounds like your surgeon is being ultra-careful with you and that is comforting.  Ask your GI how he feels about the 6mp and surgery and do some online research - see what you come up with.  As for the blood tests - never took them on pred - but since on AZA - at the beginning took them once a week - then once every other week - and now once a month.  Been doing this for about 3 years now.  The PA said I could really start going once in 3 months but the GI prefers that I go once a month so he can monitor my meds.

Mamas Boys
Colazal, Azathioprine, Remicade
Culturelle, MultiVitamin, Folic Acid, Viactiv
Status: Remission!!

Elite Member

Date Joined Apr 2004
Total Posts : 23551
   Posted 3/4/2009 8:26 AM (GMT -6)   
The only thing I can think of that might interfer with your surgery while on 6mp is if your WBC dropped too low. That is why anyone who is on an immune suppressing drug should have frequent blood testing. If your WBC stays within the normal range, then I don't see how healing would be an issue. The same for infections. My WBC is within the normal range and only once did it get on the low side - but it quickly went back up. I have had some minor surgeries - 2 wisdom teeth removed, Endometrial ablation (well this wasn't exactly minor - more moderate lol), D&C, cyst removals and just recently had a punch biopsy (still with 3 stitches) and ingrown toenail removed twice. I have actually healed rather fast with no infections. But it's always good to persue both sides before having any sort of surgery - both from the GI and from the Ortho. It's good to be informed.
Moderator for Allergies/Asthma and Co-moderator for UC
~Left sided Uc-'92-Colazal(9 daily),6mp(50-100mgs),Bentyl, Prilosec,Biotin,Forvia,Pro-Bio**Unable to tolerate Asacol, Rowasa or Canasa**~Year-round allergies-Singulair, Zyrtec~Secondary Reynauds Syndrome-'04-Norvasc~Sacroiliitis-epidural injections~bulging and herniated discs C5/C6 & C6/C7~3 epidural injections-second series starts 2/17, OA in my fingers -Celebrex, Tylonel Arthritis and Voltaren Gel
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