Pre Surgery Requirements for RA Patients

[ChellNC 162]

Right now I'm waiting for insurance approval and boy is it driving me nuts! I'm so ready for my surgery date!!!

Since I have Rheumatoid Arthritis my date has to be a month after approval so I can come off my RA meds for a month before the procedure. Anyone else have to deal with this? I'll also have to be off of them for a month after surgery. In the long run, I know it will be worth it but I'm wondering what I'm facing being off those meds for 2 months.

[DaleCruse 756]

I'm curious why you'd have to be off those meds. Were you told why?

Regardless, good luck to you. You are not alone.

[ChellNC 162]

Thanks. The meds target and prevent inflammation. Since inflammation is part of the healing process the meds would slow down healing and potentially cause issues.

[Frustr8 7,886]

Thank you Chell for the info , I too have RA although it is dormant, haven't had a flare in a while. Now I'm concerned whether surgery could cause a flare? Already on pins and needles because it is supposed to be this month and they haven't given me a firm date. Maybe I need a turban so i,can lay on my bed of nails better!!😪

[ChellNC 162]

You're welcome. Hopefully it won't cause a flare for you. I'm anxiously awaiting my date too.

[Mhy12784 423]

Weird your surgeon would make you wait for approval before setting a date.

I had my surgery date set like 4 months in advanced, and got my approval a week or 2 before

Also some RA drugs make you more prone to infection and others make you bleed more which is why they wouldn't want you taking them within a certain amount of time before surgery

[ChellNC 162]

Thanks. That's how the program here works. All patients using insurance have to have approval by insurance before they schedule sx.

I'm completely on board with his decision around holding my meds & understand why. I'm looking for others who have done the same and want to see what they experienced. Hopefully my RA is well enough under control right now that I won't have a flare during those 2 months.

[Mhy12784 423]

I have to ask, why is it you are getting a bypass if you have RA?

I have arthritis (not RA) and this was a discussion that came up between me and my physician.

Our conclusion was that having a bypass would limit my treatment options for arthritis.

I'm not criticizing or anything of the like, just trying to understand the thought process here

Edited July 8, 2018 by Mhy12784

[Frustr8 7,886]

I can't answer for Chell but I can tell you mine. My GERD is much worse right now than the arthritis, ole Art and I have been lifemates since age 25, that's nearly 48 years of his crippling dirty tricks on my joints. NSAIDS and I parted company when they, instead of h. pylori, gave me Hector my,itty bitty gastric ulcer and gastritis. I am already on Dexilant which my gastroenterologist calls the Ferrari of PPI because it runs over $350 per month, praises be I do have insurance. that covers all but $3.60.
Plus the fact you lose faster and to a deeper extent than with a sleeve or band. I don't have ,at 72, time to fiddle aro7nd with maybe it will work and maybe it won't and hope for a future surgery to fix me better. I will cut to the chase, have one surgery🏣 and have it be the Gold Standard at that. My surgeon 😷pioneered laprascopic gastric bypass in this section of Ohio so I think he qualifies as Gold Standard also. All that eludes me at this time is my definate date in Columbus and that should be coming soon. And you are cordially invited to share my joy when. it does occur!😛

[Mhy12784 423]

5 minutes ago, Frustr8 said:

I can't answer for Chell but I can tell you mine. My GERD is much worse right now than the arthritis, ole Art and I have been lifemates since age 25, that's nearly 48 years of his crippling dirty tricks on my joints. NSAIDS and I parted company when they, instead of h. pylori, gave me Hector my,itty bitty gastric ulcer and gastritis. I am already on Dexilant which my gastroenterologist calls the Ferrari of PPI because it runs over $350 per month, praises be I do have insurance. that covers all but $3.60.
Plus the fact you lose faster and to a deeper extent than with a sleeve or band. I don't have ,at 72, time to fiddle aro7nd with maybe it will work and maybe it won't and hope for a future surgery to fix me better. I will cut to the chase, have one surgery🏣 and have it be the Gold Standard at that. My surgeon 😷pioneered laprascopic gastric bypass in this section of Ohio so I think he qualifies as Gold Standard also. All that eludes me at this time is my definate date in Columbus and that should be coming soon. And you are cordially invited to share my joy when. it does occur!😛

That's a fair point, but assuming you have a bypass at 72 it's not like you have to worry about the arthritis getting worse for the next 50 years.

If you were in your 20s and 30s that could be 50 years of undertreated arthritis where you can't have nsaids and limited steroids, which could have a huge difference on quality of life. Especially something like RA where you should be aggressive early on

It's a difficult situation and I don't think there is a clear cut answer

[ChellNC 162]

My story to decide to do sx isn't the normal one. I was referred to a surgeon because of my severe reflux. He was the one who suggested bypass instead of the other options. First thing he told me was that I was a complicated case due to my RA, OA and other issues. He said we'd have to coordinate everything with my other doctors, especially my Rheumatologist. During visits with my family dr & Rheumy we discussed their thoughts on proceeding with this procedure and they were both on board. We've discussed what treatment will look like for me in the long run and feel like this is the best plan for me. My main RA meds are injections so we don't think they'll be a big issue down the road. If I need short term steroids those can also be given by injection.

In addition to discussing with each of my providers I've done a lot of research and feel like this is the right path for me.

[Plucky 24]

I'm on methotrexate and Actemra. My Rheumatologist wants me off of them a full 7 days before the surgery, and another 7 days afterward, provided that I am healing well.

[Plucky 24]

On 7/8/2018 at 3:16 PM, Mhy12784 said:

I have to ask, why is it you are getting a bypass if you have RA?

I have arthritis (not RA) and this was a discussion that came up between me and my physician.

Our conclusion was that having a bypass would limit my treatment options for arthritis.

I'm not criticizing or anything of the like, just trying to understand the thought process here

I'm having the Gastric Sleeve but it is my Rheumatologist who recommended the surgery. I'm allergic to NSAIDs, so Prednisone is my only "painkiller," but the side effects are awful so I'm not taking them any longer. I take a DMARD and a biologic but still my RA hovers between low severe and high moderate. He's had a few patients that have gone into remission, or at the very least able to control the RA. I don't see it as any other choice at this point, I want my life back

[ChellNC 162]

Plucky I've decided I have a love/hate relationship with Prednisone. I love the improvements but hate the side effects. I'm hoping we all see improvements in our RA after surgery.

[Plucky 24]

1 minute ago, ChellNC said:

Plucky I've decided I have a love/hate relationship with Prednisone. I love the improvements but hate the side effects. I'm hoping we all see improvements in our RA after surgery.

Prednisone sometimes kept me going, but long term it was horrible. I hope your surgery gives you relief, this disease just stinks!