Approved meds for orthopedic surgery in Ibd patient

[Optimistic]

My son is having an orthopedic surgery for a sports injury. Surgeon knows he has Crohn's and I have call in to GI for guidance.

Any knowiedge about how they will handle painkillers, antibiotics, etc? Any advice?

 

[Maya142]

My daughter has bad arthritis and is allowed to be on pain medications for the pain. They cause constipation, she's feels pretty foggy and out of it, but no other issues. We give her Miralax for the constipation.

She was also allowed pain meds when she got her wisdom teeth out. She was not given antibiotics for those, as far as I can remember (I could be wrong though!). She also recently had a GJ tube placed and was given IV pain meds and then oral pain meds without any issues.

She was taken off MTX/Humira for her wisdom teeth surgery but for her G tube placement was not told to get off anything.

I can't remember what your son is on but I'm guessing he's the one who is doing well on diet? So hopefully no med issues.

Overall we've had LOTS of experience with pain meds and no real issues. When she's been admitted for GI issues, they give her Nubain, which is an IV opioid that has fewer gut side effects. It's not as strong as Oxycodone/Vicodin/Morphine, as far as I know, so they may not want to give that for a surgery.

I hope the surgery goes well - good luck!

 

[Clash]

C has only had resection surgery. He had to come off Remicade and had the surgery with a pain pump. He was given oral pain meds to go home with, they were really strong though I can't remember which they were now. He only took 2 half pills at bedtime during the first week though.

Maya142, it looks like C will be having wisdom teeth surgery in January. How long before did M have to come off humira and mtx? And then how long after did she start back?

 

[Maya142]

Just a few weeks - but her pediatric rheumatologist was being VERY conservative. Every other doctor we saw thought she did not need to come off them for a minor surgery. And I know several JIA/JSpA kiddos who have had their wisdom teeth out without being taken off their biologics.

That said, my older daughter was also made to come off Humira and MTX. Both girls healed beautifully.

3 weeks for both girls (I think). And 2 weeks for NSAIDs.

 

[Optimistic]

I'm sorry that you are so knowledgeable but I do appreciate you sharing!

Now he takes just Omeprazole. He has taken oxy successfully and honestly who knows what else when he has been hospitalized. I just feel like we finally got him to a decent place and fear doing anything to possibly upset that delicate house of cards we've built here... ive been thinking about what could have triggered his first flare and what could trigger the next. I know, Crohn's isn't logical!

He is stressed about exams and told me his stomach hurts so I'm on high alert. I need to learn to chill.

 

[Maya142]

He is stressed about exams and told me his stomach hurts so I'm on high alert. I need to learn to chill.

^Spoken like a true IBD Mom !

I was terrified my girls would flare with even their wisdom teeth! They did, but probably because they were taken off their meds. When M had the GJ tube placed (which was definitely the more painful surgery), she was allowed to stay on Simponi and did not flare.

Unfortunately, there's not much you can do but hope...we'll be thinking of your boy. I would definitely ask about antibiotics since they're known to trigger a flare (but of course, you don't want him to get an infection either).

One more tip for the pain meds - if Miralax doesn't work, then Milk of Magnesia might.

And Clash - wasn't your son on Dilaudid? It's stronger than Morphine - they gave it to M after her GJ tube placement and she almost fainted when trying to stand - it was too strong for her. When my girls got their wisdom teeth out, one was given Tylenol with codeine and the other Vicodin.

 

[Clash]

Yes dilaudid! That was it! I knew it wasn't oxycodeine or whatever it's called but I couldn't think of what it was!

 

[Tesscorm]

I always worry that any change will alter the good place S is in as well! But, while he hasn't had surgery, so far (touch wood, etc.! , any illness/injury has not affected his crohns. I hope all goes well!! When will he be having his surgery?

But, FWIW, S has had antibiotics a number of times in the last few years and it has never been an issue.

Re wisdom teeth, S did not change his remi schedule when he had his wisdom teeth pulled. However, I do remember that we were advised (GI and/or dentist??) to schedule it mid-cycle. Can't remember if he was given antibiotics.

 

[Sascot]

I am the same. Pain killers don't tend to cause any issues, it's the antibiotics that make me paranoid! My son had an infected toe that needed antibiotics and minor op and thankfully nothing bad happened. It took a little longer to heal but is fine. Good luck for the surgery!

 

[Catherine]

I would get antibiotics for wisdom teeth.

Because the removal of wisdom teeth can allow normal occurring bacteria in the mouth to enter the blood stream.

A friend of our on humira had dental work without antibiotics. He developed new back pain. The bacteria travel from his mouth to his back by the time the caught the infection it had began to eat the bones in his lower back.

End result back surgery, 2 week in UCI, 4 week in hospital and 12 weeks of work.

 

[Optimistic]

Thank you all for the feedback.

Knee surgery is next week and shouldn't be a big deal in a "regular" patient and hopefully not an IBD one either.

I dare not say it, but either he has caught the virus his siblings had over weekend and his is much worse ...or....I hate Crohns. Anybody with me on this?

 

[Maya142]

My girl is sick with a virus and is feeling awful too. It's just going around .

Sending HUGS - hope the surgery goes well.

 

[Tesscorm]

Yep, here too. S was sick last couple weeks - stomach bug, vomiting, nausea... took a few days to really feel better... overlapped (same bug??) to a bit of a chest cold, which took a few more days. But, all better now. Hopefully, it'll be short lived and he'll feel better in a couple of days.

 

[Optimistic]

Ty for the support. He is doing much better now and even took exams. I need to learn not to freak out. This is the first real gastro virus he has had since dignosis and I just wasn't equipped to handle it! When he had told me he felt sick before and then said it was his throat or headache I wanted to shout for joy!!! This time I was sure it was a flare and was already planning coverage for others kids if he went to hospital. I know. I assume I'll get better. But I did feel relief when I heard about a kid getting sick in parking lot at school. Sorry, whoever that poor girl is, I hope she is better! To me it just meant maybe this was going to be ok. I was outside bathroom door asking in what quadrants he felt pain.

Do you think crohns patients have more GI illnesses?

Maya and Tess - I hope your children recover quickly. For the obvious reasons, we want them to have good health and enjoy the holiday, but also because moms can't handle this stress!!

 

[Maya142]

Fwiw, my daughter is rarely sick with "regular kid stuff" - with GI illnesses or colds. She's always been like that - even through elementary school when the other kids were sick all the time!

She is still sick but getting better quickly.

Sending hugs - the first day she was sick, I was worrying about having to take her to the hospital too!

 

[crohnsinct]

Can I be in your club? Watching my younger one and logging like a hawk. :ylol:

 

[Mehita]

Three more days of germy friends and school, then I can lock them up in my sanitized house for two weeks. There is so much going around...

 

[Sascot]

I don't think my son gets any more viruses than anyone else. Even in the house he still manages to not catch anything sometimes. However I do run around disinfecting everything from light switches to remote controls!

 

[Tesscorm]

We've all been where you are... where that rollercoaster ride starts as soon as you hear of the slightest symptom! But, once he's gotten sick a few times and recovered like everyone else, you start to relax a bit. I don't think the question 'Is it a flare?!' will ever completely leave your mind but, it becomes much easier to watch and wait a bit before true panic sets in!! utahere:

Until this year, I don't think S has gotten sick more often than anyone else. A few months after starting remicade, one of his roommates contracted mono and had to leave school! S was fine... He's been around lots of sick friends while at school (and, there is NO ONE there to disinfect! :lol and he's been good. And, if he did get sick, he recovered as normally and quickly as anyone else. (It's only been this year that he seems to have had a number of issues??? Not sure why??).

Glad your son is already feeling better!!

 

[Optimistic]

He had knee surgery and is doing well.

The only blip was that his file must have been marked as crohns In huge bold letters. While I am glad they were mindful it just highlighted for me that regardless of how well he may be doing now this is a lifelong thing that doesn't go away! Good reminder.

Merry Christmas.

 

[my little penguin]

Glad the surgery went well
Crohns is a notable code
Meaning it always shows up on the paperwork no matter what is being done

 

[pdx]

Thanks for the update! Hope his recovery continues to go well.

 

[Maya142]

Glad it went well! How's he feeling?

 

[CarolinAlaska]

At least with some serious diagnoses on the chart, if I take J to the hospital, they take her symptoms seriously. I do appreciate that.

 

[Tesscorm]

I missed your update. Glad surgery went well. Hope the recovery is going well!

S has hurt his shoulder again (seems like it's getting hurt every two to three weeks recently), I'm starting to think he will end up needing to have surgery.

How has your son handled the pain since surgery?

 

[pdx]

Optimistic--is your son completely recovered from his surgery? How did he do with the antibiotics and pain meds?

 

[Optimistic]

Sorry, I think I had turned off notifications.

Tess, I am sorry that S is having a shoulder problem. Is it better? Teen boys and their injuries...

PDX and Maya, surgery recovery went very well. He did have oxy for a few days and then actual took some advil for a week which made me panic. He did start to have an upset stomach a few times a day and lost about ten pounds. The good news is that he has gained it back and slowly the stomach returned to normal (well whatever normal is for a Crohn's patient).

And yes MLP and Carol it must be all over his files. Even when he went for PT the therapist said Oh, you have Crohn's!

He does have occasional pains in some joints that I am hoping is just him growing or being rough on them. It isnt really one area enough to do anything about but more of an overall thing. Is that how it starts?

 

[Maya142]

Just watch the pain in his joints - signs of inflammatory arthritis are morning stiffness and pain that gets better with activity. For example, sitting through class or a movie is very hard for my daughter.

Pain that moves from joint to joint is common in juvenile spondyloarthritis - that is one of the reasons it is difficult to diagnose. Joints that are often involved include the hips, knees, ankles and feet (including the heels). Lower back or SI joint pain is also common. However, really any joint can be involved.

Just watch...I hope it's just him being a teenage boy. Glad his recovery went well and that he gained all that weight back!