Maintenance Therapy after Surgery

[Mel13]

Hi everyone,

I just wanted to know how long after surgery you started maintenance therapy?

I'm almost 3 weeks post operation and my surgeon asked me what my gastroenterologist wants me to do re: maintenance. My Gastro has mentioned previously that she wants me on methotrexate but at no point has she or my surgeon suggested when I should start this.

I see my surgeon in a week but I was curious to know when you wonderful people started your maintenance therapy after the op.

Xxx

 

[DustyKat]

My daughter was diagnosed on the operating table so did not see a GI until 3 months after surgery. IIRC the GP contacted the GI about 3 weeks post op and she was commenced on Imuran then.

My son commenced on Imuran at diagnosis and was operated on 4 months later. He never stopped taking the Imuran.

Dusty. xxx

 

[Mel13]

Hi DustyKat,

Thank you so much for taking the time to reply! I tried Imuran a few years ago but my liver did not like it one bit and started to break down. Needless to say, I had to stop that abruptly!

Have your children ever had any issues with Imuran? Any side effects?

After my reaction to Imuran, I was scared off immunosuppressing drugs. I can't help but think if I'd tried another, I may not have needed the surgery. Ah the beauty of hindsight....!!!

 

[DustyKat]

Hey Mel,

Neither of my children have had problems with Imuran, no side effects.

It may be worth your while having a TPMT test done to see if you the enzyme present help metabolise the thiopurines. Sometimes when you have a reaction to Imuran it doesn't necessarily mean you will have the same response to the other thiopurine, 6mp. Also if your reaction was due to the dosage it may be worth considering looking into adding Allopurinol. Doing so means you reduce the amount of thiopurine drug required to a quarter of the original dose, so 100mg becomes 25mg.

As to hindsight...it is a fair dinkum bitch! :lol:

Dusty. xxx

 

[Jennifer]

It honestly depends on the medication Mel13. I was still taking Prednisone, Asacol and 6MP before surgery and continued taking them after surgery (was weaning off the Prednisone still). That was 13 years ago though so I'm not sure if they let you continue on meds like that anymore. With Prednisone you can't just stop it so you'd have to keep taking it. For things like Remicade I'm told people have to wait at least 4 months after surgery before starting it.

I've never taken Methotrexate but found this little study on it if you want to take a look at it: http://rheumatology.oxfordjournals.org/content/36/9/1009.full.pdf "There was great variation in the timing of stopping the drug with most stopping treatment within 2 weeks before surgery and restarting within 2 weeks after surgery."

 

[Mel13]

Hi Crabby

Thank you so much for sharing the study with me- it was an interesting read. I'm yet to try any immunomodulating drugs so I'm appreciative of any info on these.

I'd like to think that after having this surgery I could be med free but I don't think that's going to happen somehow!

 

[doctor's mom]

My daughter is taking 6mp for about 10 years after her surgery in 2002. Also she tried Remi, but got severe reaction. Some people very successful with LDN, you can look it up in our LDN forum.