Methotrexate and surgery

Posted , 5 users are following.

Hi all:

I wanted to pass on an experience and ask if anyone else had the same experience.

I had oral surgery a year and a half ago. My rheumatologist told me to stop taking MTX and mobic two weeks before the surgery to allow my immune system to work better and to control bleeding. Then when the surgery was done, the periodontist told me not to take the MTX for another two weeks in case a postoperative infection took hold.

 

Anyway, I was apprehensive about not having my MTX for a whole month. But I was surprised to note that I did not notice the lack of MTX. I still felt fine. I told the rheumatologist and he said I had enough in my body to carry me over. At least I gave my liver a vacation!

Has anyone else had a similar experience? I do not think that the average patient has any idea that this has to be done before surgery and they might not think to ask their rheumatologist.

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21 Replies

  • Posted

    I have had various surgery over the last few years and have always stopped the MTX like you. It does build up in your system so you won't notice much difference if any. But its best to keep it topped up rather than stopping and starting so my advice is don't interrupt it unless for a good reason.

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  • Posted

    I have had both hips replaced, applied a little common sense, and decided I would not take my MTX a few days before surgery, and again in the hospital, refused when the nurses offered me the MTX., two days after surgery.

    From surgeons reaction in the operating theatre - thank goodness you didn't take your MTX, I found myself doing a double take when they mentioned, as they had said nothing previous.

    It seems there is a opinion that not taking it is a good idea in the same week as surgery, and then giving yourself a break even after surgery if you can tolerate the changes without it.

    They all seem to get a little nervous around you when you mention you are on MTX, apparently you are cyto toxic, and need to be treated differently to other patients, here in Australia, you are dressed in bright purple, and all you sheets, urine are treated as dangerous, even nurses use different gloves when dealing with you, a little disconcerting, and other patients in the same room wondering if you have something they can catch, they notice the difference, very unattractive colour.

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    • Posted

      Never had the same treatment before, maybe I had a paranoid team leader on the nursing staff when I was back on the wards.

      I was well enough and able to explain to the others on my shared ward what was going on, and why, that laid any fears to rest.

      Also had a bladder infection after i was sent home, went back to ER, and again was treated like a lepper, purple gloves and aprons all round. GRRRR.

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    • Posted

      I've met one or two doctors who should not have been doctors simply due to a lack of empathy for their patients. We have to remember who is hiring who. Hang in ther, lyn.

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  • Posted

    The doctor giving you surgery should enquire about what drugs you take and what your other issues are. That is standard routine. He is the one who should be advising you about MTX in consultation with your rheumatologist, if necessary.

    MTX usually takes between 3 to 6 weeks to kick in, so it makes sense that if you've been taking it for a while, you many not feel a return of symptons while being off it for 4 weeks.

    He was right to stop the MTX during and after surgery.

    Glad all is well!

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  • Posted

    If you're on fish oil you should also stop that,   Not just for ops but also for steroid injections.

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    • Posted

      I get it at any large drug store. Sometimes they have a 2-fer, buy one get one free. Comes in a red box. I don't think I am allowed to say the Mega Red brand name. No fish breath.

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    • Posted

      I have been looking into this and apparently there is actually mimsicule amounts of fish oil in the capsules we take. In fact if you ate a medium portion of salmon you would get much more fish oil. So basically I think that stopping fish oil, even if it was detrimental to surgery recover, is negligible.
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    • Posted

      For both hip repleacements, hospital chemists in pre-surgery checks, said to me you must stop taking your fish oil a week before surgery, but never mentioned adjusting the MTX, which I found very strange as well. They even gave me a hand written letter saying STOP and then listed what I must stop taking, and when, and also mentioned no aspirin prior to surgery for pain, I wasn't on aspirin, I was on morphine patches by that stage.

      I assume the fish oil withdrawl is because as I understand it Fish Oil makes your blood thinner, and thats the last thing they need during surgery, is more bleeding.

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    • Posted

      From what I remember, krill oil can cause bleeding. But I have never had a doctor tell me to stop fish oil for surgery. The things they told me to stop were 81 mg aspirin, mobic, and methotrexate.
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    • Posted

      And no fish for lunch or dinner for how long prior to surgery? I have had numerous major surgeries over the last few years and been taking fish oil throughout. I think I would have heard of this by now. The Royal Marsden is a famous cancer hospital in London and they don't advocate this theory. I am still here as well so my fish oil intake has not hurt me. If you took a cup of fish oil pre surgery it might be a problem but even then only might. Google it folks.

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