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stopping and starting Humira

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Crohn's Disease
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Posted 6/18/2017 3:18 PM (GMT 0)
Heres my situation, I have a really bad underbite and considering getting surgery to correct this (1st I need to get braces)

I was told by maxofacial surgeon that I need to stop any medication that lowers my immune system, but my GI said, I can keep taking Humira because the operating room is a sterile environment, so nothing to worry about (oh boy)

I'm doing really well w/ Humira/6mp and hate to go backwards BUT my underbite is brutal. How dicey is it to go off Humira and go back on it? I was told that if you go off it, your body will develop antibodies and Humira will no longer be effective.
Posted 6/19/2017 12:58 PM (GMT 0)
I don't know the answer but heard the same about the antibodies. I really need to have surgery on my foot and will be asking my GI his thoughts on continuing Humira. If he says I need to take a break from Humira I won't have the surgery. Remission is way to precious to me. I'm curious to see what others have done.
Posted 6/19/2017 7:58 PM (GMT 0)
I'm sure most surgeons would prefer that we're not on any immunosuppressants or steroids at the time of a surgery (lesser odds of an infection and quicker recovery) but it isn't always a realistic proposal. Even if one were to stop humira today, it would take 2-3 months or more to fully clear out of our system during which time we might flare. It is often then that the antibodies start forming while it is clearing from our system, and then when we try to reintroduce the humira it either no longer works or is at least less effective. Their's no guarantee we will flare or develop antibodies when we stop a med, but there is certainly a risk and I'd bet that risk far outweighs the risk of an infection while staying on our meds. The gasteroenteroligist doesn't want your UC to flare, the surgeon doesn't want you to get an infection, and both are only looking out for their side of things and not collaborating (one risk has got to be higher than the other)...
Posted 6/23/2017 1:14 PM (GMT 0)
Yeah, the room might be sterile but the mouth isn't. even if it was sterilized for surgery you still have a major healing time in which it could get infected. as I have mentioned before I have an annoying cross bite that I need two jaw surgeries for. I have put them on hold for now. I am really supposed to have one of the surgeries before braces and one after but considering how my health has been we are going wait on the surgeries.
I am also having hernia surgery. in relation to that, my GI similarly felt that the risk of flaring was far worse than the risk of infection. My surgeon had no issues with doing the surgery with me on remicade it but said it would be better if I could be off of it. Im going through with that one in several months and we shall see how it goes.

how long will you need braces for before the surgery?
make sure you have a really good knowledgeable surgeon to do it. Both my Surgeon and orthodontist have expressed their understanding of being cautious with crohns since they both have family friends and other patients with the disease.
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