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Delayed Remicade Infusion - How Do I Not Flare?

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Posted 11/6/2013 4:10 AM (GMT 0)
I am getting a tonsillectomy next week. I was scheduled for a remicade infusion the following week. Now we are delaying that infusion by 2.5 weeks. The last time I delayed Remicade by a week I began to see blood and have bad urgency. Any suggestions for help?
Posted 11/6/2013 5:06 AM (GMT 0)
Are they worried that your immune system will go too low if you have the infusion first? They gave my girl one before her appendectomy, granted not by choice. They could even give you a slightly lower dose of Remi. If you go longer than12 weeks, all Remi will be completely gone- maybe as soon as 8 weeks.
I'd start rectal meds pretty quick, probably steroid based if they are going to withhold it.
Posted 11/6/2013 8:16 AM (GMT 0)
I would never delay a remicade infusion. My nurse used to say it's better you get the infusion earlier than later. So maybe you can get your infusion this week and you should be fine for your tonsillectomy. I would not risk a flare over this. Also the risk of developing antibodies against remicade is definitely not worth it.

I hope everything goes well for you.
Posted 11/6/2013 1:54 PM (GMT 0)
I second getting the infusion prior to surgery- have you actually spoken with your GI? And they recommend delaying it? The risk of infection is not that high- by the time you're able to really eat solild food, things will be pretty well healed. I had my tonsils out at 26, & was not able to eat much of anything for quite a while. Plus, you will be on antibiotics post-surgery. I'd be very surprised if your GI and/or PCP, & the ENT docs also, recommend delaying Remicade.
Posted 11/6/2013 2:07 PM (GMT 0)
The ENT said that we would do what the GI doctor wants. The GI doctor is saying I should have surgery four weeks before or after an infusion. PCP doesn't know much about it I don't think, didn't really ask him yesterday.
Posted 11/6/2013 3:11 PM (GMT 0)
I agree, if you could get the infusion this week and then do the surgery in ~3 weeks, that is probably best... I don't think anyone is going to be able to suggest a "trick" to avoid flaring despite delaying your Remicade, if anyone knew that then we wouldn't really need Remicade.
Posted 11/6/2013 4:07 PM (GMT 0)
If you have the Remi prior to your surgery and if you're worried about infection, perhaps asked to be placed on a gut friendly antibiotic during your recovery. I can't recall if I was on antibiotics when I had my tonsilectomy/adnoidectomy but I am thinking I wasn't. I wasn't on Remi either.

However, I was placed on an antibiotic following my foot surgery because of the Remi. I had to discontinue it because it was causing me gut issues but I still recovered fine.
Posted 11/6/2013 5:16 PM (GMT 0)
No way to move the surgery to a different date?
Posted 11/7/2013 2:23 AM (GMT 0)
I had my Remicade infusion the week prior to my bowel resection surgery. In the past I had issues where I would flare a bit when I was a couple weeks out for my next infusion and my doc would "bridge the gap" with a low dose of prednisone. Prednisone works very well for me and that held me over till my infusion then got off it quickly.
Posted 11/7/2013 3:24 AM (GMT 0)
Thanks all. After even more stresses coming my way next week I decided to wait and try to work things out for mid-December for the surgery. I was getting scared about flaring and reworked all my scheduling out today.
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