I have rheumatoid arthritis and am taking enbrel. Even with the enbrel, my c reactives and other immune response markers are very high. Without the enbrel, every joint in my body swells, gets hot, has extreme pain and locks up to a point where I cannot get out of bed, get dressed or go to the bathroom without help. It took 3 months for the enbrel to work for me. Now, my gallbladder needs to be removed. They tell me that I must get off the enbrel a week before the surgery and cannot restart it until another week after the surgery. They tell me the reason for getting off the enbrel is to prevent infection, but they offer to let me take prednisone (which gives me bad effects like very easy bleeding). I question this because I say the prednisone will not be any better than the enbrel regarding infection... I am so afraid of the pain of being off enbrel that I am tempted just to keep my gallbladder..the pain of my gallbladder is much less than the pain of the arthritis without enbrel and I can't see becoming a total invalid for 3 months. As far as I can find, the manufacturer does not recommend getting off the enbrel for surgery. I would think that since my immune system is on overdrive even with the enbrel (I don't catch anything) I do not need to get off the enbrel. I also worry about suddenly increasing my c reactive proteins because of my heart. I read that it can cause heart attacks and my family history is awful. Anyway, do you have any wisdom on this?
TNF inhibitors such as Enbrel appear to increase the risk of postoperative infections, therefore, they should be discontinued early enough before surgery to permit their elimination from the body and not resumed until at least 2 weeks after surgery. In order to compensate for stopping Enbrel, many patients are giving the option of taking prednisone. Please address these concerns with your surgeon and rheumatologist.
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