Surgery

By sweetannie

1 min read

I have an important question about surgery and RA. I will share my story later, but this is important. I take Humira. How do people with RA fair with healing after surgery on shoulders, neck and hips? Does anyone know how long you must stay off the Humira before surgery and after surgery, when you can start Humira again. Thanks so much. Claudia

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Michael Booth Moderator
Hi Sweetannie, thank you for posting. I am sorry to hear you are having to deal with this. I too am on Humira and am being considered for a possible elbow surgery. I can't answer all of your questions, as I have not been through the process, but I can answer a few. It is important to keep in mind that we cannot offer medical advice, but can share information and personal experience. We encourage you to make any decisions based off of information provided by your doctor. From my understanding, there is not a clinical consensus on when/if to stop Humira before surgery. The doctor is weighing two risks, that of a significant flare happening during the window of surgery, and the risk of infection. This is something that your doctor will know best. From discussing my potential surgery with my own doctor and some online research, a general guideline is stopping two weeks before surgery, and beginning again after any stitches or staples have been removed, and you have been cleared of any risk of infection. These articles are from reputable sources and might give you some information there: <a href='http://www.arthritis.org/living-with-arthritis/treatments/medication/drug-types/biologics/precautions-biologics.php' target='_blank' rel='noopener noreferrer ugc'>http://www.arthritis.org/living-with-arthritis/treatments/medication/drug-types/biologics/precautions-biologics.php</a> <a href='http://www.hopkinsarthritis.org/ask-the-expert/humira-and-surgery/' target='_blank' rel='noopener noreferrer ugc'>http://www.hopkinsarthritis.org/ask-the-expert/humira-and-surgery/</a> I have not had a surgery yet since being diagnosed with RA, so I am not sure how the healing process goes. Perhaps someone with first hand experience can chime in here. Thank you again, and best wishes for healing and recovery. —Michael (rheumatoidarthritis.net team member)
1. sweetannie Member
 Thank you so much.
Carla Kienast Member
Hi Sweetannie: Unfortunately I've had a lot of surgery (including three joint replacements, two spinal fusions and two rotator cuff surgeries)since my diagnosis and I've been on a number of biologics including Humira. Michael's information is consistent with my experience. My surgeons have invariably wanted me off my RA medications for at least two weeks prior to surgery. Usually there has been a two-week post-surgery checkup at which time the surgeon has generally cleared me to resume my treatment plan. The main thing is that you're healing well and there is no sign of infection. One thing that my rheumatologist has recommended for me and which my surgeons have approved is to go on a low dose of prednisone (5 mg or so) while I've been off the main treatment plan. This helps control inflammation and flares and, interestingly, can promote healing. This is something you need to discuss with both your rheumatologist and your surgeon. Good luck with your surgery and thanks for posting your question. I'm sure this is one that a lot of people face.
1. sweetannie Member
 Thank you so much.
mapski Member
Hi Claudia: I inject Orencia once a week, a biologic, as is Humira. I had a total hip replacement on 12/21/15 & am currently recuperating from the second one, 6/17/16! In both cases I stopped the Orencia two weeks before surgery and resumed two weeks after. I also was released from the hospital w/a script Sephalexin 500 mg capsules, 1 capsule four times a day for seven days. After the December surgery, I returned to work as a teacher in 6 weeks, this June surgery was not as painful going into, but is taking longer to heal. I feel great and wish you well! MaryAnn
1. sweetannie Member
 Thank you.
Richard Faust Community Admin
Sorry to hear you need surgery sweetannie, but hopefully it will help in long-run. Here are a couple of articles from the editorial team: This one on questions to ask: <a href='https://rheumatoidarthritis.net/surgery/questions-to-ask-your-doctor-before-surgery/' target='_blank'>https://rheumatoidarthritis.net/surgery/questions-to-ask-your-doctor-before-surgery/</a>. This one tips on preparing for surgery: <a href='https://rheumatoidarthritis.net/surgery/tips-on-preparing-for-ra-surgery/' target='_blank'>https://rheumatoidarthritis.net/surgery/tips-on-preparing-for-ra-surgery/</a>. Keep us posted on how it goes. Best, Richard (RheumatoidArthritis.net Team)

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