Let me tell you about my surgery…

Swerd

Swerd

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#1
I've always privately dreaded it when a friend or acquaintance accosted me to tell me all about his or her surgery. I would politely listen, but also vow to myself that I'll never ever do that :rolleyes:. Now, I get it. It's a big big deal, and they are usually a) exhilarated about the outcome, or b) greatly relieved that a serious medical problem was dealt with – or both. So, let me tell you about my surgery… :cool:

Yesterday, I had cataract surgery on my left eye. So far, one day later, it seems like all went well. I can already see MUCH BETTER than before, and that's with the other eye yet to be fixed until a month or so goes by. These days, cataract surgery is a commonly done procedure. So why am I so happy?

For at least six years, I've suffered from an auto-immune eye inflammation, called idopathic scleritis (that's Greek for a sore owie of the eye of unknown cause). My immune system decided, on its own, to attack my left eye as a foreign invader. My right eye is apparently a regular guy, but look out for that left eye. When the inflammation was going full on, my left eye was bright red like a Christmas tree ornament. (People avoided standing near me on elevators.)

The treatment is similar to that for rheumatoid arthritis – suppress the immune system with drugs like prednisone and methotrexate, on a continuous basis. One of the many unwanted side effects of prednisone is the early development of cataracts. As a result, I've rapidly gotten bad cataracts in the past several years. Most older people do get cataracts, but they develop them very gradually over a decade or two. I was by far the youngest patient in the waiting room yesterday as I waited my turn for surgery.

Because my eye doctors (I have 2 plus the surgeon) were afraid that surgery might activate my suppressed inflammation, I had to start taking high-dose prednisone as a precaution a few days before surgery. Prednisone makes me hyper and sleepless, and I was already a bit anxious about the surgery. Yesterday was surgery, and this morning I went back to the eye surgeon's office for a day +1 check. Everything looks good, no inflammation, and I can already see much better!

So far, I have avoided accosting strangers on the street to tell them my news. But you, dear readers are hardly strangers :).
 
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Out-Of-Phase

Out-Of-Phase

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#3
Bless you, Swerd. I too need to be on Prednisone, but I don't want to take it because of the side effects. I have PMR symptoms that are worse in the morning. All the best to you my friend!
 
everettT

everettT

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Steroids are a huge double edged sword. But if you are relatively healthy, it should be all good.
Glad it all went well, I'm sick of hospitals and outpatient facilities as I've had 4 knee and 2 neck in the last 9 years, and was on the annual colonoscopy plan for 4 years.. thank God that I'm now every 3 years . Sorry you opened the door :)
 
Swerd

Swerd

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Bless you, Swerd. I too need to be on Prednisone, but I don't want to take it because of the side effects. I have PMR symptoms that are worse in the morning. All the best to you my friend!
Does PMR stand for polymyalgia rheumatica? (I had to look that up.) You certainly got my sympathies on using prednisone. It can be tough when the dose is high. What dose do you take? I had to start off taking 80 mg/day, a wild roller coaster ride. (Prednisone – The Breakfast of Champions!) Gradually that dose dropped to 7.5 mg/day. I don't notice that at all.

The good news is that when you take it, prednisone usually works really fast.
 
Swerd

Swerd

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#7
Steroids are a huge double edged sword. But if you are relatively healthy, it should be all good.
Glad it all went well, I'm sick of hospitals and outpatient facilities as I've had 4 knee and 2 neck in the last 9 years, and was on the annual colonoscopy plan for 4 years.. thank God that I'm now every 3 years . Sorry you opened the door :)
Whew! Four knee and two neck surgeries in 9 years, plus annual colonoscopies too!?! And I thought I had it tough. I can get anxious when I hear the word prednisone. You probably react that way whenever you see a Metamucil commercial on TV!
 
everettT

everettT

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#9
Whew! Four knee and two neck surgeries in 9 years, plus annual colonoscopies too!?! And I thought I had it tough. I can get anxious when I hear the word prednisone. You probably react that way whenever you see a Metamucil commercial on TV!
MRIs kill me as I've developed a phobia in the late 90s, they have to valium me out for a closed machine. Good luck brother..
 
Out-Of-Phase

Out-Of-Phase

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#10
Does PMR stand for polymyalgia rheumatica? (I had to look that up.) You certainly got my sympathies on using prednisone. It can be tough when the dose is high. What dose do you take? I had to start off taking 80 mg/day, a wild roller coaster ride. (Prednisone – The Breakfast of Champions!) Gradually that dose dropped to 7.5 mg/day. I don't notice that at all.

The good news is that when you take it, prednisone usually works really fast.
Yes, you are correct. Polymyalgia Rheumatica. It is an immune disorder that attacks the blood vessels and affects the muscles and tissue surrounding the joints. There is no cure or cause, so Prednisone is used to suppress the immune system to relieve the stiffness and pain. No, I wouldn't take 80MG, more like 15MG then you start a tapering process until you are at the lowest level where you feel no PMR symptoms. That drug causes the adrenaline gland to shut down so you have to taper off very, very slowly.
 
Swerd

Swerd

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#11
Yes, you are correct. Polymyalgia Rheumatica. It is an immune disorder that attacks the blood vessels and affects the muscles and tissue surrounding the joints. There is no cure or cause, so Prednisone is used to suppress the immune system to relieve the stiffness and pain. No, I wouldn't take 80MG, more like 15MG then you start a tapering process until you are at the lowest level where you feel no PMR symptoms.
When my eye first got inflamed, I had to start at 80 mg prednisone each day. I was lucky if I slept 2 hours at night. I had to go on sleeping pills for about 4 months. Over about 6 months, the prednisone was very gradually tapered down to 7.5 mg/day. A few years later, the inflammation returned and I had to add methotrexate to the prednisone. If I didn't treat it, I would have lost my eyesight because of the inflammation.

Lately an injected antibody called Humira (generic name adalimumab) has been very successful at treating a number of different auto-immune rheumatoid arthritis-like diseases. I wonder if it is being tested as a treatment for PMR? It's extremely expensive if you want to treat something that has not been tested by clinical trial. No health insurance will pay for it unless it has FDA approval. Been there, done that, got the T-shirt.
That drug causes the adrenaline gland to shut down so you have to taper off very, very slowly.
Yep, Been there, done that, got the T-shirt for that too.
 
Out-Of-Phase

Out-Of-Phase

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#12
Sorry about your immune troubles. Yes, Humira is the drug for RA. The thing I don't like about any of these drugs is the side effects. The side effects are as bad or worse than the affliction.

Humira costs approximately $4370 per month (2017).

There is strong evidence that adalimumab increases risk of serious infections, such as tuberculosis. It also increases the risk of cancers, including lymphoma and solid malignancies. The risk of cancer is higher with higher doses of adalimumab.
 
Swerd

Swerd

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#13
Sorry about your immune troubles. Yes, Humira is the drug for RA. The thing I don't like about any of these drugs is the side effects. The side effects are as bad or worse than the affliction.

Humira costs approximately $4370 per month (2017).

There is strong evidence that adalimumab increases risk of serious infections, such as tuberculosis. It also increases the risk of cancers, including lymphoma and solid malignancies. The risk of cancer is higher with higher doses of adalimumab.
All of what you say is correct. However, I would disagree that the side effects of adalimumab are always worse than the affliction. It really depends on the affliction. Progressive RA can be quite bad. So is Crohn's disease, Juvenile Rheumatoid Arthritis, ulcerative cholitis, and a few others I don't know how to spell without looking them up.

The usual chemical therapy treatments, such as prednisone combined with methotrexate don't usually work indefinitely. They eventually fail. That's why new treatments such as adalimumab are such an important break through. All these treatments come with a side effect cost to the patient, and over time, they can be large.

Adalimmumab is still pretty new, and we are just getting a good feel of how effective for how long it can work. Yes, patients who take it long term must be monitored for things like tuberculosis and newly developed cancers. But if you suffer from a serious life-altering or -threatening auto-immune disease, it can be worth it.

It's hard for me to speak about Humira without getting political. In the past, newly approved drugs in the USA won patent protection against generic competitors for 18½ years. The manufacturers could sell it at high price during that time with federal government enforced protection. After that that time period, sales of generic equivalents was allowed. Over the past two or three decades, thanks to a Congress too heavily influenced by money from lobbies of big US and international pharmaceutical companies, this patent protection has been extended several times. In particular, the manufacturer of Humira has benefited from this. This drug should have lost its patent protection over two years ago. There now exists an effective generic equivalent to Humira, made in India and sold in Europe. Because of big pharma's lobbying efforts, it cannot be sold in the US. Other than obscene profits for AbVie and other companies like it, there is nothing right about this. These laws must be changed. Both you, I, and many others might benefit. There, [\RANT OVER]
 
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Out-Of-Phase

Out-Of-Phase

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#14
Here's the thing, I went to my GP and he said PMR, then I went to a Rheumatologist and she said Seronegative RA, then I went to another Rheumatologist and he said PMR. The best two out of three?
 
speakerman39

speakerman39

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Richard, you mentioned up above that you have had (2) neck surgeries. Did they make you have a myelogram? I had to and it was so darn painful. Also had to have an injection right where I was supposed to have neck surgery. Mine has been postponed for now b/c the injection helped a lot w/the pain. Still have a lot of numbness and tingling. Now my sinuses may need surgery. Have been told not much is more painful than sinus surgery. Glad things are better for you. Will be sure to keep you in my prayers. ;)


Cheers,

Phil
 
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lovinthehd

lovinthehd

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#16
Glad it's improved your vision and good luck on the next eye. My cataracts are slow in coming altho they're definitely coming. As to surgeries, have had quite a few in my life and I don't find them all that interesting :) Just rather stay off drugs (except for recreational) and out of hospitals. If I could only find a way to stop seeing dentists and oral surgeons, tho....
 
Johnny2Bad

Johnny2Bad

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#17
Happy for your good result.

Now, this is the internet. So you won't be hearing about my surgery, but I do understand the need to share among friends and family.
 

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