Off Medication to Heal

I'm looking for input from those who perhaps have gone through something similar... I am not doubting my doctor, just looking for some help in weighing the factors.

I feel like I'm in somewhat of a no-win situation. On Friday I'm going to have a minor surgery to remove a cyst that likes to grow and got inflamed this summer. It was cleaned out in July, and the tiny incision from that still hasn't completely healed. Now I'm going to be having the whole thing removed, and there is talk of stitches. I have been anxious that it will take a very long time to heal.

So I asked my rheumy about it, and he said it was okay to go off my chemo drugs in order to heal better. No MTX, no azathioprine (Imuran), for one week before and one week after the procedure, staying on my prednisone meanwhile. I saw him yesterday, so I began cutting out the azathioprine last night. MTX is no big deal, as I take it on Fridays already anyway.

What I'm worried about NOW is how it is going to make me feel to go two weeks without these drugs. Both of them have significantly helped me feel better over the last year. I'm worried about how much I will hurt, and how much this will slow me down. I've got things going on during this weeks and a half that I really can't NOT do...

But if I choose to go back on my meds, then it may take me six months to heal from this thing, if I'm lucky. The idea of messing with being cautious with it that long is not something I savor.

Anyone here had a similar circumstance? Any advice?

Hi Talencia,

While I am not familiar with the medications that you are reducing, I am familiar with this situation and Prednisone. My wife needs major abdominal surgery for the surgical removal of a long term infection, but can't have it because her cumulative Prednisone intake, and her Prednisone dosage was too high and the surgeons felt that the incision would not close, and that leaving an immunocompromised patient in long term ICU with an large open wound would not have a successful outcome. Prednisone inhibits inflammation which is one of the body's 4 cascading responses to heal a wound. That was damned if you do, so everyone decided to go with damned if you don't. Damned if you don't was lifetime antibiotics, and a Prednisone taper in the hopes that the surgery could be performed with a more successful outcome at a later date. Almost two years later the result is CNS with paranoia, psychosis, reduced cognitive function, divorce, and a custody fight.

The bottom line is that no one will be able to predict how either course of action will affect your Lupus in the long term. I would suggest that if you have confidence in your doctors, trust their advice, do what you can do, and do not worry about the rest. The stress will only aggravate your Lupus, and that we know is bad.

I had to come off of MTX and my biologic (I have PsA, no lupus) recently for surgery. I had to be off of MTX for one week and my bio for two weeks before and after surgery until the sutures came out. It stunk, but it wasn’t as bad as I thought it might be. I didn’t realize how much the hernia was making me feel junky, so after the surgery, I actually felt better than I had in a really long time. Then, it took about three weeks for the sutures to come out, so that wasn’t fun. But after the sutures came out, and wound was pink and healed I was able to take my MTX and infusion. It was a wonderful day for me and I was able to feel results within the next few days.

Good luck to you. I hope the surgery really helps you feel better, and that you have a quick recovery.