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Medical Forum / Diseases and Disorders / Arthritis / March 2006Elbow experiences
Hi I've been a lurker for some time & you all seem a pretty nice bunch. I'm a 37 year old male living in the UK, suffering with RA. I've been a sufferer for approx 15 years. I currently take Methotrexate & Humira for disease activity , this is the first time I have had near clinical remmission I have damage in knees, shoulders, elbows, wrists & hands. With the RA more or less controlled I was referred to an upper limb specialist Dec 2005. He took X-rays & examined my elbows ( as these give the most pain & deformity) He gave me 3 options. Fusion, replacement or radial head excision. Due to my relative young age I declined the replacement at this time & felt that fusion would be a last resort which left the radial head removal. Can anyone give me any advice or there own experience of elbow surgery, I 've read conflicting reports from various sources about the benefits & risks, but felt it is better to get 1st hand experience. Any help would be gratefully received. I'm currently on the NHS waiting list, I have no date yet but expect it to be before June. I have flexion contractures of > 60 Deg, in both elbows, no wrist rotation on the left & a little on the right. My wrists are virtually fused. Does anyone report much improvement in ROM. Thanks While I have no real advice for you, my heart and prayers go out to you. Vickie B. Just out of curiosity Dave, did they say anything about the need to get off of your drugs before surgery? I'm having a tendon problem in my ankle and am currently on 20mg of metho/week - wondering if I will have to go off of that drug before having surgery? (god forbid). Thanks, Mark 55 yrs old RA 9 years > Hi > [quoted text clipped - 22 lines] > > Thanks > Just out of curiosity Dave, did they say anything about the need to get > off of your drugs before surgery? I'm having a tendon problem in my [quoted text clipped - 4 lines] > Mark > 55 yrs old RA 9 years Hi Mark,,,, different doctor handle this in different ways and your doctor will thank you for asking him/her about this. Harv . Can anyone give me any >advice or there own experience of elbow surgery, I 've read conflicting >reports from various sources about the benefits & risks, but felt it is >better to get 1st hand experience. Any help would be gratefully >received. I actually had that procedure done in 1986 or so, with good result. I am able to turn my hand palm up or palm down, and have relatively good strength. At the moment I am having elbow pain, but the side that was not done is much worse. Rose Rose @}>->-- Being educated means that rather than fearing the unknown, one seeks to understand it. RB Please remove "Ima" to reply. Hi all Thanks for the responses, it sounds like it worked for you Rose. Mark, I believe I will need to stop the Humira about 2 weeks before surgery, not sure about Methotrexate I will need to ask. I don't think that you can't start the Humira again till the wounds have healed, hope I don't flare too much as it's taken so long to get remmission. It will be nice to have less pain from the elbow though. Dave Hi Dave, I had a total elbow replacement in 1992. ROM is nearly normal. I also have wrist fusion, but shoulder is more limiting than the wrist. Good luck! Thanks Sunny, good to hear a success story. How is the elbow holding up after 14 years of use, & what sort of activities can you do/not do. I've had a date come through for the surgery 20th April, with a assessment on the 5th. What was the recovery time like for you, although I don't think the radial head excision is quite as invasive as a replacement & how long before you reached optimum function? Had a bit a of scare last week, I had my monthly blood check on the 6th March & received a call from the hospital on the 8th., to say that they were concerned about my liver function. I t has been somewhat erratic previously but usually only a little above "normal", however this time it was significantly higher so they need to monitor me every week from now on. I'm hoping this doesn't jeopardise my operation, or the continuation of the drug therapy that has bought about this remission. Anyone had a similar experience? Dave > Thanks Sunny, good to hear a success story. > [quoted text clipped - 16 lines] > > Dave Hi Dave, What medicine do you take an how much? The last couple of times my liver enzymes have gone up, I took milk thistle for awhile and the next blood test it was OK again. It is a good idea to let your RD know that you are doing it so the doc will understand the change. If your medicine is causing stress to your liver the doc needs to know that. Harv Hi Dave, Yes, I suspect the elbow replacement is more invasive. I was doing physical therapy almost immediatley after surgery. Therapy continued actively for at least eight weeks. After that period a therapist was no longer required, and I was left to continue on my own. I am able to do just about anything I want. I am restricted to lifting no more than 20 pounds. Jar opening is a problem, but I have a mechanical device for that. Everyone, and every situation is different. I am not suggesting your experience will be the same. I wish you well. Please let us know how you are progressing. Hi Harv Current meds are :- Humira 40mg once bi-weekly Methotrexate 20mg once weekly Arcoxia 90mg once daily Tramadol Hydrochloride 100mg twice daily Paracetomol 100mg two four times daily. It's a bit of a cocktail, but it seems to work for me. Regards Dave. Forgot 5mg Folic acid weekly > Hi Harv > [quoted text clipped - 11 lines] > > Dave. thanks Dave,,,, It is a great deal of medicine and I am glad that it works for you. Its about control and your RD has it and you are lucky to have her/him. Harv Hi I had my bloods done yesterday, after the higher than normal ALT (119 U/l) 60 NORM. I saw my GP (your MD) today to see if I should reduce my MTX in the run up to the elbow op, as I'm worried they may not do the surgery with the raised enzyme levels. Anyone with similar experience? She's fairly good & said that I should ring my RD's office on Fri to see if the levels are raised again & take it from there. I would really hate to have to postpone my op as I'm looking forward to having the chance of improved function & some pain relief. I'm not due to see the RD till after the op, I have a rheumatology nurse I can ring, so depending on the results on Friday I may give them a call. Feeling concerned, but trying to remain positive. All the best Dave. do you take milk thistle extract? Lots of us here take it to help our livers survive all these nasty meds we put through them. If your ALT is still elevated, your RD may very well want you off the mtx for a while to see if your enzymes recover on their own. You may or may not be looking at aa liver biopsy, depending on how aggressively your RD wants to investigate this and how your liver enzymes respond to dropping mtx. Whether or not they post-pone your elbow surgery for this will most likely depend on how concerned your RD is about this round of lab results. I say relax as much as possible until your labs are back, then call that rheumatology nurse and discuss it with them. Or if you feel really nervous, go ahead and call just to know what you might be facing. Sometimes just knowing the probable course of action is the best stress reducer.  SignatureNann remove the Gator cheer to email me Simply the thing I am shall make me live --- William Shakespeare > Hi > [quoted text clipped - 18 lines] > > Dave. Thanks Nann, This weeks liver function test results, although still higher than norm, were less than the previous ones. So there heading the right way at the moment, fingers crossed. I have also started to take milk thistle so hope this will keep the ALT levels lower. I'm due to see the orthaepedic surgeon on the 5th April, so I will have more idea then. Thanks for all the concern, it's true that a problem shared, is a problem spared. Regards Dave |
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