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Stopping Plaquenil before surgery

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  • Stopping Plaquenil before surgery

    Hi All,
    I was due to have gynae surgery tomorrow (it may involve a small rectal resection also)but the gynae nurse called me last Wed and told me to stop Plaquenil and postponed surgery for a week on the surgeon's orders. I had a similar but less invasive surgery last Sept and the gynae surgeon wrote to Rheuma to ask if I needed to stop Plaquenil. The Rheuma said no. I am very annoyed that my surgery is delayed because this nurse forgot to tell me to stop the drug when she should have and also because as I explained to her on the phone this question came up last time and the rheuma advice was not to stop.

    I asked the nurse if she would remind the gynae surgeon that this has come up before but she didn't want to and said she'd get him to call me on Thursday. Against my better judgement I stopped taking Plaquenil on Wed. No call from the gynae on Thursday or Friday. Yesterday I started feeling very tired, bad headache and today my knees and hands are killing me-not sure if the plaquenil would wear off that quick (been on it since Aug 09) or if the stress of this is triggering it. I'm also on 2.5 mg pred a day and have been doing quite well. Stupid nurses and gynae surgeon not listening to me.
    Can I ask if anyone else has been advised to stop Plaquenil before surgery or is this silly man confusing it with other DMARDS?

  • #2
    No, never hear the need to ever stop Plaquenil before surgery....the Nurse is just a Nurse...NOT the Rhuematologist!

    You should be following advise straight from your Rhuematologist, not from a Nurse.... I hope you have on the advise of the Rhuematogist re-commensensed back on the Plaquenil !

    The only consulatation is that you have not been off is that long and once back on it, it hopefully it wiil help you very soon...I hope


    • #3
      I have never had to stop Plaquenil for surgery.
      I hope they get this sorted out.
      Sorry this happened to you.
      I have had to stop my blood thinner but never Plaq.


      • #4
        How annoying for you!

        I have been advised to stop my lupus meds one week before surgery, elective hernia repair, dental surgery such as extractions and chopping gums about, and now I stop a couple of days before dentist's, all to reduce bleeding risks. The meds are or were aspirin 75 mgs, and two antimalarials which very slightly thin the blood, and 75 mgs Imuran at one point.
        Then there's sometimes the issue of raising the Prednisone. All supplements and herbals need at least to be mentioned to anesthetist or surgeon
        I'd have thought that all this would be discussed at some pre-op stage along with checking platelet levels and all that.

        It's not very likely that stopping the Plaquenil would have any noticeable effect on symptoms so soon, but stress sure could.

        All the best


        • #5
          I just had major spine surgery in November. The surgeon had me check with my rheumy about stopping Plaquenil and I was told to continue it, or just stop it the day of surgery then get right back on, I asked what would happen if I stopped for a week and was told I'd risk going into a flare. I stayed on it and surgery went OK. I agree though, don't take the nurses decision, get it straight from the surgeon and/or rheumy! good luck, hope you get it figured out and that your surgery goes well!



          • #6
            Thanks everybody, I had a feeling it wasn't necessary. I'm not too bad today but that awful morning feeling is definitely back with a vengeance. I'm waiting on a call from the rheuma, he's usually very good at getting back to me quickly. I wonder if the gynae nurse and secretary even bothered to query the gynae surgeon as it would have been in my notes from the last time. I'll let you all know and thanks again.

            Update-as we all suspected the Rheuma says no need to stop Plaquenil however the gynae's sec said he was adamant when she spoke to him (gynae surgeon) last Thursday that I should stop-she said he mentioned something about bleeding excessively. He was supposed to call me on Friday but didn't. The rheuma sec is resending the letter from last Sept but I've decided to stay off it in the meantime as I'm afraid he'll refuse to operate again and I really need this surgery. I wish all docs would be as open to listening as my rheuma is. Flippin surgeons think they are Gods, I bet he's now too embarrassed to admit that a 39 yr old rhupus patient with no medical training knows more about Plaquenil than he does. Deep breaths lol
            Last edited by littleboots; 01-24-2011, 04:01 PM. Reason: Update


            • #7
              Plaquenil has a half life of almost 2 months (52 days if I remember right) so I don't think even a few days will make much of a difference. I have to wonder if the doc is confusing Plaq. with a blood thinning med? I hope everything went well for you.