I Had Surgery and Delayed My Last Treatment, Here’s What Happened
Last month, I had an outpatient surgical procedure that would require my body to heal as quickly as possible. I reached out to my local GI and inflammatory bowel disease specialist to get their feedback on whether to inject or not.
You see, my due date for the next injection of my biologic was the day prior to the surgical procedure. My local GI wanted a delay but deferred to the specialist for how long. Once I received word on how long to delay, naturally, I had concerns.
Reader, I would love to tell you that I sent a message to my specialist and received a prompt response back. But the pandemic has made things more complicated where communicating is concerned.
It took a little over three weeks to get instructions from my doctor, but they eventually arrived. He said to inject at week 8, which was also around time for post-op medical clearance.
Delaying my biologic schedule
I am pretty compliant with instructions from my care team. I was expecting a 5 or 7-day postponement. However, 14-days felt like an eternity.
Flashbacks of when I was originally on an 8-week regimen and knew it was time to move it up came flooding in. During those days, the less-talked-about Crohn’s symptoms like chills without fever, night sweats, and insomnia mixed with severe fatigue were strong. Not to mention the nastier symptoms associated with Crohn's disease and psoriatic diseases.
Worries about remission when delaying my biologic
I worried about what would come of my remission. We (doctors and me as the patient) fought really hard for this remission.
As injection day came and went, it was a weird feeling. I’ve missed injection days before. Usually, it meant I was pushing it out a day or two or had injected a day or two early.
But this was different. It felt like I was doing something wrong; something I wasn’t totally on board with, either.
I’ve written before about falling off track with consistently having labs drawn because I needed a break. After writing about it, I got back on the ball.
Thankfully, due to recent labs with the IBD team as well as pre-op blood work, we had quite a lot of data. The labs were some of the best we’d seen in forever.
Anger and increased symptoms in recovery
Having this data was helpful because as week-one post-op and one week delayed from med went by, I felt my body growing angry. It grew angrier each day.
Recovery from the surgery knocked me physically for a loop, as well. Being in bed without moving too much didn’t help my psoriatic arthritis. I was not living in the bathroom as some medication commercials would suggest, but I was not living much either.
As I started to break out into cold sweats at night as well as during the day, I set a 10-day max. Having chills without a fever is never fun and is a little scary since surgery was involved. Needless to say, by day 10 I injected and informed my care team that I couldn’t hold out. They understood.
Worries about symptoms and a Crohn's flare
Usually, the injection alleviates, almost immediately, the majority of the symptoms I mentioned above. This time around, though, it took a little longer. Worries floated through my head about slipping into a Crohn's flare.
I had to keep reminding myself that the labs were good and I was in a good position to push the envelope a little. I had an option to change my shot schedule and wait for another 6-week cycle before injecting, or inject on the normal due date. The normal due date would put the next shot about 4-weeks-later.
I opted for my regular due date aka 4-weeks-later and I have no regrets. My body needed that boost.
It’ll be interesting to see how I feel over the next 4-6 weeks. Over the past few months, I had no problem going to the 6-week mark and feeling rushed to inject until after this surgery. But that is also the point of moving an injection schedule up – you want to remain symptom-free.
I think one lesson I’m walking away with is to never get too comfortable where Crohn’s disease is concerned. Another lesson is that sometimes you have to pushback on medical directives.
Have you experienced complications due to surgery delaying your medication schedule? How did you get through that challenge?
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