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Crohn's Disease Forum » Parents of Kids with IBD » Suture anchors/clamps/pins and MREs


 
08-01-2016, 05:10 PM   #1
Tesscorm
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Suture anchors/clamps/pins and MREs

Hi,

Something popped into my mind and just wondering if anyone already has experience with this... from info I've found, I think it's okay but wondering if anyone has experience with it (Maya??)

S's shoulder surgery will involve the placement of suture anchors/clamps, which will stay in his shoulder. If these are made of metal, will this be a problem for future MREs?

Is this something I should discuss with his ortho and/or GI?

Thanks
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Tess, mom to S, 22
Diagnosed May 2011

Treatment:
May-July 2011 - 6 wks Exclusive EN via NG tube - 2000 ml/night, 1 wk IV Flagyl
July 2011-July 2013 - Supplemental EN via NG, 1000 ml/night, 5 nites/wk, Nexium, 40 mg
Feb. 2013-present - Remicade, 5 mg/kg every 6 wks
Supplements: 1-2 Boost shakes, D3 - 2000 IUs, Krill Oil
08-01-2016, 05:21 PM   #2
Maya142
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Hmmm...I'm not sure. My husband has his hips replaced, but they were still able to do an MRI on him. He just had to tell them before the MRI.

I'd check with the orthopedist.

Good luck!! I hope the surgery goes smoothly and S's recovery is relatively easy. With all my husband's surgeries, we've found that if the pain is under control, he recovers faster, so I'd have a plan for pain management.
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Mom of M (20)
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Juvenile Idiopathic Arthritis at 12
Juvenile Ankylosing Spondylitis at 16

Mom of S (23)
dx with JIA at 14
Ankylosing Spondylitis at 18
08-01-2016, 05:39 PM   #3
my little penguin
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Artificial hips are typical made from titanium - or cobalt
Both are biocompatible
Titanium is not magnetic so not an issue
You can have magnetic metal and have an Mre but the metal disrupts the magnetic field and can cause it to not be as clear .

Tess you should be able to find out which alloys they are using
I would expect titanium sutures/clamps -possible cobalt( typically cheaper and not used as much ) or composite made from powder .
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08-01-2016, 05:42 PM   #4
Maya142
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Thanks MLP! Never knew that! I always wondered why he could have an MRI.
08-01-2016, 05:51 PM   #5
Tesscorm
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Thanks!

From what I've read, there are bioabsorbable and nonabsorbable anchors and both types seem fairly equal in preventing future dislocations. But, I haven't been able to find the material of the nonabsorbable nor how often one type is used over the other.

Seems like an email to the surgeon couldn't hurt!

08-01-2016, 05:55 PM   #6
pdx
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Is the surgery coming up soon? Hope it goes well!
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Daughter E (15) dx with Crohn's 12/18/14 at age 12

Current treatment:

Remicade started 12/24/14 (currently on 9 mg/kg every 6 weeks)
Oral methotrexate restarted 12/2/16 (15 mg weekly)
vitamin D, folic acid, multivitamin, Prozac

Past Treatment
90% EN via NG tube 2/9/15 - 4/2/15
50% EN via NG tube 4/3/15 - 4/18/15
Supplemental EN via NG tube 5/7/15-6/19/15
Budesonide 3/3/15-6/30/15
Oral methotrexate 3/13/15 - 5/14/16 (15 mg weekly)
Topical clobetasol for Remicade-induced psoriasis
08-01-2016, 08:15 PM   #7
Tesscorm
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Surgery is Aug. 17. And, it just happens he's scheduled for an MRE the week before. Plus, his GI follow-up is two days before his surgery. I'm glad all will be done within a couple weeks.

I have another question for his GI (actually, will add it to the surgeon's email as well)... his next remi infusion is four days after his surgery. Maybe it would be better to delay two or three days?? Although, I don't know if delaying a couple of days would really make any difference?? (Aside from possible shoulder pain/discomfort)
08-01-2016, 08:19 PM   #8
my little penguin
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I know when Ds had his tonsils /adenoids out we delayed humira by at least a week
He was every two weeks at the time
The ent wanted to give his body more time to heal
Healing is very slow on biologics
All skin biopsies Ds has had /mole removals et too a very very long time to heal so please be prepared
08-01-2016, 08:39 PM   #9
Tesscorm
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Thanks for the warning. I've been told shoulder surgery recovery can be quite painful. I'm hoping it's not too rough for him and doesn't take a very long time. Especially as he'll be leaving to go back to school just over two weeks after surgery. We're going to get him moved back (same apartment, so more just clothes, etc.) before his surgery so he won't have much to do when he returns to school.

As his remi levels were recently tested and were close to 12, I'm hoping we can safely move from a six to seven week cycle. If this is the case, then I'll certainly move his infusion out by, at least, a week. I'll discuss this with his GI at the follow-up.
08-01-2016, 09:56 PM   #10
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M went to school two weeks after her GJ tube placement surgery. Not fun, but she managed ok, even on pain meds. Unfortunately, her site got infected within a couple weeks at school and that was NOT fun. Tell him to be very careful and watch closely for infections.

I would imagine moving to 7 weeks just the one time will be no big deal. But, as far as I remember, we were told with an arthroscopic surgery, M's Remicade schedule would stay the same (but they did want to schedule the surgery in the middle of the Remi cycle).

Good luck!
08-02-2016, 02:33 AM   #11
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Best of luck with the surgery! Hope all goes well. I know my mother has pins and screws in her back and is fine in an MRI
08-08-2016, 09:20 PM   #12
Tesscorm
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No worries about anchors and MREs - anchors are made of plastic. And, ortho has no concerns about remicade 3 days after surgery... We will have GI apptmt 2 days before surgery and a delay (or lengthening in cycle) is still something I'll ask GI, especially as his remi levels were more than sufficient at last levels test... so we'll see about remi date.

Now I have a new worry... And, I know it's probably silly, and if S hadn't mentioned it and I hadn't googled the procedure (like I really needed that detail?!?!? ), I'd be much better off! At his pre-op today, they told him they rank post-surgery pain as mild, moderate and severe. His type of surgery is ranked at the severe end of severe. S has the option of having a nerve block (at least, S seemed to believe he ad the option to choose yes or no?). S told me there are risks of permanent arm numbness but the risk is very low. Of course, believing there is the choice, I've read a bit about it (stopped because the site I found had pictures, diagrams, etc and it was freaking me out a bit! ). On the other hand, it also seems to be very common and done routinely with this type of surgery. It's used to lessen the amount of anesthesia given and post-operative pain medication, reducing those risks (which is a good thing). Of course, S is all for it, said the risk is so low, he'd rather avoid the pain.

Ugh, I just wish I didn't know about it. I hadn't been too worried about this surgery... thinking arthroscopic, three little cuts, how bad, risk-wise, could it be???

Anything you know that I should know??
08-08-2016, 09:52 PM   #13
Maya142
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I only know that nerve blocks are quite common - used at a lot of hospitals now quite routinely. Definitely for hips and I'd imagine for shoulders. My husband had one for his last hip replacements and it definitely helped a lot. He needed way less pain medicine.

I also would not get hung up on if they say pain will be moderate or severe. In fact, I don't think it's good to tell someone it will be the severe end of severe! That will just make poor S anticipate the pain and anxiety and tension will make it worse. Of course, it's good to know a little bit but they shouldn't have been specific -- poor kid (and poor mom)!

People deal with the pain differently and you might be surprised. My younger daughter has a very hard time, even with minor surgery. My husband, on the other hand, has been fine within days after major surgeries (multiple). It REALLY depends and they will be well prepared.

I would not be afraid to speak up and tell them his pain isn't controlled if that's the case. They can always switch the pain med if necessary or up the dose. Also tell him to speak up if he gets sick from it -- for example, my daughter got very sick with Vicodin but did great on Oxycodone or Morphine.

Remind me -- is he being kept overnight? We found that staying a night or two always helps (IV pain meds/pain pump) but I don't know if they do that for arthroscopic surgeries.

Good luck!! I hope it all goes smoothly!
08-09-2016, 08:43 AM   #14
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Thanks Maya! It's difficult when they go to these apptmts on their own and you're left with their version of what's been discussed... But, now I'm thinking it is exactly as you said, a routine part of these surgeries...

After speaking with S a bit more and then finding the paperwork he'd left sitting on the steps (he'd forgotten about them! )... I think some of the info he'd shared was related to a study the hospital is running. I forget what it's called now but they are testing the comparability of post-op pain level using a different type of pain management, still an injection but not exactly a nerve block, and with lower risks. I think this is the 'choice' he was offered, not just whether or not to have the nerve block in itself. (does that make sense?? )

It's the choices that mess me up! I always feel they give you a choice when the risks are worse! And it's always hard to choose 'yes' to anything with risks! But, if not given the choice... well... head happily in the sand building castles!

And, agree with you, Maya, re the 'severe end of severe'! Ugh, how is that helpful?!? I agree with preparing you for a certain level of pain but... oh well. I guess we're now prepared for the worst anyway, so things can only be 'better' than expected.

Unless things change, he will not be staying the night...

I hate that, next week, I can only take one day off! It just happens that my co-worker is away and one of us must be there! I've already insisted that I must take Wednesday off but, now anticipating the pain, I'm so upset that I can't be there Thursday, Friday. Hubby will be there most of the time, so it's not like S will be totally on his own but, I hate not being there for him. Ugh, just nothing I can do about it... bad timing.
08-09-2016, 11:32 AM   #15
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How stressful! Bet they think they are helping giving too many details but sometimes ignorance is bliss. Hope it all goes well
08-13-2016, 11:24 AM   #16
Tesscorm
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Seriously, this guy cannot catch a break! Went to his last hockey game bfr surgery on Thursday, last minute of game, other team got sucky and slashed at legs (with hockey sticks) at a couple of them! One being S! He iced ankle at home then said it was sore but tolerable and wanted to go with team for wings, etc. And stay at friend's. Called at 4am that he needed to go to ER, foot was throbbing and killing! Thankfully, nothing was broken but he has a bad sprain. I was so worried - how wud he hv managed with a fracture, crutches and shoulder surgery!? Especially as he leaves for school in three weeks! So we dodged the worst of it!! His teammate did, unfortunately, end up with a fracture in his foot. Disgusting! Outside of a game, this would be assault but, in hockey, apparently it's 'tolerated'!! Makes me so mad! Anyway, he is on crutches but I'm thinking he'll be able to step on it by Wednesday. And, somehow, I need to get him downtown for GI apptmt on Monday... Ugh!

Btw, to keep things interesting, daughters bf broke up on Thursday too, she's devastated. MIL is staying with us for a few days as she moves, have her stuff all over house and she's full of 'advice' ...
08-13-2016, 11:31 AM   #17
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the advice part I get. It's like with some people.

I'm glad it's not fractured.
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I'm mom to............... Little Farm Girl 8 yr old
Ibd (microscopic)
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dx Juvenile Arthritis
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dx Erthema Nodosum
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Bladder and Bowel Dysfunction
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08-13-2016, 11:35 AM   #18
Maya142
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Oh no!! Poor S! That seems crazy, that it's allowed in hockey. And dangerous!

Does he have to be on crutches for his sprain? When is his surgery?
08-13-2016, 12:46 PM   #19
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This type of behaviour isn't really 'allowed' but once you allow legal 'hitting' (sounds crazy eh?), the line between what's allowed and not becomes very blurred and easy to cross. He's playing in a non-contact league now but, after years of this sort of behaviour being 'tolerated', it continues to rear it's head even in non-contact leagues. I used to absolutely dread some of his contact games when he was younger!

His surgery is Wednesday, so still a few days away. And, no, normally a sprain doesn't require crutches but, I this one is bad enough that he still can't put his foot down at all. I'm a little surprised that it happened Thursday evening and he still can't put any weight at all on it but we'll see how it goes... Worst thing, we'll have the surgeon look at it on Wednesday!
08-13-2016, 05:07 PM   #20
pdx
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Yikes--just a little going on at your house this week!

Hope his ankle improves a lot over the next few days, so that he can concentrate on the shoulder surgery.
08-13-2016, 07:25 PM   #21
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Yep, it's been a bit crazy! Our house is usually very calm and routine but, last couple of days...

My MIL is 90 and is already overwhelmed with the move alone, she comes over and finds daughter crying off-on because of BF, wakes to find out we've been at ER and S is coming home on crutches, is a bit afraid of dogs and we have two big ones! Friday morning, she decided to have a bath instead of shower and then couldn't get out! I wake hearing my husband speaking 'loudly' to his mom and sounding very frustrated, asking 'why a bath and not a shower? You never have baths, why now?' I'm thinking she wants to have one but my husband is insisting she has a shower... Then he comes to wake me (I'd gone back to bed after ER), fairly annoyed and I find daughter and friend trying to get MIL out of bathtub! Just what I wanted to wake up and do! And she's asking why our tub is so deep (it's not!)...

S stayed in bed all day trying to sleep because he'd been up all night... everytime one of the dogs came near my MIL, she'd yell out!... He's asking me 'what is going on down there?!?'...

Our vacuum broke yesterday, so we had to use an old industrial one that's as loud as a jet engine... S is asking WTH we're doing because it's so loud and so much commotion in the house... MIL is asking 'is this what it's like here all the time? And if we bought a vacuum like hers, it would be better.'

To distract herself, my daughter decides to invite four friends over and they're going to make pizza ... MIL can't understand why they're all sleeping over ('even the boy?' )... and, what do we mean they'll all sleep on the couch and floor!

It's been interesting...
08-13-2016, 07:31 PM   #22
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Sounds like a rough couple of days ! I hope everything calms down and the surgery goes smoothly!

I also hope S takes time to REST after the surgery (and before school) -- I know how stubborn young adults can be ! I'd ask the doc if he can use heat/ice and have those on hand, just in case. I'm sure they will give him pain meds and hopefully everything will be under control.

We also found having something to look forward to -- a tv show you want to watch on Netflix for example, or a season of his favorite show on DVD -- it can make the recovery seem faster. Anything to pass the time while resting!

Good luck!
08-13-2016, 07:38 PM   #23
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It really stinks that this happened, especially now. I would definitely let the orthopedist know Monday if he is still on crutches-- maybe the doc could check it.

You do need crutches in a severe sprain. Did his ankle get hurt when it was hit by a hockey stick? That sounds like an unusual mechanism for a sprain. Usually sprains happen when there is a twisting or rolling motion. Perhaps that happened in response to being hit?

Hoping his ankle recovers quickly and his shoulder surgery goes well!
08-13-2016, 07:45 PM   #24
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Thanks for reminding me!!! A friend's husband recently had shoulder surgery and he has some sort of shoulder ice wrap! I am going to borrow it... I'd forgotten but you just reminded me to call her tomorrow!

You're so right about being stubborn... he just went out to a friends'. They're just going to stay in but there are a few friends going... I know he'll be up and about. I warned him to please, please be careful and not slip! But, I felt sorry for him, he'd had all sorts of plans for this weekend because he knew he'd be 'out of commission' for a while after the surgery...

I did speak to surgeon about pain meds, he told me he would give him 'something' (I forget what) as he's aware that S can't have nsaids.

And, yes, thank God for Netflix and laptops!!
08-13-2016, 07:51 PM   #25
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xmdmom - both his GI and ortho are in the same hospital... As we'll be there for his GI apptmt on Monday, I'd thought we'd go to their ER dept if he still needs crutches to walk. If the ER doctor thinks it's necessary, he can call his ortho at the same time???

The local ER doctor didn't explain much but said the impact hit his ankle ligaments and then S walking/standing on it for two hours afterwards worsened the inflammation. He said the ligaments were badly sprained and to use crutches and stay off it for a week. S didn't say anything about a roll, just that the player slashed him. (The doctor didn't seem worried, even when we mentioned surgery on Wednesday, and I was so relieved it wasn't broken, I didn't ask anything more.)
08-13-2016, 08:21 PM   #26
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If his ankle is very painful, you could ask for Voltaren gel. It is an NSAID, but it's topical so it's not as bad for the gut. And I'm sure if S's IBD is controlled, it would be fine.

My kiddo hurt her hip somehow in the winter (we're still not quite sure if it was an injury or an arthritis flare), but anyway, she was told to stay on crutches for a week to rest it. It REALLY helped! She had to use crutches (or a cane) all the time though -- even when she got up to use the bathroom! But the extra rest made a big difference.
08-13-2016, 09:33 PM   #27
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S has used voltaren in the past without a problem. We suggested it last night but ER had given him some Tylenol 2s so he was okay with just that. It hurt to just touch his ankle so he didn't want to be rubbing anything on it.

So far, S has been using the crutches... the challenge will be once it starts to feel just a little better. But, if I can keep him down till Wednesday, I don't think he'll be walking around much for a few days after surgery...

It's still four more days till surgery so I'm pretty confident it should be healed enough that walking short distances won't be a problem. Silly details that young adults don't consider but if he still can't walk well, how will we get him from the car, into the house and up the stairs?!? If the surgery is as painful as we've been told, it would be horrible to have to limp or 'hop' each step! Both are on the left side so we won't be able to hold him up on the sore ankle side...
08-13-2016, 10:49 PM   #28
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Yes - I was thinking crutches and a shoulder surgery don't really mix! I would actually suggest a cane for those days. His ankle should be better by then and he might be able to walk on it with some help. A cane would be in the opposite hand -- if it's his left ankle, then his right hand and that would also save his left shoulder.

You could also try an OTC ankle brace and see if that helps, once it's a bit better (and doesn't hurt to touch).

Good luck Tess!! Surgery is always a bit scary, even when you're told it's not a huge surgery.
08-14-2016, 10:19 AM   #29
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Thanks for the cane suggestion! I'll keep that in mind for sure!
08-14-2016, 08:55 PM   #30
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Oh Tess, when it rains there, it's a hurricane! You poor thing! I feel for you with all that's going on. If your son can't walk tomorrow, I'd recommend looking into a knee scooter. He puts the bent knee of the bad ankle on the scooter and can push himself around. My husband who has a bad ankle and is between two surgeries is finding this more doable than crutches when his shoulder starts killing him from too much crutching.
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