Here is My Question:
I have been taking Copaxone for relapsing remitting MS for over a year. I just had to have outpatient surgery on my toes for ingrown toenails. It has been over a week and the toes have shown a daily digression as to healing. I have continued seeing my specialist and he is guessing I am having a reaction to the chemical they put on the nail matrix, but I'm not really sure. I'm on an antibiotic and have no infection. My toes ARE bright red down to bend of toe with some swelling and continued drainage. I am wondering if Copaxone is known to cause a delay in healing associated with surgery? I did not have general anesthesia, rather it was topical. The doctor says we just have to stay on the antibiotics and wait it out.

Answer:
Theoretically, any immunomodulator could alter the healing process.  While I can’t exclude the possibility that Copaxone may be impairing wound healing, I think it is less likely.  Patients on the injectable disease modifying therapies tend to continue their medication throughout the pre- and post-operative course without difficulty or deviation from normal recovery.  As your surgeon pointed out, you may have a reaction to another drug used in the procedure.  I would suggest speaking with your MS treating physician about the appropriateness of Copaxone during your recovery period.  Clarity on the ‘cause and effect’ in your case may come with time and careful observation.
—ASN

PLEASE NOTE:  The information/opinions on this site should be used as an information resource only.  This information does not create any patient-HCP relationship, and should not be used as a substitute for professional diagnosis and treatment.  Please consult your health care provider before making any healthcare decisions or for guidance about a specific medical condition.

Here is My Question:
Hi! I have been on the medication Tysabri for almost a year now and I wanted to know if it is safe for me to get plastic surgery. I don't know if the being on the medication Tysabri and anesthesia for the surgery is ok... Please let me know! Thanks!

Answer:
There is no evidence that Tysabri inhibits wound healing after surgery or increases the risk of infection after surgery. I recommend that my patients continue on Tysabri without interruption if they plan to undergo surgery including plastic surgery, but as always, please discuss with your physician.

Good luck

Rip Kinkel, MD

PLEASE NOTE:  The information/opinions on this site should be used as an information resource only.  This information does not create any patient-HCP relationship, and should not be used as a substitute for professional diagnosis and treatment.  Please consult your health care provider before making any healthcare decisions or for guidance about a specific medical condition.

Here Is My Question:
I am having two surgeries in the next few months; one is to remove a lump in my breast the other is to have a supra pubic catheter placed. I am very concerned about the general anesthesia, can I really end up making the ms worse? I am scared but I don't have a lot of choice.

Answer:
Very good question; many anesthesiology and surgery textbooks still mention that the stress of surgery or perhaps anesthesia may cause a relapse of MS, although there is no evidence (anecdotal or otherwise) in the modern era to support this statement. I have seen old case reports describing transient worsening of MS symptoms following surgery with anesthesia but no reports for many decades. In fact the evidence suggests that surgery, general anesthesia and epidural anesthesia are NOT associated with worsening of MS.

The real question is whether both surgical procedures can be performed at the same time to limit the amount of anesthesia and the combined recovery time from surgery. After all anesthesia has it’s own very small risks, even without MS, and post operative pain from any surgical procedure  often increases muscle spasms in people with MS. Limiting these problems to one surgical episode would be a good idea, although your doctors may have very good reasons not to combine the two procedures. It is certainly an idea worth discussing with them.

Good luck and be brave. Most people with MS  do great with surgery.

-Rip Kinkel, MD

If anyone out there has had these types of surgeries or has some helpful advice for the person that asked this question, please make a comment below.  Thanks!