Hi

I have recently experienced living with RA without my Remicade treatments for 4 months.  This in March when I had surgery for sleep anea.  My Remicade was stopped about 3-4 weeks before the surgery to allow my immune system to build up before the surgery.  The week before the surgery was like a week in hell.  My RA pain reared it's ugly head and attacked almost every joint in my body.  At this point I didn't know if I could stand not being on the Remicade for another 3-4 weeks after the surgery.  But I went through with it.  I was put on antibiotics during and after the surgery.  (for those of you who don't know what sleep apnea surgery is, this is when an ENT doc removes the uvula, tonsills, and some of the soft palate at the back of your throat to give you a larger airway.  THen an Oral surgeon comes in and cuts the bottom of your chin bone and moves it forward, which then moves the tongue forward since the chin bone is attached to ligaments to your tongue and puts a plate in to hold it together)  All sounds so simple when discussing it in the doctors office but it was a 4.5hr surgery with a 2 day hospital stay. 

Getting back to my story I came through the surgery ok but about a month and a half later in April I started develping severe pain when I was chewing anything.  I also noticed a white spot on my gums near the incision.  Off I went to the Oral surgeon(OS) to see what was going on.  He took xrays and checked it and said that one of the screws in the plate in my chin was probably loose and said that if he took out the plate and screws it would get better.  So off I go to surgery again plate, screws and small infection are all taken out.  He then changed my antibiotics and home I went.  Another couple of weeks go by and I notice a white area aound the stiches in my mouth so I go back to the office but my Oral surgeon isn't there so I see one of his associates.  He looks at it and says I haven't been cleaning it well enough(which was a lot of BS).  He send me home and tells me to clean the area better.  That Saturday I am looking at the incision and noticed that the infection is raging in my gums my husband calls the OS and tells him about the new development.  Sunday morning I am in his office he takes one look at it and sends me to the Emergency room.  At this point an infectious control(IC) doctr gets involved and she has them put me on Vancomycin, flagyl and levaquin 3 heavy duty antibiotics.  From the CAT scan they did when I was admitted they found that the infection had infiltrated my chin bone. At this point the OS has to go back in and clean out the infection to save the bone.  Tuesday morning I am back in surgery to have this done.  So after a weeks stay in the hospital and a pic line put in my arm I was sent home to administer the antibiotics on my own.

A couple of weeks go by having seen the OS each week for a follow up I notice that one of my bottom teeth in the front is sticking up above the rest of my teeth, I have straight teeth so I knew this wasn't right.  My next follow up the following week the OS has his saff take 2 different xrays the second of which he proceeds to show me that my jaw was cracked.  So another surgery is scheduled for the next day to fix my cracked jaw bone.  This happened from the infections and all the scraping to get it clean, it weakened the bone so much that it cracked.  Braces were put on my lower teeth and a plate in my jaw to hold everything together.  It has been 4 months later after the first surgery I am now recovering from a broken jaw.