The neurosurgeon that wanted to do a lumbar fusion said I would need to be off prednisone and Actemra for a month before and a month after surgery. The neurosurgeon said I would be given corticosteroids only "as needed" for adrenal problems but otherwise not. Pain would be controlled with conventional narcotics as needed after surgery.

A month after surgery, I could resume treatment to suppress my immune system again but that would be decided by my rheumatologist ... not the neurosurgeon. I haven't done the lumbar fusion yet.

I had knee replacements done a long time ago while on prednisone. The orthopedic surgeon said I didn't need to stop taking prednisone but he said precautions would be taken to prevent an infection and reduce the risk of an adrenal crisis. I got IV steroids during surgery and after surgery until I resumed prednisone again.

I had "aberrant healing" after my knee replacements but no infections. My prosthetic knee joints "look good" but the soft tissues that surround the joint don't. The orthopedic surgeon advised me not to have surgery again unless absolutely necessary.

The orthopedic surgeon blamed my "deranged immune system" for the aberrant healing.