Transplant: Amoxicillin for dental appointment

Posted by hello1234 @hello1234, Nov 17, 2021

Hi all,
I have an 8am morning dentist appointment next week. The dentist would like me to take 2,000mg amoxicillin one hour before the appointment to prevent infection. Normally at 7am I take my Cellcept and Envarsus XR. What do you do in this instance? Has anyone taken amoxicillin with Cellcept and Envarsus XR? Do you take amoxicillin when you visit your dentist or go for a dental cleaning? Thanks everyone!!

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@hello1234

Hi @contentandwell JK! 😊 Thanks so much for jumping in to help me! I hope all is well with you!
I called my transplant team and they told me I could take my immune suppression drugs and the 2,000mg amoxicillin at the same time, so that was good news... I think I am going to try to separate them by 30 minutes or so.
Do you have a hip replacement or knee replacement that needs amoxicillin before dental work? I forget which organ you had transplanted, did you have a liver or kidney transplant? Did you have your transplant first and then your orthopedic surgery?

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@hello1234 I have had both knees replaced, so far my hips are not arthritic, they just have bursitis and one has sciatica. The first orthopedic surgeon did not suggest lifetime amoxicillin but the second one did. He is really great but he is cautious. I presume he must at some point had a patient affected by dental work beyond the typical two years when amoxicillin is usually advised.

I had my liver transplanted. I had my first knee replacement before my liver showed problems. I was planning to have the second one done when I was not yet diagnosed with cirrhosis but having problems, one being low platelets. I was put on prednisone for two weeks by my hematologist to help get my platelet count up and it seemed to help but on the morning of the surgery the count was not good enough for the surgeon to operate so it was delayed. I was outside of the OR, all set to go in for the surgery, intravenous in my arm and all, when the surgeon came out and told me the bad news.

It ended up being a long delay because that was in February of 2014 and my transplant was in September 2016. I could have had the TKR 6months after my transplant but I couldn't bear the thought of being in the hospital again so soon so I waited a full year.
JK

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@athenalee

Yes, pandemic memories…being increasingly ill at the start of the pandemic, not being able to see my liver doctor, having my transplant team interviews delayed, then (fortunately!!) started via webinar, ending up in the emergency room multiple times (my support person made me strip in my garage and then walk up the stairs to shower immediately upon return due to Covid fears!), and in the hospital for one month and a week and no visitors…lots of stress upon stress! I kind of grew tired of people complaining they couldn’t go out to restaurants or movies!

Unfortunately no Mayo in my area. I went to Lahey, which is just outside Boston. My team was great. Two female surgeons. I think the follow up lacks the team approach of Mayo, however. Although, I’ve asked to see a rheumatologist at Lahey to help get a more coordinated treatment plan, so I’m hopeful.

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Good morning @athenalee 😊 Hey, did you say you were in the hospital for a month and a week?....Is that the normal amount of hospital time after a liver transplant?

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@contentandwell

@hello1234 I have had both knees replaced, so far my hips are not arthritic, they just have bursitis and one has sciatica. The first orthopedic surgeon did not suggest lifetime amoxicillin but the second one did. He is really great but he is cautious. I presume he must at some point had a patient affected by dental work beyond the typical two years when amoxicillin is usually advised.

I had my liver transplanted. I had my first knee replacement before my liver showed problems. I was planning to have the second one done when I was not yet diagnosed with cirrhosis but having problems, one being low platelets. I was put on prednisone for two weeks by my hematologist to help get my platelet count up and it seemed to help but on the morning of the surgery the count was not good enough for the surgeon to operate so it was delayed. I was outside of the OR, all set to go in for the surgery, intravenous in my arm and all, when the surgeon came out and told me the bad news.

It ended up being a long delay because that was in February of 2014 and my transplant was in September 2016. I could have had the TKR 6months after my transplant but I couldn't bear the thought of being in the hospital again so soon so I waited a full year.
JK

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Hi @contentandwell 😊 So great to hear from you! .... I see that you mentioned sciatica in one hip. I have the same in my right hip. Have you found any relief in certain exercises or any other remedy? My sciatica comes and goes for apparently no reason. I can't determine if it's something I am doing to bring it on?

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@leahdrose

@hello1234, It’s always nerve wracking checking the lab test results and such a huge relief when it came out good. I’ll ask UCLA what their protocol is on kidney biopsy. I will keep you updated after my appointment with UCLA tomorrow.

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Good morning @leahdrose 😊 Is today the day you have your appointment with your UCLA transplant nephrologist? I am thinking of you and looking forward to hearing about your visit! Please remember to ask about the protocol biopsy schedule at UCLA. I am interested in comparing it to Mayo's protocol schedule since I am very apprehensive about so many biopsies too. I hate the idea of an even tiny possibility of upsetting my fabulous new kidney. I know you feel the same way. Good luck on your visit! ❤

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@hello1234

Hi @contentandwell 😊 So great to hear from you! .... I see that you mentioned sciatica in one hip. I have the same in my right hip. Have you found any relief in certain exercises or any other remedy? My sciatica comes and goes for apparently no reason. I can't determine if it's something I am doing to bring it on?

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@hello1234 I have found nothing so far for my sciatica. I'm considering going to a doctor but I'm not sure which type of doctor to go to. I have heard neurologists but I was also wondering about orthopedic doctors and/or physiatrists. I may google today to see if I can find some exercises. I do know that excessive sitting can cause problems.
JK

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@contentandwell If you find any good solutions to the sciatica, please let me know! There are sciatica exercise videos posted on YouTube by several physical therapists. I would think your orthopedic doctor may be a good resource too. It seems that the sciatica nerve gets inflamed and then feels like "pins and needles". If I walk too much, I can get it sometimes. If I sit too much, I can sometimes get it.... It's very arbitrary for me.
Thanks for all the good info JK!! 😊

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@hello1234

@contentandwell If you find any good solutions to the sciatica, please let me know! There are sciatica exercise videos posted on YouTube by several physical therapists. I would think your orthopedic doctor may be a good resource too. It seems that the sciatica nerve gets inflamed and then feels like "pins and needles". If I walk too much, I can get it sometimes. If I sit too much, I can sometimes get it.... It's very arbitrary for me.
Thanks for all the good info JK!! 😊

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@hello1234 There is a lot of good info on this site:

https://www.emedicinehealth.com/what_triggers_sciatica/article_em.htm

including this:
Triggers for sciatic nerve pain include:
"Sitting too much
Being overweight/obese
Wearing high heels or uncomfortable/uncushioned shoes
Wearing overly tight, form-fitting pants, shorts, or skirts
Carrying bulky items in a back pocket, such as wallets and phones"

I strongly suspect my current flare has to do with sitting too much. I've been trying to Christmas shop on the computer.
JK

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@contentandwell

@hello1234 There is a lot of good info on this site:

https://www.emedicinehealth.com/what_triggers_sciatica/article_em.htm

including this:
Triggers for sciatic nerve pain include:
"Sitting too much
Being overweight/obese
Wearing high heels or uncomfortable/uncushioned shoes
Wearing overly tight, form-fitting pants, shorts, or skirts
Carrying bulky items in a back pocket, such as wallets and phones"

I strongly suspect my current flare has to do with sitting too much. I've been trying to Christmas shop on the computer.
JK

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Thank you for the great info @contentandwell I think sitting too long at the computer may be my reason too...Holiday Shopping Season! 😊

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@hello1234

Good morning @athenalee 😊 Hey, did you say you were in the hospital for a month and a week?....Is that the normal amount of hospital time after a liver transplant?

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No. I had a severe reaction to prednisone. But they didn’t want to take me off it for at least a week. I had wicked hallucinations! I kept trying to run away as I thought the nurses had kidnapped me. Then, there were bugs on the walls. My dog came to visit. Weird.

And, then I had to stay longer as I wasn’t getting enough protein and they kept me on the feeding tube the whole time…plus, I left with it.

And, I had some infection issues and trouble with ascites which had to be drained off…yuck. Not a pretty site. Funny, I was roaming through my photos the other day and found one just before my transplant when I weighed in at 137 due to ascites (107 now!). Having never been pregnant, I had new found great admiration for pregnant woman. And, one of my favorite homecoming experiences was getting to wear my favorite shoes again!

How long were you in the hospital for your transplant? Any issues? How’d you cope with Covid during your pre-transplant and hospital stay?

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@athenalee

No. I had a severe reaction to prednisone. But they didn’t want to take me off it for at least a week. I had wicked hallucinations! I kept trying to run away as I thought the nurses had kidnapped me. Then, there were bugs on the walls. My dog came to visit. Weird.

And, then I had to stay longer as I wasn’t getting enough protein and they kept me on the feeding tube the whole time…plus, I left with it.

And, I had some infection issues and trouble with ascites which had to be drained off…yuck. Not a pretty site. Funny, I was roaming through my photos the other day and found one just before my transplant when I weighed in at 137 due to ascites (107 now!). Having never been pregnant, I had new found great admiration for pregnant woman. And, one of my favorite homecoming experiences was getting to wear my favorite shoes again!

How long were you in the hospital for your transplant? Any issues? How’d you cope with Covid during your pre-transplant and hospital stay?

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@athenalee I had no idea that you experienced such an ordeal post-transplant. Over a month in the hospital. (And on top of all of this, due to covid you had no visitors). After the month and a week was over, did you go home or did you need to live close to the hospital in nearby long term housing? I'm not sure how far you live from Boston?
My post kidney transplant experience was pretty textbook (I am very, very,
very grateful!). I had my surgery on Thursday and I was discharged on Sunday morning. They were talking about Saturday, but it became Sunday morning which was no problem. Then I stayed at long term housing (rental) in Jacksonville for one month to be close to Mayo for my regularly scheduled 6am lab work and afternoon doctor appointments. They took great care of me! Of course my Tac was adjusted regularly too. The great thing about Mayo's lab is they have the Tac number in a few hours and my nurse would call me with any adjustment. At my local lab in South Florida, they have the Tac results in 5 DAYS, not five HOURS! My local hospital sends the blood vial to Labcorp on Monday and I normally get the Tac result on Friday. (That's another wonderful thing about Mayo...their lab and testing centers are extraordinary.) All in all, it was a great experience and I happily left with my new kidney! My only concern now is my elevated LIVER enzymes that are probably caused by the immune suppression drugs. My fear is ultimately they may need to further adjust or reduce my meds, which can increase the likelihood of rejection. My kidney numbers are doing so well. I wish the same was happening with the liver. I am not sure if they can just keep the liver enzymes running high without ultimately damaging the organ. I assume they are always weighing the pros and cons, similar to your awful prednisone side effects. They decided to keep you on the drug in spite of the adverse reactions. I am not sure if the liver will be same thing or if they will be forced to make an adjustment since these meds are lifetime and may cause damage to the liver after time?
I am so happy that you are through that early experience and now back to long chilly walks and dancing in the kitchen!! 💃😊💃

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