Oral biopsy when immunosuppressed.

Posted by ktgirl @ktgirl, Dec 5, 2023

I'm worried about having an oral biopsy when I'm on Actemra that suppresses my immune system. I have RA along with other autoimmune diseases. A year ago I had an infection on my thumb that took months to heal after many visits to a wound clinic and then I was off Orencia all that time. Then when it finally healed I had knee replacement surgery and was off the drug another month. It pretty much goofed up my body then after the surgery I ended up with pneumonia and once I was off antibiotics for that I started Actemra. The pneumonia left me with pulmonary fibrosis and I had to quit my job. To say the least it's been a rough year for me and I don't want to take a chance with this biopsy. I have Sjögren's so my mouth is super dry and it's painful to eat any fruit or anything slightly spicy. I wanted to have an oral surgeon look at it but when he said I might need a biopsy it made me very apprehensive about it after this last year.
What do you all think? Any suggestions? Am I being too concerned about this?
Any suggestions??
Thanks!

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What’s involved in the the biopsy you need? I mean if it’s a cheek scrape vs a chunk of your gum - different expectations in terms of infection risk.

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@pb50

What’s involved in the the biopsy you need? I mean if it’s a cheek scrape vs a chunk of your gum - different expectations in terms of infection risk.

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I'm not sure exactly. I saw the oral surgeon a couple weeks ago and he gave me a corticosteroid gel to use on the sore spot and that helped but he wanted me to come back. They want me to fast and no water for 6 hours before because they would put me under. I'm assuming they will take a chunk out then. I would think if they just scraped my cheek they wouldn't have to. I'm not sure though.

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@ktgirl

I'm not sure exactly. I saw the oral surgeon a couple weeks ago and he gave me a corticosteroid gel to use on the sore spot and that helped but he wanted me to come back. They want me to fast and no water for 6 hours before because they would put me under. I'm assuming they will take a chunk out then. I would think if they just scraped my cheek they wouldn't have to. I'm not sure though.

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You know you. Have you had a history of gum and other mouth infections? If not, and you are miserable, just do a risk and control chart: column A are risks such as focal Infection, systemic infection, severe pain etc.
Column B shows corresponding controls - meaning how do you hope to prevent or satisfactorily manage the risk? Like prophylactic antibiotics or intensive antiseptic lavage, etc (I’m making stuff up since I know nothing about specifics here). And you may need the doctor or his Nurse /PA to help.

When I resist getting carried away with reactive nonsense, that method always helps me get to a decision or get peaceful with an inclination.

Still sending good JuJu your way!!

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@pb50

You know you. Have you had a history of gum and other mouth infections? If not, and you are miserable, just do a risk and control chart: column A are risks such as focal Infection, systemic infection, severe pain etc.
Column B shows corresponding controls - meaning how do you hope to prevent or satisfactorily manage the risk? Like prophylactic antibiotics or intensive antiseptic lavage, etc (I’m making stuff up since I know nothing about specifics here). And you may need the doctor or his Nurse /PA to help.

When I resist getting carried away with reactive nonsense, that method always helps me get to a decision or get peaceful with an inclination.

Still sending good JuJu your way!!

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I just called the clinic and talked to the nurse and she isn't sure if he will do a biopsy or not. My thought is because of my dry mouth it could be something like thrush or something like that. Thanks for the idea about the columns! I don't know what to write down either so I'll find out tomorrow! Thanks for responding! I appreciate it.

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I opted not to have the biopsy done for diagnosis. I just treat myself as if I have Sjogerns for sure. Having a definitive diagnosis one way or the other doesn’t change that. The things I do to help my Sjogerns are good for my overall health anyway.

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@cpd54

I opted not to have the biopsy done for diagnosis. I just treat myself as if I have Sjogerns for sure. Having a definitive diagnosis one way or the other doesn’t change that. The things I do to help my Sjogerns are good for my overall health anyway.

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I already know I have Sjögren's so I don't know what he's looking for exactly. I know there can be a chance of cancer but he said the first time I saw him that he didn't think it was by the way it looked. I'm hoping he's ok with me opting out too. Does your mouth burn if you eat anything acidic or spicy? Sometimes just drinking water hurts my mouth.

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@ktgirl

I already know I have Sjögren's so I don't know what he's looking for exactly. I know there can be a chance of cancer but he said the first time I saw him that he didn't think it was by the way it looked. I'm hoping he's ok with me opting out too. Does your mouth burn if you eat anything acidic or spicy? Sometimes just drinking water hurts my mouth.

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I ate fresh pineapple and my tongue got very irritated, so yes to acidic foods. This may be coincidental but I’ve started taking 182 mcg of Vitamin K2 in the form of MK7, for osteoporosis. My saliva production has increased and I also don’t have to use eye drops as often. You won’t find any studies on this but I have seen some articles about K2 helping with cavities.

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@cpd54

I ate fresh pineapple and my tongue got very irritated, so yes to acidic foods. This may be coincidental but I’ve started taking 182 mcg of Vitamin K2 in the form of MK7, for osteoporosis. My saliva production has increased and I also don’t have to use eye drops as often. You won’t find any studies on this but I have seen some articles about K2 helping with cavities.

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That's good to hear regarding the vitamin K2. I've read a lot of good things about K2 and might check that out. I think it is also recommended to take D3 with K2 together. We heard about that after the Covid stuff. My husband takes it so I better give that a try. Glad to hear it may be helping you. Pretty harmless to try it anyway. So what is MK7? I'm not familiar with that.

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@ktgirl

That's good to hear regarding the vitamin K2. I've read a lot of good things about K2 and might check that out. I think it is also recommended to take D3 with K2 together. We heard about that after the Covid stuff. My husband takes it so I better give that a try. Glad to hear it may be helping you. Pretty harmless to try it anyway. So what is MK7? I'm not familiar with that.

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MK 7 is a form of vitamin K2. I have osteoporosis and MK7 and MK4 help your body to utilize calcium correctly. Along with D3 and A.

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Ok. Thanks. I have osteoporosis and RA along with Sjögren's and Raynauds. I'm just a big mess!! Thanks so much for the info. I'm going to check it out for sure.

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