Dr Pierre Mason
Disappearance of symptoms from Rheumatoid Arthritis following removal of surgical steel chest wires
I underwent an aortic valve replacement operation in February 2007 in which standard surgical steel wires were used. Within 6 months of the op, I began to suffer the symptoms of acute arthritis in my wrists, knees and feet – the pain was so severe that I could at times not dress myself unassisted. This was accompanied by auras, a perceptual disturbance more common in sufferers of neurological conditions such as migraine.
Three months later I was diagnosed with Rheumatoid Arthritis. This seemed unusual to me, as a GP, as there was no history of Rheumatoid Arthritis in my family and it would normally develop earlier in life.
My symptoms were treated with a combination of co-codamol, anti-inflammatories and Methotrexate, a common treatment for Rheumatoid Arthritis – however, these were palliative measures, as there is no known ‘cure’.
I experienced a facial rash upon wearing a new pair of glasses, which I discovered to be largely composed of nickel, indicating a metal allergy. This was combined with the flare up of my arthritis after eating salmon (also high in nickel), which lead me to research the surgical steel wires used in the operation. I discovered that the stainless steel compound contained 40% nickel.
After a consultation with my specialists I was told that there was no link between metal allergy and the development of arthritis. My cardiac surgeon however agreed to remove the wires in case there was a link. This was a year after my original operation.
Before having the wires removed, I took the MELISA test, which confirmed a severe allergy to nickel, molybdenum and manganese and a milder reaction to chromium.
The removal surgery went ahead on 29th April 2008. Over the following three months, my arthritis improved noticeably but did not disappear. I returned to the gym, performed strenuous tasks without extreme difficulty and my daily auras had gone. However, as I still experienced some pain, I continued with methotrexate treatment.
Over a period of two years, my symptoms declined – by September 2009, my arthritis was restricted to mild symptoms in one hand and I experienced auras only occasionally. I decided to stop taking methotrexate six months later in March 2010 after all my symptoms had disappeared.
As of October 2010, I have been off methotrexate for a significant period and I am completely symptom-free. Naturally, defining whether either the methotrexate or the removal of my chest wires was primarily responsible for my recovery is difficult. It is prescient that Rheumatoid Arthritis is usually viewed as an incurable disease even when treated with powerful medications such as methotrexate and it was upon the removal of the surgical steel that my symptoms began to subside. I believe that my symptoms were a direct result of an allergic reaction to the materials used in my operation.
Dr Pierre Mason, United Kingdom