Should I increase Pred. dose for minor procedure in Hospital?

[AussiePolyDee]

Hi everyone, Have gleaned great info. from this site so hoping you can help me regarding day procedure next week. Going for gastroscopy&colonoscopy and have been on Prednisolone for 7 years now. Actually got down to 1mg last year, but had 3 major flares in quick succession after TKR in July 2016 and increased up to 25 mg. Very slow reduction now on 9.5mg daily. Question: should I increase for this procedure, or am I just being 'paranoid and anxious' because of flares following surgery last year? My surgeon last year did not think I needed any Hydrocortisone following procedure and I certainly suffered for it. (will remember this when get other knee 'done' later this year)

Thanks for any advice you can give me, Regards, Dee

[PMRandRA]

In my opinion, which is non medical, you should do what your doctor, consultant says. Sorry I can't be more specific.

All the best with your procedure.xxxxx.

🌺

[AussiePolyDee in reply to PMRandRA]

I did ask and he didn't seem to think there would be any problem but I will ask again on Monday prior to procedure. Didn't have any probs. 2 years ago but was only on small maintenance dose. Thank you for reply

[PMRpro Ambassador]

Surgery and invasive procedures are one thing and I'm surprised you weren't told to take a bit more pred for a day or two at the very least. But surgery is known to lead to flares of PMR in some people so a bit more pred if that happens should be suggested.

I've had a colonoscopy done and didn't take more steroid. To some extent it depends on how anxious you are about the procedure - it takes a lot to faze me , others are petrified by the thought of a medical procedure. But since it isn't invasive you should be OK with just taking more pred on the day if you are worried. After 7 years you won't have a lot of adrenal function in response to stressful situations.

[AussiePolyDee in reply to PMRpro]

Hi PMRpro, I'm anxious because of last years flares after knee replacement, which was very stressful.

I did ask re a bit more pred. but gastroenterologist didn't think the procedure warranted extra pred. I have Coeliac disease (few other auto immune ones as well as other people do I know) and I think I'm 'over anticipating' things. Thank you for your reassurance re colonoscopy and gastroscopy and no need to take extra pred. on the day. (I will take my bottle of pred. with me though! .....security blanket)

Thank you for your advice. Dee

[PMRpro Ambassador in reply to AussiePolyDee]

I doubt it will be the gastroenterologist doing the scope - so why not discuss it with the staff in the endoscopy suite? The gastro is probably thinking about "normal" patients - a lot of them have no idea about those of us who aren't in that class

[AussiePolyDee in reply to PMRpro]

Don't think I've ever been 'normal' (lol) but I will definitely be asking staff when admitted thru day surgery suite at hospital. Just going over the pre admission stuff, and anaesthetist will see me when admitted, so I'll make sure I let him know as well. Thanks for the advice.

[PMRpro Ambassador in reply to AussiePolyDee]

The anaesthetist is probably the best person to ask about it - they are the ones who have to pick up the pieces in surgery while the surgeon stands there...

[AussiePolyDee in reply to PMRpro]

Ha Ha! That's 100% correct! Hopefully I don't prattle on too much to him (anxiety makes my mouth work too much!) so I'll be practising deep breathing (with mouth closed preferably!) Thanks for your advice, it's really comforting to get good positive (informed) advice from those 'in the know' Leaving soon, friend picking me up at md. Regards, Dee

[PMRpro Ambassador in reply to AussiePolyDee]

They may need you to open your mouth for the gastroscopy...

[AussiePolyDee in reply to PMRpro]

Rofl! YES, they even shoved a 'silence of the lambs' type mouthpiece in before anaesthetic took me away!! Home today after 'survive' yesterday! Few probs. but all removed and just await path. results in 2 weeks. I took my pred. early as you advised and feeling ok today.

I'll definitely plan ahead re pred. when get other knee replacement later in year. (if I don't chicken out) !

[sealine30]

I had this same procedure a few weeks ago and was well enough to be back at work the nect day with no increase in pred. But everyone is different. I found having a sedative for the procedure meant that i had to rest for the rest of the day which probably helped too

[AussiePolyDee in reply to sealine30]

Hi, Thank you for reassurance, I'm becoming a bit of an over-anticipator worrying about possible flares that may never happen! Did have gastr.& colonoscopy 2 years ago but was then only on small maintenance dose. AND Sedation sounds good to me, I'll sleep rest of day! Dee

[Sallyaches]

I am having this procedure too. I am on 6mg of Prednisilone and asked about taking it. The consultant told me to double up the dose I.e take 12mg the day before and the day of the procedure . Apparently some people can find the bowel prep laxatives a stress to the system as it can be a bit dehydrating. This made sense to me.

Best wishes

Sallyaches

[AussiePolyDee in reply to Sallyaches]

I've had procedure a couple years ago, but was only on small maintenance dose and no probs then. On 9.5mg now on dsns

I'll be checking with the endoscopy staff as PMRpro advised, and I'll also make sure anaesthetist aware too. No-one else seemed to be 'concerned' at pre-procedure appointment. I'm think I've become over anxious because of last years flares (obviously different as was Knee replacement surgery, and super stressful). Hope yours goes well too. xD

[Sandybo]

Hi AussiePolyDee, I had a gastroscopy and colonoscopy recently, my appointment was at 2pm and I took my prednisolone at 6am in the morning, this was as advised on my information sheet regarding the procedures.

All the best to you, my experience was fine!

[AussiePolyDee in reply to Sandybo]

My prep. sheet just said take usual medications in morning, so I'll get up earlier that the Oroxine etc. then the Pred 1/2 hr later. That's good to know all went well with you too, thank you for sharing with me

[Jankie]

Last year I had surgery for breast cancer. Lumpectomy. Had discussion with anaesthetist. He was happy with my dose. Continued with usual dose and stayed on that with no real PMR problems

[Jankie]

I was taking 6mg

[AussiePolyDee]

Hi Jankie, Thank you for your reply. Hope all is going well for you now. xD

[SusanEleven]

I had a colonoscopy and asked my rheum doc about any need for extra pred. She said my regular dose was fine. (Interestingly she did suggest a little bit of extra pred for a multi-hour and difficult dental procedure I had.)

For what it's worth, I have a lot of anxiety (understatement) about sedation so I researched doctors who were skilled in doing colonoscopy without sedation. Turns out there was one at my regular medical center. To me it was actually quite easy and fast. No pain. Just some occasional pressure. And I didn't need anyone to drive me home.

[AussiePolyDee]

Hi Susan, Thank you for your reply, I'm doing deep breathing (not helping much lol) and just about to be picked up by friend for 12md hospital admission.

Took current dose of Pred. early this morning, so far so good. Think I'm just getting old and 'anxious, and my daughter said 'get a grip!' (she's a teacher... enough said ha ha!) Thanks again for your support, living on my own (as lots of others do too), it's comforting to have 'friends' online who understand the issues surrounding pmr. and share advice. xD