Surgery

[Manchesterlady]

I am due to have surgery within the next couple of weeks and am worried how I will cope with my prednisone.what happens if I can’t take it the day of my operation and afterwards . I am on 8mg at the moment . Is that too high for them to operate .

[podo]

You may actually be asked to increase your Pred for the day of the operation, I was for tooth surgery. Ask your consultant before you go in and good luck with the procedure.

[PMRpro Ambassador]

That is the job of the anaesthetist - mostly you can take essential medications before surgery anyway and the anaesthetist can add it to the mix they are using in theatre via the cannula you will have inserted. Some surgeons like to add a bit of pred to cover for compromised adrenal function, others don't. It really does seem to be a personal preference.

Just make sure that ALL of them, but especially the anaesthetist, know ablout you being on long term pred and have written it down and acknowledged it to you.

Millions of people all over the worl are on that sort of dose or higher for life - and many of them have surgery with no problems at all. It is actually about the same amount of corticosteroid your body makes naturally in the form of cortisol to function properly.

[Mary63]

Had an op in December when I was on 10mg. The anaesthetist gave me some extra hydrocortisone during the op. I am havin another op on Tuesday. I am now between 8 and 7.5 mg. they say they will do the same thing. Good luck

[SheffieldJane]

You and your surgeon and anaesthetist should have this discussion a few days before the op. Try to ensure that this happens. Surgeons have their own preferences and you don’t want to feel worse than necessary. Good luck with your operation. I hope it is a complete success!💐

[piglette]

I had to give my pred to the hospital which gave it to me the correct dose when I was supposed to take it. They then gave it back when I left. I must admit I was worried about it before I went in, but everything went smoothly. My surgeon did want me to be on quite a low dose though and we discussed that beforehand.

[Telian]

PMRpro has explained it exactly as I would, when I had cancer surgery I was on 40mg Pred. and they gave me a top up of another 40mg prior to surgery plus antiobiotics, I still needed another 40mg extra the next day and then things started to settle as it did affect my GCA badly. This week (4 years later and with PMR also) am now on 3mg Pred as can't get lower I had a colonoscopy. I've had three over the past 4 years as keep getting polyps! and have always been given a 20mg top-up of pred. This time the consultant said I didn't need anything as on such a low dose of pred. ( he did remove another Polyp just the one this time compared to 7 previously) and the next day I had a flare up with right sided sore head numbness of the face and really bad jaw ache (my usual GCA symptoms) my body was stiff and I felt terrible, as it was bank holiday I took a small increase making it 5mg pred and it took nearly all of the symptoms off. So in answer to your question are you on too high a dose I would say not but your anaesthetist should have all the answers make sure he knows your history and acknowledges it!

Best wishes with the surgery

PS I would be interested to know if anyone else has started to get Polyps while on Pred or is it just some get them regardless?

[PMRpro Ambassador in reply to Telian]

My MIL had them - never been on pred in her life! I know a few people in the same boat - polyps, no pred.

[Telian in reply to PMRpro]

Thanks for that - that's what they said some people are just prone to them...I'm only glad we have the bowel cancer screening programme as I had no symptoms with them and if not removed they do eventually (up to 10 years) become cancerous, by which time you will get some symptoms but it's too late to treat!

[Bailybiscuit]

I had my hip replaced last summer. After reading people saying how their surgeons wouldn't operate unless they were below 10mg pred or off it completely I was really worried. I needn't have though as when I met the surgeon he said that they would deal with me being on 20mg and they often had emergencies where people were on steroids and had to be operated on. I also worried about slow healing but the operation went well and I healed as a person not on steroids should have. Good luck.