SURGERY

[ConventCassie]

I need to have inguimal hernia surgery. I’m currently on 4.5 mg of Prednisone. I don’t know whether to increase the Pred before or after the surgery and how much and for how long. I’m also concerned about the Anesthesiologist and if he or she will understand PMR and a systemic disease and subsequent painkillers that go with prednisone. I appreciate any input. Thanks.

[PMRpro Ambassador]

I don't think you need to worry too much about the anaesthetist (providing it is a doctor and not a nurse you see) - and they are the person to speak to about the steroid dose. Many surgeons/anaesthetists like to give a boost of steroid via the infusion set up during surgery so you should discuss it with them rather than add to your usual dose without consulting their preferences. Some teams prefer to monitor the patient and give a boost if required rather than prophylactically as was the case in the past.

Of all doctors. anaesthesiologists are amongst the most aware of drugs and interactions. Providing you have discussed your medications with the surgical team and made sure they have noted them it shouldn't be a problem.

[ConventCassie in reply to PMRpro]

Wow! Thanks. That puts my mind at ease.

[DorsetLady PMRGCAuk volunteer]

Hi,

I presume you will have an assessment a couple of weeks before your operation, and that is the time to raise your queries. Even if the person you have the assessment with cannot directly answer your question they should be able to get the anaesthetist to discuss with you. It’s normal procedure to discuss medication etc a few weeks before any op.

[ConventCassie in reply to DorsetLady]

Thank you. Will do.

[Lee1945]

As the others have said, do not make this decision yourself! It is vital that you discuss it with the doctor/anaethetist in advance of surgery date - they will need to know your situation so they can advise you and be prepared.

[ConventCassie]

Of course I’ll communicate with my doctors, but I threw this out there because my Rheumy and PC don’t have a clue about “flares” I’m not confident my anesthesiologist will be any more informed. During one ‘flare’ I did not know it was a flare at the time, my PC helpfully suggested I had Facit Joint DJD and sent me to a Physical Therapist. Of course it involves the Joints!!! So much pain, I told the PT if I lie on my back that will be the last part of the exam, because I can’t move after that. The Rheumy equally helpful asked in a scale of 1-10 how do you feel. “Oh, 17 or 20.”

“Good let’s just reduce by 1 Mg a month!”

[Hidden]

Hi Cassie

When you go into hospital these days they ask you your Name/Date of Birth so many times & every time they did l said “I’m the lady on Steroids”

I had a Consultation with the anaesthetist before surgery & she reassured me they’d be monitoring me very closely but l was having Hydrocortisone cover in theatre prescribed in advance.

I walked to Theatre & everyone asked my Name & DOB so l started asking them who they were & what they did! Just me pretending to be fine about the whole thing!

Wishing you all the best for your surgery & recovery.

Best Wishes

Mrs N 💅🏼