Surgery

[Libertylane]

Another question. Any one have surgery while on the high dose prednisone I was supposed to have spinal fusion and catarac surgery

[Yellowbluebell]

Lots of people have had hip and knee replacements whilst on pred. Some surgeons insist on a lower dose of pred before op but others are happy to operate and will give pred during op.

I really think you need to find out if you actually have gca before considering what you will do regards ops.

[SheffieldJane]

Your own surgeons and anaesthetist will have views on whether these surgeries can safely go ahead and what to do about your high Pred dose. You have plenty to contend with right now in the minute. Try not to leap far ahead in your worries. Easier said than done, I know. Try listening to some relaxation sounds, they are available all over the internet and help to block out unhelpful thoughts. White noise is found to be helpful by some folk.

[Blearyeyed]

The best person to discuss this with is the Rheumatologist that you are seeing today , or the Surgeons you are signed under to undertake the Surgeries.

Many surgeons have different opinions on Pred doseage and surgery , it often also depends on the type of surgery being undertaken and your past history of infection from any invasive procedures. It also depends on your individual Medical history.

Some Specialists prefer you to be on a lower dose of Steroids for the surgery then boost it afterwards. Others prefer a low Pred dose for some time before and after surgery , and then others follow the theory of increasing your Steroids as a form of " Stress dose" .

It all depends on the surgeon and their theory of practice .

So , the Doctors themselves will need to be the ones that help to guide your choices there , and your need for a higher dose of Pred , if GCA is confirmed may change the date that they wish to do the surgery on , and which of your Medical issues they feel it is more important to get under control first.

Take a notebook with you to your consultation with all the questions you want answered , and tick the questions off and write notes as you go a long.

Or , if you feel that you may suffer with Stress and Anxiety at an appointment which you feel could hinder you asking all the things you want to ask take someone with you that you can trust to advocate for you and ask questions or take notes on your behalf which you can read through and digest when you are in calmer surroundings.

Good luck tomorrow

[PMRpro Ambassador]

It very much depends on the dose and the situation. Emergency surgery would be done if necessary but elective surgery is another matter as the risk of infection is increased when on higher doses of steroids and healing may be impaired. At what dose surgery will be done is a factor for the surgery team to decide - some won;t operate on patients on any pred, others are more relaxed about it.

But really, the best thing for you to try to do at present is to cross each bridge as you get to it - some of the obstacles you are worrying about may never arise.

[Lafontainepam1 in reply to PMRpro]

I finally had my super spinal fusion, with all the hardware on Oct. 1st.-L-3-4-5, and S1. I was on 15 mg, up from the month before because I was falling apart with pain and fatigue from pulling my body around with severe stenosis. I’ve never had a problem with infections or being sick so I stayed on the 15, after 3 months I’m still at 15. The recovery is slow, energy just from moving around the house, low, but getting better. Since you cannot bend, twist, or reach, you cannot do much. I have been walking, which you have to do, no matter if it’s only a short distance. My Dr. Just retired so I have been doing my own thing with my family Dr.

My surgeon never suggested anything about my dosage before or after surgery. I do feel with my body trying to get through this recovery has rocked my PMR because I have been losing hair for the last month. So what road do you take, a higher dose than you usually do or more to compensate for the struggle of a long recovery. I was on 7 mg two months before surgery and had been for two years.

[PMRpro Ambassador in reply to Lafontainepam1]

Good start at least - but the hair loss could well be reaction to the major surgery. How long do they forecast for recovery? 2 years?

[Lafontainepam1 in reply to PMRpro]

He really didn’t say, I thought maybe a year, my husband had one disk and hardwear and was good at 3 months. I’m about to go crazy with this kind of recovery. I thought by increasing to 15mg it would help keep my head above water.

[PMRpro Ambassador in reply to Lafontainepam1]

Not quite the same but I had an episode (not surgery) 6 years ago that took me months to get over and I really got terribly down after about 4 months because I didn't seem to be improving at all and all I could manage was a short crawl around the village on crutches! The GP was good - not a lot of practical help but kind and encouraging and suddenly I realised she was right and I was far better than I had been. Last summer I had a pacemaker inserted and I was surprised how long that took to recover from. We do have to remember we aren't teenagers any more!!

[Lafontainepam1 in reply to PMRpro]

At 70, definitely not a teenager anymore! I remember when you got the pacemaker I didn’t realize how much of a recovery it was.

In your opinion should I stay on 15 mg and not be in a hurry to reduce? My feet are starting to look like my own the last couple of days so I thought maybe the Prednisone was helping to take the inflammation away.

[PMRpro Ambassador in reply to Lafontainepam1]

I certainly would be in no hurry if you are feeling good on it!!

[Lafontainepam1 in reply to PMRpro]

I tried to go down a couple weeks ago, stopped at 13, felt like I was losing ground, went back to 15. As we have talked about before, quality of life😎

I have months of being in the house with our winters in Michigan lasting until April! I don’t want to become depressed from trying to reduce😎

[Brantuk]

I was down to 7.5mg daily of prednisalone before my major surgery - so not exactly low dose. But the surgeon raised it to 10mg daily two weeks before the op. At the same time he also stopped my methotrexate completely, until about a month after the operation. It was explained to me that raising the pred will help control inflammation, and stopping the mtx will give my immune system a boost against post op infection. I did get a chest infection after the op anyway, and had to have large doses of antibiotics to clear it. The op was an aortic arch replacement, not small by any means. As mentioned above, it would be a good idea to talk with your rheumy and the surgeon about your particular case.