Upcoming surgery

I'm not sure if this an appropriate post but am facing a situation that is worrying about. I was first treated for PMR in Jan 2018 and started with various doses of Prednisone...mostly it settled at 15 mg per day. I have experienced a couple of flares and am now down to 2 mg. The dilemma I am facing is that I am scheduled for anal fissures/sphincterotomy tomorrow and am very anxious on how/if this will affect my Pmr. I have started feeling increasing pains and tightness in my shoulders, neck and arms. I believe caused by my anxiety about this "procedure" and after. My rheumy advised me to up to 5 mg for the next few days and drop back down to 2. Does that seem reasonable. To say I'm anxious is an understatement......any thoughts?

[DorsetLady PMRGCAuk volunteer]

You are obviously flaring as a result of your anxiety about your upcoming operation. Good idea to increase dose to 5mg, but remain on for at least a week, and then drop back down to 3mg or 3.5mg not 2mg.

If 2mg has not been enough, I doubt very much it will be sufficient until after you have recovered completely after your procedure.

[Hidden in reply to DorsetLady]

Thank you so much for your response. I will take your advice. This is such a strange journey and so glad you and the others are there to help us get through some of these hurdles.

[SheffieldJane]

I agree with Dorsetlady’s advice. I wonder if they will give you a pre-med which will banish the anxiety? I really hope this operation improves your life! It’s a pretty successful op apparently. I wonder if you have children? It’s just that the procedure sounds similar to something I had done after an episiotomy, following a difficult birth. In fact, not as bad. Of course the baby is a distraction.

[Hidden in reply to SheffieldJane]

Interestingly, I did have a difficult delivery but that was 52 years ago. He was a fairly large baby and no episiotomy was done and there was tearing instead. Not sure if that played into this but I do know I am very anxious and I believe it is contributing to an increase in PMR symptoms. I do have a mild tranquilizer I can take...thank you for your words of encouragement.

[SheffieldJane in reply to Hidden]

I bet it is connected, a tear is much worse that a cut. Stress does that to our symptoms, doesn’t? Even arguments have my shoulders pinging with pain. Good luck!

[PMRpro Ambassador]

I think your rheumy's suggestion is a good one - AND you have permission!!! But like DL - I wouldn't be in any hurry to go back to 2.

I hope you have made it clear to the anaesthetist you are a longterm corticosteroid patient?

[Hidden in reply to PMRpro]

Yes I did tell the anaesthist that I was on Prednisone long term. He asked what for and when I told him I had PMR he said that is a very complicated illness and told me his last patient had it too.

[bunnymom in reply to Hidden]

Amen to complicated!

[Hidden]

Hi just to say I have had a hip replacement while having PMR. The people who did the opp had all the information from me about my PMR. I was given a high dose of something similar when I had the opp Then had to take a little higher does of prednisanol when I came home just for a week or two if I remember. Ask when you have your opp they should put you right. Everything was fine with me

[PMR2011]

No worries, I had a bowel resection whilst on Pred for PMR. Was in hospital 3 days. Anesthesiologist gave me a stress dose of steroids just before and my PMR actually felt best it had for while after the surgery!

[Hidden]

I obviously can't comment about you being on Pred prior to surgery, the hospital will advise on that...it's not like they're Warfarin that is a blood thinner that has to be stopped before any surgery. However, regarding your op. My daughters friend had this done a few weeks ago and is absolutely fine and recovered so quickly she is in her early forties. Good luck and try not to stress as that will make your PMR worse. Easy to say as I'm the biggest of worriers. Daft isn't it, as what does worrying achieve except to make us feel worse.

Take care and good luck with surgery. Keep us posted

Anne

[YuliK]

Yes your rheumatologist is spot on.

Good luck with your procedure...it shouldn’t affect your PMR...

Let us know how you are getting on. 👍

YuliK 🌹🌹🌹🤗