In a week I am having a laminectomy to relieve pressure on my spinal cord and nerves. Diagnosed with PMR in April 2019. Currently on 12.5mg prednisone, and on a very slow taper to 11.5mg over 5 weeks.
How should I manage my steroid dose before and after surgery? Should I up the dose for a few days? Thanks!
Discuss it with the anaesthetist. Don't mess about with your dose without their say-so. You will be given a boost in an infusion during surgery for adrenal function support. You may need a bit more post-op to manage OMR symptoms and guard against a flare but that is something to discuss with the surgical team.
Make sure the anaesthetist is aware by speaking to them beforehand - do not rely on a nurse having passed on the message. Have you already had your pre-op consultation? Usually the anaesthetist comes to see the patient the night before - but check
Thanks . I have my pre op assessment on Thursday and the anaesthetist will visit before the op on the day. (I’m private). Trying to talk to my rheumatologist is impossible.
That’s fine, this really isn’t their bag anyway.
I also had private spinal surgery 18 months ago (decompression and fusion). Was on 4mg of Pred at the time. I was told at my pre op assessment to carry on as normal with my usual dose of Pred including the morning of my surgery. It is very important to tell the anaesthetist again on the day of your op. I was given 2 x 25mg shots infused during the surgery. Carried on with my normal dose the following day. Incidentally I was up and walking the following day. Good luck.
Thank you. That’s very reassuring. On other sites I’m told patients are taken off or reduced steroids which seems mad.
They may be if the steroid use has been short term - but once a patient has been on long term steroids they can't just stop and the likelihood of the underlying disease flaring and then being difficult to control again must be taken into consideration.
As Pro says the man or woman to discuss this with is the Anaesthetist both at Pre Op & when they come to see you Pre Surgery.
When l had my Surgery, they constantly ask you your Name & DoB, l always replied by adding l was on Prednisolone as well!
I got chatting to the ODA (Operating Department Practitioner) the Anaesthetist’s Right Hand Man & he even showed me the Hydrocortisone 😉 l think they were glad to put me to sleep as l was chatting to everyone but that’s my way of dealing with a very stressful situation......
The Registrar rang my Rheumatologist the following morning for advice regarding my ongoing dose & they increased it by 2.5mg for two weeks Post Op.
I would remain on 12.5mg & not attempt to reduce before surgery so you are stable.
Good Luck 🍀 with your Surgery.
MrsN 🌹
Thank you. My pre op assessment is tomorrow. I might write Prednisone User on my forehead when I go down to theatre!
Probably not a bad idea 
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