Approaching operation

[DDKRM]

I’m wondering what information I should make sure the surgeon and the team have before the operation. They will have my health record I’m assuming but at a previous operation, on my hip, I was not given the increase in predisolone I should have had and I ended up having a very bad flare. This was despite the anaesthetist having been made aware of my taking predisolone. So I’m concerned this won’t happen again. I’m on a lower dose of pred now 3mg. Thinking cortisol levels as well?? Not used to having to go into hospital! So not sure of protocol. Any experience gratefully received.

[DorsetLady PMRGCAuk volunteer]

Take any information that you think might be useful to your pre-op assessment appointment - usually a couple of weeks before op date. ..and make sure it's written down!

You should see surgeon and anaesthetist a hour or so before the daily list is commenced, so, double check with them....and if you have someone with you (depending on Covid restrictions) during that time, prime them to enquire on your behalf.

good luck.

[DDKRM in reply to DorsetLady]

Thanks Dorset Lady! I’ve had my pre op assessment appointment but I’m not sure how much the pred information was appreciated. Didn’t discuss it anyway.

[DorsetLady PMRGCAuk volunteer in reply to DDKRM]

Okay,

Do you have any way of contacting department and say you forgot to mention, but would like it noted on paperwork?

[DDKRM in reply to DorsetLady]

I’ll check it out.

[Nextoneplease in reply to DDKRM]

Can you copy your steroid card and take it in? Or take the original, I guess?

[Nextoneplease]

Excellent advice from DorsetLady as ever - I was about to post much the same 😊

All the best with your op x

[PMRpro Ambassador]

I would make sure the anaesthetist doing the op knows you are a long term corticosteroid patient - and ask what cover will they be giving intra-op since you are now at such a low dose and potentially your adrenal function is suppressed. Preferably in writing and with a witness!!!

[123-go in reply to PMRpro]

Belt and braces-tick!

[PMRpro Ambassador in reply to 123-go]

Don't forget the velcro ...

[autumnlass]

In August of this year I was admitted as an emergency with severe renalcolic, and CT scan revealed a 19mm

stone in ureter. A stent under GA was put in. The anaesthetist was marvellous and as sodium levels were low, had to give alternative anaesthesia. She came and discussed this about 2 hours beforehand and I told her about PMR history and Prednisolone. She was really ‘on it’ and gave me enough steroid cover to avoid a flare and pain. When in theatre before the breathing and the mask on face.. I remember her saying ‘I’ve just given you the pred’. Squeaky wheel gets the oil! Keep squeaking and I wish you the best! 🌺🌸

[123mossie]

All of the above plus I’d email the secretary with the info, to be passed on to the surgeon & anaestetist and request a reply, that way you’ve got a record of the communication.I was in a similar position with a hip replacement, neither surgeon nor anaesthetist engaged with what I was telling them, I received nothing during the op. I flared on 3rd post op day at home, I added another 5 to my existing 5mgm & it settled in 24hrs.

[autumnlass in reply to 123mossie]

Well done you for your decisive action, but sorry 😞 that you had to experience this horrid discomfort on top of a major operation. Hoping all is well with you now. 🌺

[123mossie in reply to autumnlass]

Thanks to this forum! It gives us the knowledge and confidence to self manage when we need to.

[Heather270240 in reply to 123mossie]

Don't you have a copy of the Sick day rules - steroid cover which states what has to be done in surgery situations. It can be downloaded to print off. Take it to pre op assessment. I have mine on my phone in case of emergency. Good luck.

[DDKRM in reply to Heather270240]

Hadn’t been aware of the sick day rules. I checked them out and they are absolutely what is needed. Thanks so much for that info. Cheers Heather. I’ll refer the consultant to them when I get in touch with him. And thanks everyone for all your advice. Forum as reliably helpful as ever!

[123mossie in reply to Heather270240]

Yes I have but the gp didn’t take it on board, said leave it to ‘them’. They did nothing henc the flare.

[2013mayo]

Hi, I’ve recently had a big op on my hip, I was told I didn’t need to take any extra pred prior to op, I was on 5mg. I was given a huge dose of pred during the op yet a few hours after the op when I came round I could feel my GCA had gone haywire, I was then told to double up for 5 days. It seems to me that even though they tell you not to increase pred you still have to.

I don’t know why they just don’t tell you to double up for a few days. Don’t get stressed about the situation, just take extra if you need to for a few days after, I’m sure you will be fine.

Good luck with the op, hope all goes well.

🍀🤞😍

[MrsNails]

When you are admitted they ask you at every turn for your Name & DOB - just keep adding - ‘I’m on long term steroids’ - you should meet the Anaesthetist before Surgery & they are the person who really needs to know……When l had my Surgery they were exceptionally good & the ODA even showed me the Hydrocortisone 😉 l spent most of my time concentrating on that rather than the Surgery l was facing…..

There is another leaflet in FAQ’s you may find helpful - l’ll add it for you.

healthunlocked.com/pmrgcauk...

Good Luck 🍀

Kind Regards

MrsN

[musicality]

Best 2 check with GP. One is usually advised 2 up the Pred as a temporary measure, and sometimes stop others, especially over the counter ones. For my op I had short notice, so cd not follow pre op advice in time.