on 3.5mgs of Prednisolone & having a colonoscopy with sedation on Saturday. Should I increase my dose of pred beforehand?

[Cact]

Hi all, looking for advice from you lovely knowledgeable people.

I’ve tapered down from 10mg in June last year to 3.5mg 2 weeks ago with no problems, (apart from pains in my legs during the night, but I think that might be something else). I often wonder if the PMR might actually be in remission because it’s been such any easy taper.

But I’m a little concerned about my upcoming colonoscopy & whether 3.5mg will be enough, also worried if my adrenals haven’t woken up yet. I had to leave a voicemail when I rang the colorectal nurse today, they’ll answer within 24 hours hopefully. I also need them to tell me what medication I should stop taking. I’m on Metformin & Gliclazide for Type2, also Evacal & Atorvastatin.

I looked in sick day rules but only found posts concerning Covid, Cataracts & surgery, none about medical procedures & pred.

If anyone has any advice or experience of something similar, I’d be very grateful for your input.

Thanks in advance.

[PMRpro Ambassador]

It isn't an invasive procedure so shouldn't be a problem.

What time is your procedure? When must you take your prep?

[Cact in reply to PMRpro]

Procedure at 9.30, I’ll have to take them around 7am as nothing to drink 2 hours beforehand.

[PMRpro Ambassador in reply to Cact]

Is it an endoscopy (from the top) or a colonoscopy (from the bottom)? Ask them about taking tablet as they may interfere with the view.

[Cact in reply to PMRpro]

It’s a colonoscopy, however I’m unable to swallow tablets no matter how small so I’ll have to crush them up somehow. I usually hide them in my porridge every morning, it’s a phobia I have & forget the name of it. So if they’re crushed hopefully they won’t be seen & should be well dissolved in over 2 hours. I’m just worried about getting a flare afterwards, I’d hate having to up my dose after doing so well the last year. Thanks for your reply 😊.

[Cact in reply to PMRpro]

Sorry PMRpro, I misread your 1st reply. My prep is Friday afternoon to evening. To me that’s the worst part of the whole shebang, makes me gag just thinking about it.

[PMRpro Ambassador in reply to Cact]

Me too - the colonoscopy was quite interesting - no sedation here and you get to watch the TV!

If it is a colonoscopy it won't be a problem, won't have reached that low! I used to have to grind stuff up in honey for OH ...

[Cact in reply to PMRpro]

Wow, you’re very brave to have a colonoscopy with no sedation, I couldn’t do that. I had 2 last year & the 1st one I remember waking twice in terrible pain, only for a few seconds & I heard the shout for more sedation & I was gone under again. It’s that disgusting Moviprep I hate, not the actual procedure itself. This is the last one I’m having, but I remember saying that the last time 😁.

[PMRpro Ambassador in reply to Cact]

It's normal here - and absolutely fine with a good doctor. Because the patient is "present" they go about it more gently - and I suspect they have fewer problems as a result. If you really can't tolerate it they do offer something but it is unusual.

[SheffieldJane]

The doctor who performed my colonoscopy also added hydrocortisone to the line for sedation. This was in addition to my 7 mgs dose of Pred. Presumably for Adrenal demands. I did not feel very sedated, I said so, nor did the gas and air seem to contain much. The rather charmless nurse dismissed this. Thank goodness it wasn’t childbirth.

[Telian in reply to SheffieldJane]

I was told firmly they do not sedate us - whatever they give has an amnesiac effect - makes us forget when it gets too uncomfortable.

[SheffieldJane in reply to Telian]

I remember it all quite clearly. The nurse referred to it as sedation, perhaps there’s been a change? I also watched the film with interest. Saw them removing 6 polyps.

[Telian in reply to SheffieldJane]

They do call it sedation but it doesn’t put you out- it has the amnesiac effect. I remember being in a lot of pain when they removed 7 polyps and when I said you must have put me out she said no it makes you forget!

[PMRCanada]

I had one in 2017 and don’t remember a thing, but agree the prep the day/evening prior was the worst part. I wasn’t on pred then so sorry I can’t contribute any advice.

Now I have to have another one post diverticulitis so hoping the results are ok. Admittedly I am more nervous about a potential perforation during the procedure given I’ve been on pred for 4+ years, and if my intestine skin is as thin as my outside skin, it could be tricky! The good thing is I have a wonderful gastro surgeon who has loads of experience and is aware of my concerns.

Hope your procedure goes smoothly!

[Cact in reply to PMRCanada]

Thank you PMRCanada. I try not to think about things that can go wrong, especially the perforation bit. I’ve been on pred since September 2020 with only one flare in April 2021, the fault of the rheumatologist who tapered me too fast to 4mg by April. I hope everything goes well for you too.

[Nanny71]

Hi Had colonoscopy with sedation 3 wks ago. Im on 3 mg . All went extremely well . Good Luck 🌺

[Cact in reply to Nanny71]

Thank you Nanny71. That’s very reassuring as we are both on a similar dose. I had 2 colonoscopies last year but was on 10mg & 9.5mg so I had no worries about adrenal insufficiency then.

[Lizzery]

Hi, I’m due to have a colonoscopy soon. My concern is as to when to take meds, as I usually have them after my Greek yoghurt and fruit breakfast. I have asked for a morning apt so that I’ll be able to take them as soon as I can after the procedure. Ummm the moviprep, the least said about that the better!

[Cact in reply to Lizzery]

Hi Lizzery, I got a call from the hospital this morning regarding my medication as I’m also on Metformin & Gliclazide twice a day for my Type2 diabetes. I can take the morning meds on Friday, then no more until after my colonoscopy on Saturday at 9am. Being diabetic I always have an early morning appointment for the many scans & oscopies I’ve had the last 2 years, because the Metformin has to be stopped for a day or two.

[LBM1953]

I had the same procedure last year. Wasn't asked to change my meds. Was asked if I wanted any sedative or anesthesia and we agreed that I would try without and we would stop and administer some if I asked for it. To be honest I hardly knew it was going on apart from some minor feelings of pressure but no pain at all. The doctor was great and if I was going again I would do the same.

[cranberryt]

You should call and ask your doctor. Mine said no medication prior to the procedure. They actually gave me a big dose of prednisone in my IV after the procesure and then instructed to resume regular dose the day after. Because there is a risk of bleeding, they probably don’t want you taking it the morning of.

[Cact in reply to cranberryt]

Thank you cranberryt, it’s as difficult as ever to get a face2face or even a callback at my medical centre. Tried last week for another reason, was told 3 weeks for a face2face & 4 days for a callback. I had to insist I speak to someone urgently, got a callback within an hour.

[Nanny71]

Hi again I had an 8.30 appointment so took medication when I was given tea and toast afterwards and yes the prep is disgusting . Saw a newsfeed this week that they now have a tablet form in the USA. Hope it gets here soon 🌺

[Cact in reply to Nanny71]

A tablet form would be great, I’m just surprised it’s taken so long for someone to realise this. I had major bowel surgery July last year & this colonoscopy is a yearly follow up to make sure everything is ok apparently. I’ve decided no more after this one, I’ve had enough now, 3 since June last year.

Thank you Nanny71 for the info. ☺️