Steroid dose after operation

[Hidcote]

I am having an eye operation next week. It involves a retina peel because of a perimedial retina and an cataract operation. For a number of reasons, I am having it done under general anaesthetic. I know it will involve a steroid injection. At the moment, I am on 6.5 m . The anaesthetist has said I don’t need to increase the steroid dose either before or after the operation because the procedure is not intrusive . But my anxiety levels are off the scale so I hope you don’t mind me asking for your wise advice.

[PMRpro Ambassador]

The anaesthetist is quite correct. They will monitor you during surgery, you will have a drip in anyway and they will give you extra steroid to deal with the stress of the op. After the op you should be aware of how you feel in case of a flare but it really shouldn't lead to a flare.

An increase in pred for Sick Day Rules is something to discuss with your doctor but it is intended for infections or operations like having your appendix out or a joint replacement or being seriously ill. This is an op that isn't involving cutting into your body, that is what they mean by invasive.

[Hidcote in reply to PMRpro]

thanks so much for your advice which is very reassuring

[MrsNails]

Hi Hidcote - as you are having a GA they will be monitoring you closely & give Hydrocortisone as required to cover you.

After my Mastectomy they rang my Rheumatologist for advice re my Pred Dose Post Surgery & it was increased in accordance with her opinion.

You just need to take your usual dose in the run up to the Surgery & then be guided by the Anaesthetist.

Good Luck 🍀 with your Surgery.

There is info on Sick Day Rules & on Patients undergoing Surgery in FAQ’s

[Hidcote in reply to MrsNails]

thanks so much for your advice

[herdysheep]

Only thing I could add is to try some relaxation exercises from now on in, if you don't do them already. They will be handy whilst you are waiting. My friend had this procedure a while back and was impressed with the difference it made. Hope all goes well.

[Hidcote in reply to herdysheep]

thanks I am having a massage on the morning of the op which should help

[DorsetLady PMRGCAuk volunteer]

Won’t add more to excellent advice you’ve already been given, except to say good luck….

[Hidcote in reply to DorsetLady]

thanks so much

[piglette]

It is natural to feel nervous. There are not many people who can go for any operation without any nerves at all. The operation you are going for is a very successful one. I have never increased my steroid dose when going for an op. In fact I had fights with my surgeon who wanted me on zero. We compromised at 5mg in the end!

[Hidcote in reply to piglette]

thank you Piglette

[HappyDiamonds]

I had an operation in July for a macular hole and chose not to have a GA. At the time I was on 4.5mg Pred and TCZ but I had to stop my injections for 4 weeks as I was on antibiotics. Unfortunately I had a small flare the very day I was due to restart TCZ which I got on top of very quickly without having to increase Pred very much. But it was the lack of TCZ that caused the flare although my Rheumy did say an eye operation (I have GCA that side) could have contributed. My op was a complete success and I hope all goes well very you. Good Luck.

[Hidcote in reply to HappyDiamonds]

thanks for the advice and good wishes

Glad your op was a success