increasing dose when having surgery advice

[Sumojo]

In three weeks I’ll be having a gluteal repair operation. I’ll be non weight bearing for several weeks on right leg.

I’ve been on 5mg pred for several months and feeling good on that dose. I tried to reduce to 4.5 mg but PMR symptoms of a flare sent me scurrying back to five mg.

The reason I’ve resisted trying another reduction was because of the up coming surgery.

My question is, should I increase my pred dosage while undergoing surgery?

[SheffieldJane]

I would seek the surgical team’s advice. They can differ. Best to be on the same page. Good luck with it all. I expect you will needs physio at some point. Xxxx

[DorsetLady PMRGCAuk volunteer]

That is something you need to discuss with surgical team in advance - and the anaesthetist in particular- everyone needs to be aware yiur are in steroids. They may well give you an extra infusion during the surgery…

[Sumojo in reply to DorsetLady]

thank you

[PMRpro Ambassador]

You will get cover while in surgery, the anaesthetist is the person to take care of that. Then afterwards it will depend - some don't flare, others do so it is a question of waiting and seeing and reacting promptly if you appear to be flaring. You have to be well enough to do the rehab. And I think Sick Day Rules should apply for post-op recovery, probably for up to 2 weeks, but that is something you may have to get approval from from your GP.

[Sumojo in reply to PMRpro]

thank you, good advice. Sue

[MrsNails]

Hi Sumojo - when l had my Surgery l was given 100mg Hydrocortisone cover in Theatre & again post operatively in Recovery.

The Registrar rang my Rheumatologist the next morning for advice on my dose post operatively & she advised increasing to 10mg for two weeks then straight back to 7.5mg

The person who needs to be aware of your Pred Dosage is the Anaesthetist.

I would not reduce my Pred Dose before Surgery unless advised by a Medic.

Good Luck with your Surgery 🍀 and your Recovery 🍀

[Sumojo in reply to MrsNails]

thanks for the advice and information.

[piglette]

Have you told your surgeon you are on steroids? Some are a bit funny about people on steroids!!

[Sumojo in reply to piglette]

I mentioned I had PMR to the surgeon. I’m waiting for a phone appointment with the anaesthetist. I’ll discuss it with him.

[piglette in reply to Sumojo]

Good idea to mention the steroids to the anaesthetist. Out of interest did your surgeon know what PMR was? A good friend of mine who is an orthopaedic surgeon hasn’t a clue, he thinks it is the same as fybromyalgia!

[Sumojo in reply to piglette]

I’m not sure if he fully understood. He just said, “ Oh, who diagnosed that?” I told him the name of the rheumatologist and he just nodded. That was the sum total of the discussion about PMR.

[piglette in reply to Sumojo]

Sounds like my friend!! Did you mention the steroids to him?

[Pass7]

hip replacement July 6. I will try to remember to tell anesthesiologist. Getting a block. Surgeon & rheumatologist coordinated date due to RA infusion schedule. Hope they are right. I can’t wait to be out of pain.

[Sumojo in reply to Pass7]

Hi, no I didn’t. But I’ll talk to the anaesthetist very soon.