Advice please.

[Pink_and_Black]

Hi

I’m in A&E at the moment with my 87 year old mother. Found her this morning lying in blood soaked hair and pyjama top with cuts to her face and head. She’d fallen and banged her head.

Within 30 secs I think I had maybe an adrenal crisis. I am currently only taking 5mg. I felt sick, my face was sweating and I felt faint. Fortunately my husband was with me and helped me recover so that we could attend to my Mum. I feel really unwell and am being admitted tomorrow morning for surgery myself. My question is, do you think I need to take extra Pred. When I collapsed this morning I took my normal 5mg plus 10mg, but should I take more before tomorrow morning?

TIA.

[LucilleG]

I’m so sorry to hear about your mom. I hope she is doing alright. What type of surgery are you having tomorrow?

This is my biggest fear as my mom is in her late 80s as well. Sending hugs.

[Pink_and_Black in reply to LucilleG]

Thank you Lucille. See my reply to DL and PMRPro.

Yes, a constant worry when caring for an elderly fragile relative. Xxx

[PMRpro Ambassador]

I take it your admission tomorrow is for elective (planned) surgery? Have you already met with your anaesthetist? They are the person to discuss this with - they provide a steroid boost in the form of hydrocortisone through the i.v. infusion during the surgery itself. They are also usually responsible for immediate post-op medication.

However, I think you were right to take more when you found your mum and by doing so avoid an adrenal crisis - I think most of us would have reacted in much the same way in that situation to be honest. I can feel like that in any sudden event - even dealing with something stressful on the phone makes me weak at the knees. Bit of a come-down after years of doing such things without turning a hair!

[PMRpro Ambassador in reply to PMRpro]

PS - hope she is doing OK?

[Pink_and_Black in reply to PMRpro]

Hi Pro, thank you for your quick response. I had a lumpectomy and full axillary lymph node clearance for breast cancer in 2020. They are having to do some corrective surgery because of painful scar tissue and adhesions caused by a bad reaction to the radiotherapy following my surgeries. Xx

[PMRpro Ambassador in reply to Pink_and_Black]

I wasn't being that nosey - do hope they are successful, scar tissue and adhesions can be so unpleasant. Really bad timing isn't it!

Is your mum doing OK? Do you look after her at home? All extra stress so don't play it down with the surgical team, especially the anaesthetist. They are responsible for you.

[Pink_and_Black in reply to PMRpro]

I’m back. We had a 12 hour stint in a chaotic A&E department but my Mum was attended by an excellent young doctor who couldn’t have taken better care of her. Her surface wounds just required a bit of glue to bring the edges together, but a CT scan revealed she’d had a small bleed on her brain. The neurosurgeon didn’t think intervention was necessary and to just monitor her for 3 days. They had no bed for her and she would have been left sitting in a chair, which was totally unacceptable to me, so I opted to bring her home and get help to cover while I was in hospital and recovering. She would have been in a state of confusion without me and she would be safer at home with us

My anaesthetist was great and I explained about my reaction the previous day. She was very concerned and wanted to postpone initially, but we agreed she would give me a good top up during the surgery and all went well. She said I would have a rough ride coming out of the anaesthetic but in the event, aside from having uncontrollable shakes for a half hour, I was perfectly ok. I’m back home, and apart from being a bit sore I’m doing well.

Thank you for being there for us all, it’s very comforting and reassuring, and so very kind of you. I’ll do an update post after my follow up consultation with my surgeon in 4 weeks to see how successfully it’s been.

Best wishes xxx

[PMRpro Ambassador in reply to Pink_and_Black]

Sounds like a reasonable result all round! Now to hope the surgery did what they hoped.

I think it is true to say in most EDs they quite like the elderly patients - who rarely complain or are violent but just get on with it. And anaesthetists are the go to for real emergencies - ours in the hospital here are also some of the nicest people. The head of the department just radiates calm and serenity when you even look at him - my husband was only under his direct care for a couple of days but he recognises me and always greets me. My pain clinic doctor is much the same, quiet and competent. Their stock in trade is "No panic"

[DorsetLady PMRGCAuk volunteer in reply to Pink_and_Black]

Good to hear, but don’t do too much.. very easy if you’re caring for your mum, you need think of you as well.

[2013mayo in reply to Pink_and_Black]

Poor you and your mum, hope all goes well and get better soon. Sending you lots of love and good luck ,xx

[DorsetLady PMRGCAuk volunteer]

Sorry to hear about your mum…Hope she soon recovers.

As for you, see how you feel this evening before you decide whether to take extra - is there any way you can contact surgical team today and get some advice before you go into hospital.

PMRpro has explained re extra during procedure - and good luck with that…

[Pink_and_Black in reply to DorsetLady]

Thank you DL. I’ll do as you say and give them a call xx

[Bcol]

Medical stuff already covered, just wanted to send best wishes and speedy recovery to your Mum, and likewise to you hope that all goes well with your Op. this morning.

[Pink_and_Black in reply to Bcol]

That was very kind of you, thank you. We’re both doing ok and being well looked after. xx

[OPO4]

I have been told to take double for 3 days when greatly unwell. Perhaps you should get medical advice. Hope you feel better very soon .

[Pink_and_Black in reply to OPO4]

Thank you. Just about to see the anaesthetist so will see what he says too. X

[Sara_2611]

When I was in hospital I was given prefniserol but now - again

Sorry to hear about the hospital admissions Speedy recovery to the both of you

[Pink_and_Black in reply to Sara_2611]

Thank you. The anaesthetist gave me a top up during the surgery and I’ve doubled my dose for a couple of days to help with my recovery. xx

[Stills]

just sending good wishes to you and your Mum for speedy recovery’s 💐

[Pink_and_Black in reply to Stills]

Thank you for your kind wishes, we’re both doing ok and being well looked after. xx

[nissemor]

all good wishes to you and your mum.XXX

[Pink_and_Black in reply to nissemor]

That’s so kind of you, thank you xxx

[Viveka]

So sorry to hear about your mum, such a horrible shock. This happened to my mum. She was fine, apparently the head bleeds a lot and it can look worse than it is. Hoping this is the case with your mum and good wishes to you both, and for your op tomorrow.

[Pink_and_Black in reply to Viveka]

Thank you Viveka. That was the case with her surface wounds which just needed a bit of wound glue, but a CT scan revealed she’d had a small bleed on the brain. No intervention was necessary thankfully and I now have her back home under close observation xx

[Gaycreasey]

it’s a given isn’t it that with pmr you’re going along nicely and then there’s a crisis that you have to deal with. That then knocks you off your path and you have two crises to deal with!! Hope it all settles down for you and your mum.

[Pink_and_Black in reply to Gaycreasey]

Thank you, we’re both doing ok and both being well looked after by my dear husband. xx

[Pink_and_Black in reply to Gaycreasey]

Ha, isn’t it just! We’re both doing ok now thank you, though has a massive black eye!

[Missus835]

For my recent vertebroplasties I was awake, there was no anesthesiologist to ask, per se but I did ask the surgeon. They don't do a steroid cover, but do antibiotics. Anyway, I had upped the Pred on my own. 20 mg. as I believe I was at 17 at that time. I did let them know this as well.

Hope Mum and you are on the mend. So very scary. Take care.🌹

[Pink_and_Black in reply to Missus835]

Thank you, we’re both doing well. My anaesthetist had a drip on me with extra steroids, so all good and aside from about half an hour of uncontrollable shakes when I came round, my recovery was good. xx

[musicality]

Yes it's well known that stress can cause a flare or panic attack. My GP said doubling your Pred b4 op helps ur body 2 cope then after 2/3 days reduce slowly until on previous dose. Hope ur Mum and you recover soon. Xx

[Pink_and_Black]

Yes, that was my first real experience of severe reaction to stress/shock. I’ve doubled up to cover my post surgery recovery and will reduce back down to 5mg in a few days time. Thank you for your good wishes, we’re both doing ok. xx