advice for forth coming endescope investigation

[Crwbin1]

Hi, first of, thank you to the people running this site , it has been so helpful and supportive.

I have a question which I would be grateful for guidance on.

I have an endescope procedure booked for the end of the month (30th). I am currently on 18 mg of Prednisone. I have requested a sedative when having this procedure (it’s a day appointment) as I get panic attacks when having this procedure in the past (before prednisone days).

I read on a recent post that if you have sickness/trauma/forthcoming operation then sick Day rules apply. Can someone help as regards What are your thoughts and advice on amount of pred/ how long for/ when to start if an upped dose to help supplement whilst this procedure/day is being done.

Thanks in anticipation.

[PMRpro Ambassador]

If you are having a medical or surgical procedure you shouldn't be increasing your dose off your own bat but discussing it with the medical team who are treating you. Different units have their own approach and my daughter says they administer hydrocortisone shortly before the procedure - so they need to know in advance. It is NOT advisable to increase your pred dose as it increases the risk of bleeding if they were to need to take a biopsy or remove polyps during the procedure. In fact, it is more likely if there were any change to dose that it would be lowered.

[Crwbin1 in reply to PMRpro]

Many thanks PMRpro for the reply.

You are quite right, I would not muck around with the dose age without talking to the doctor first.

I had not heard of this sick day protocol until recently .

For my endoscope investigation at the end of this month, I told the pre operation staff when filling in the questionnaire via telephone , I was on prednisone and they didn’t ask how much nor said about any reduction. I also told them I was on warfarin along with all my other medications. And they told me to take all my medication as normal. I just want to get all the relevant facts so I can then discuss with the consultant beforehand if this sick day protocol is even a “thing”.

Thanks again.

[DorsetLady PMRGCAuk volunteer in reply to Crwbin1]

Yes it is a ‘thing’ - any has been discussed a lot on here, and certainly more since covid - but it’s been around for a long time.

This from FAQs

healthunlocked.com/pmrgcauk...

Bit more -

endocrinology.org/media/414...

[Crwbin1 in reply to DorsetLady]

Thank you DorsetLady. I can see it is a real “thing”.

I will keep a copy of these documents with me as they are so important.

[PMRpro Ambassador in reply to Crwbin1]

SDRs are for SICKNESS, that confine you to bed or require antibiotics. Not for out-patient protocols like scopes. They are certainly a "thing" as you put it and were drawn up and implemented by the College of Endocrinologists because HCPs at various levels seemed oblivious to the risks longterm steroid patients faced when ill or requiring major procedures and patients were becoming seriously ill as a result although we get the impression many STILL are ignorant of the guidelines. We quote nothing here that isn't backed by medical approval.

[Crwbin1 in reply to PMRpro]

Thank you pMRPro for your reply.

From your most recent reply , it feels as I have upset you by my last comment in my previous reply to you. It was not intended to upset or annoy , on reflection it was probably an unwise use of the phrase “thing” as regards the sick day protocol. I just wanted to have clarification. It was an innocent comment and not intended to upset in anyway. Again, apologies if this is the case.

Thank you for your help , I do appreciate it.

[PMRpro Ambassador in reply to Crwbin1]

It didn't upset me in the least - you will realise with time that I tend to write very factually, have done so for 50 years, not going to be able to change now!!

[Crwbin1 in reply to PMRpro]

😁

[Carrollee]

I had a lung biopsy 2 weeks ago on 4mg, there was no talk of increasing pred etc. I just took it as normal. (2am with banana) I was awake for it , just local anaesthetic. I was fine. Have a chat with them to reassure yourself. All the best 🤗

[Crwbin1 in reply to Carrollee]

Thank you, for your comment, it does put my mind to rest. I hope all goes well with you.

Take care x

[Grammy80]

I'm in the states but hope this helps, I have had both an endoscopy and colonoscopy while on more than 18 mg. It is the procedure here to give the patient a Twilight sleep when doing these procedures. I took nothing additional and had no effects whatsoever. I understand it's easy to be completely relaxed when you're in a Twilight Zone and I hope they can do this for you. It isn't an anesthetic like what you would receive for a surgical procedure but I have no memory of it and just seem to be coming awake as they finish. I truly hope this helps you and may be a suggestion for your physician💕

[Crwbin1 in reply to Grammy80]

Thanks Grammy80 for your reply. It does help to hear other people’s positive experiences.

I have requested the twilight option and they have agreed to it. So will be joining the twilight club!

[Grammy80]

Smart gal....but you have experience!! and positivity!!! 💞💞