Should I increase prednisolone before arthroscopy?

[Mfaepink1973]

I’m down to 3.5 mg pred and feeling better than I have since I started with PMR. I’m having an arthroscopy in 2 weeks for a torn meniscus. Should I stay on present dose, continue with next taper or increase dose prior to the operation? I’ll be out of hospital the same day but have been warned I will be in pain for a couple of weeks so not sure if sick day rules apply.

[DorsetLady PMRGCAuk volunteer]

Probably something you should discuss with your surgeon/anaesthetist - they both need to be aware you are on steroids. They may suggest a slight increase after procedure for a few days.

Definitely no tapering until you are fully over the procedure - and so long as it doesn’t create a flare, then painkillers may well be enough for the after pain.

Good luck.

[Mfaepink1973 in reply to DorsetLady]

Thanks

[DorsetLady PMRGCAuk volunteer in reply to Mfaepink1973]

Hope all goes well..

[Mfaepink1973 in reply to DorsetLady]

Thanks Dorset Lady, so do I x

[PMRpro Ambassador]

Something to discuss with the medical team. Usually for a minor procedure you'd stay at the dose youa re at and monitor afterwards for signs of a flare. No tapering though!

All the best.

[Mfaepink1973 in reply to PMRpro]

Thanks PMRpro I’ll mention it when I see the anaesthetist before the op. x

[piglette]

As the others say talk to your surgeon/medical team. Some surgeons seem to have a horror of steroids, as they can affect healing time, and like you to be at quite a low level for the actual operation. Afterwards they may suggest an increase if needed.

[Mfaepink1973 in reply to piglette]

Thanks Piglette, I had an operation on a bunion in January and neither the surgeon or anaesthetist mentioned the steroids! I’ll definitely ask them this time.

[piglette in reply to Mfaepink1973]

I suppose they expect you to say something. Did you have a general for the bunion or a local anaesthetic?

[Mfaepink1973 in reply to piglette]

It was a general anaesthetic, I did increase my pred by 5mg for a few days after the op but was fine when I dropped back.

[piglette in reply to Mfaepink1973]

That sounds sensible. After my hip replacement my CRP went up to 412, so they said I should increase too although I felt fine.

[Miserere]

I had a knee replacement in December and made sure both surgeon and anaesthetist were aware that I was on 7mg. This didn't seem to worry them and all went well. I did not increase afterwards either but I was resting for the first few weeks and sooooo hungry! However, weight did not increase either.

[Mfaepink1973 in reply to Miserere]

Glad you got through it ok. My op is nowhere near as major as a total knee replacement so hopefully I’ll be ok. Thanks

[Janet57 in reply to Miserere]

How is your knee now? I had a full knee replacement in April. Just told the medical team about my Pred dosage and didn’t increase or taper. Everything went well. Plenty of pain after whilst exercising but that was to be expected. 12 weeks in and glad I had it done 😊

[Miserere in reply to Janet57]

My knee is great now. It has it's odd days where it can ache a bit but often I forget that it's not my own knee. I miss the complete bend that it had but I got to 110 degrees which is fine. I don't regret having it done for one minute - to be out of that pain is more than worth it. The first 3 months were the most frustrating as I always want to run before I can walk! PMR is the most bothersome thing together with steroid withdrawal. I'm still on 7.25mg and will start reducing by .25 per month shortly again. Frustration city!

Good luck with your knee - not long before you will be forgetting that you ever had it done.

[Mfaepink1973 in reply to Miserere]

Thanks, I’m just hoping it doesn’t make my PMR flare as I’ve got down to 3.5mg and don’t want to have to go up again. I’m glad you’re happy with your new knee

[Ladyhillingdon]

I had a lateral meniscus tear repair , getting it done was such a relief, to be rid of the awful pain I had been in , the op’ was simple and I didn’t look back.

I hope yours goes as well.

[Mfaepink1973 in reply to Ladyhillingdon]

Thanks Ladyhillingdon, that’s very reassuring