I have no idea if I am making a fuss over nothing, I find it so hard to tell and I am alone. I had a hysteroscopy under general anaesthetic on Wednesday. All went well, except for pain after the procedure, pain probably related to scarring from previous surgery in that area.
On 6 mg pred atm. I didn't take extra pred. The hospital were fairly relaxed about it and I have been fine so far with other minor procedures while I have been on pred. The anaesthetist was aware that I am on pred. The tech in the operating theatre noticed my wristband when he was taking my pre-op obs and remarked that I am on steroids. I heard the anaesthetist say, well she's going to have dexamethasone anyway.
Thursday morning, I felt absolutely fine, which in retrospect, might be related to the amount of morphine I had the day before. Yesterday, I was absolutely wiped out and slept for much of the day and didn't do a lot. No energy whatsoever. This morning, I had a spell of being really shaky, like I have low blood sugar, had a little lunch and still felt shaky, so I took a nap for an hour. When I woke, I felt a bit better so went into the garden to potter. The wobbliness and shakiness has come back, I'm sweating and I feel weak. Not feeling great.
Now I wonder, should I have been taking some extra pred last few days? Should I take some now? Would I be over reacting to call 111 for advice? The prospect of hanging around in urgent care for hours on end doesn't fill me with joy. I don't really know what to think.
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Gimme
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Definitely sounds like adrenals struggling following the last few days, Think it would be sensible to ring NHS 111, and say you have thought of increasing your steroids… would that be good idea, and to how much and for how long?
I can understand your reticence to go to A&E - but they might suggest a paramedic attends and gives you an hydrocortisone injection.
Thankyou, DL. Not just me then. I suppose I feel more vulnerable being alone as there is no-one here to keep an eye on me and notice if I am getting worse.
It wouldn't hurt to call 111 and speak to a doctor. Good point about the hydrocortisone injection. On reflection, I don't think that driving anywhere would be very sensible, just in case.
You have just had a major operation and I am not surprised you feel somewhat shaky. I am not sure it is extra pred you need for your symptoms. I would take it really easy and pamper yourself or get someone else to pamper you. You can always phone 111 for advice.
Thankyou piglette. It was just a hysteroscopy, so they took some biopsies, but my insides are a bit of a mess, so any minor investigation becomes more complex than it ought to be. If it related to the procedure, I would think it would be more to do with having had a general anaesthetic. But you could also be right, I need a bit more rest.
Any procedure in that area can affect you and as you get older a general can have more of an impact. I hope you start to feel better soon. Meanwhile lie back and rest.
I would ring 111 so that they can give you advice if only to help you feel more at ease. They might want to give you a once over which is no bad thing and if you say steroids and possible insufficiency and you’re alone they may well want someone to come out. I had that and a shot of hydrocortisone worked wonders when I crashed with Covid.
However, you had a general anaesthetic, this isn’t nothing and people underestimate the recovery period from that. Some can take a month to stop feeling a sluggish and off. But given the steroid taking under 10mg in the mix I would bear it in mind but not shrug this feeling off as that alone.
Thank you, snazzy. I was hoping that you would stop by as I know that you are the expert in this area.
I have called 111 and on progress so far, I hope that I am never really in adrenal crisis and if I had any suspicion that I was, I would call 999 directly. I am beginning to wish I hadn't started this. I spoke to the initial person who took loads of notes and they requested a call from a medic. The second person took me through the same questionnaire that you complete when you do an e consult. I could have done that myself. I got no sense that they had any idea what PMR is, adrenal crisis, or what steroids do, and I doubt if they were even medically qualified. He ended the call with saying that he had no idea what was causing it, despite a clear explanation from me. I am waiting for a doctor to call me back now.
I've been resting since I wrote this and as long as I don't exert myself, I don't feel too bad. Although I don't think that I am in immediate risk of adrenal crisis, I do think how I was feeling is adrenal related. If I get another attack of the jitters and sweating before the doc calls me back, I am going to take another 5 mg of pred. It means I might not sleep too well but it won't do me any real harm. At the moment, I am thinking that it might just be that it might take me a bit longer to get over the anaesthetic than I had anticipated and that I would benefit from a bit more rest for a few days. Not that I have been overdoing it since I came home on Wednesday. I've been feeling too tired to do much.
The effect of the dexamethasone will have lasted a couple of days - and will have worn of after that. I think you have totally underestimated the effect it would have on you - and not only do you need more rest, you need more pred.
Thank you for that, pro. What you say makes sense, I had no idea that the dexamethasone is so long acting. But your timescale would fit, as it is today that I started feeling rough.
If the doctor does not call within the next wee while, I'll take more pred. Do you think another 5 mg would be enough? I think I have been resting enough as I have been sleeping so much, but I would go along with not expecting too much of myself for a few more days.
Oh, I don’t know about being an expert; I’ve just had lots of scrapes!
I used to work with someone who worked in out of hours call handling to supplement our practice nurse pay. He said he had to follow a strict protocol with questions in order for the algorithm to decide what the outcome should be. Don’t worry that they weren’t like speaking to a doctor who can recognise PMR etc etc. You have been progressed to having a medical opinion which is good.
It might be that you have a mix of post anaesthetic wobblies and the stress causing you to need more cortisol than you and Pred can provide. They will want to rule out infection too. The system is pootling along and above all, you have Pred to hand.
I hope you are feeling better. I too am alone and can relate to the scariness of it. For me anaesthetics take at least 10 days to work through and that was before Pred. Just keep being kind to yourself.
you are not alone! there are always your friends here who will give good advice...beter advice than you would get from someone living with you...but I do agree it is tough living alone...I am in the same situaiton...sometimes I would really like someone to bring me a cup of coffee in the morning...mind you I live with my husband for 35 years and he never did!
An update. I got the call last night at 10.00 pm and asked to go into the Out of Hours surgery at Watford. I had already cracked long before then and taken some more pred. The doc was more interested in checking me out for post op infection, but his final decision was delayed reaction to the anaesthetic and by the way, did I realise that I was very dehydrated. It looks like it is going to be a nice sunny day again today, so I have decided to take it easy, sit in the garden and read and drink lots of water. I'll see how I am feeling later on, but at the moment, I do feel better than I did yesterday. Maybe all I need is a bit more rest and recovery time. Hope so. Thank you for all your replies, lovely folks. x
Hi Gimme, you must live close by to me as Watford is my emergency clinic! I would have made you a cuppa! Hope you are feeling better soon and sending hugs. PS do you go to the Luton group, that may be our nearest? I, when well, volunteer on Wednesdays so it is difficult for me to attend. Some in person support may be a good thing? ❤️
Lots of good advice already offered but just thought I'd mention my own recent experience.
I have PMR, and I'm currently on 2mgs of prednisolone and also underwent a hysteroscopy, laparoscopy and polyp removal under general anaesthetic, last Tues.
I spoke to the anaesthetist prior to the procedure and didn't take any extra steroid, but he did supplement my dose with extra hydrocortisone and some antibiotic mixed in with the anaesthetic and analgesic gases.
I obviously have a different set of health circumstances to yourself but despite feeling pretty good the first couple of days afterwards, I have experienced a few days of increased fatigue, digestive upset and a feeling of just being a bit 'out of sorts'.
As the anaesthetic gases and other potential substances clear from the body, its probably inevitable that we could feel worse before we begin to properly begin to feel better.
I'm also finding that as the incisions begin to heal and tighten a bit, and the bruising (both internally & externally) begins to 'come out', I'm experiencing more discomfort and soreness.
All to be expected in my case.
Having said this, it's still important to be aware of any changes to our recovery that could potentially be indicative of other health problems that may arise during our recovery from the procedure we've undergone. You clearly are well aware of the need to be vigilant though.
I wish you well Gimme, and hope you begin to feel much better very soon.
Thank you for sharing. oh yes, I remember the bruising from laparoscopies very well, though it is a couple of decades now since the last. Very uncomfortable. Hope you feel better soon.
Same here polyps and biopsies, waiting for the lab results to see if I have to face the big H. I managed to view the discharge notes online and wished I hadn't. I don't like the look of what I saw. I had a cone biopsy late 20s for abnormal cells and it is looking like all that may have come back to haunt me. I really hope not.
So sorry to hear that. I had a cone biopsy almost a year ago as I have HPV. Thankfully my 'abnormal' cells are benign at the moment, but I am being monitored regularly.
Whatever your diagnosis, all you can do is deal with the experience one day at a time.
You clearly are dealing with quite a few different 'situations' but I hope you receive positive news and your situation begins to improve soon.
Sorry that you are going through this Gimme. I think you have received the very best advice here as usual and agree rest and pamper. You say it was just a hysteroscopy but we forget our body perceives any procedure as an assault and reacts accordingly. Hope your results are positive and that you feel better soon.
I agree that keeping in touch with the NHS via 111 is a good idea, not least because post-operative infections are always a possibility. You may already be on antibiotics to ward them off, and that brings the possibility of side effects and interactions between medicines. So, above all, you need rest. You've had a major operation and need to allow healing time.
I'm alone too, Gimme. I'm having a colonoscopy with anaesthetic this coming Thursday plus the two prep days, inc 27 hours no food other than water, tea, coffee, clear broth and sugary non fizzy drink. I have to be careful not to get too low blood sugar on the best of days. So reading your post I realise I'm nervous about this because I will have no one with me or even to chat with on the Friday or the weekend. Any further advise is welcome.
I hope you recover quickly now, and feel much better soonest!
78, PMR, 11mg prednisolone per day, spreading arthritis, lumbar back vertebrae out of whack, chronic pain etcetc.
I would not term this as a major surgery. As an Anethetist, I will ask the patient to take their steroid dose on DOS and give 10mg of Dexemethosone. Although, for a scope this is precautionary and often stress dose is not needed to prevent adrenal crisis.
Check your blood pressure and drink water. If diabetic, check your blood sugar. If your pressures are low and you continue to feel dizzy than call or get driven to emergency room.
Lastly, a 10mg Dex dose equals a 60mg prednisone dose. If your anesthetist gave you Dex than you are most likely feeling the opposite of adrenal crisis. Your feeling the side effects of having an increase of steroid due to its long half life.
Having read up on the side effects of dexamethasone, I am inclined to go with what I was initially feeling now i.e. that my blood sugar had dropped. Taking into account the half life, it would have been starting to wear off on Saturday, and it certainly messes with your blood sugar. How I was feeling was nothing like the manic way I have felt on the higher doses of prednisolone; quite the opposite, the fatigue was more like I feel later in the day when I forget to take my pred first thing.
Hi - I am not going to comment on whether or not it is adrenal insufficiency as I don't understand enough about it but you definitely need to account for getting over major surgery. Especially as you are on your own. People always underestimate the impact of general anaesthetic and being operated on. Your body needs all its resources to get over it. Please try to get as much lovely protein packed food as you can and just rest up!! And hopefully you will get some good support regarding adrenals. Good luck!!!
I just found your post when I was searching for info on Pred and anaesthetics and hope you’re all back to usual by now. Replies were very interesting.
I tripped over in my gardening clogs whist getting some fence panels delivered, resulting in a large open wound around and below my knee. A&E couldn’t stitch it ( one of most painful experiences) so referred me to plastic surgery at another hospital for a possible skin graft. Plastics called a few days later (as had been referred to wrong team and given non urgent appointment a week later) and asked me to go through their A&E and a debate then ensued between orthopaedics and plastics about who should be dealing with this. In the end plastics ended up stuck with me .😂
Had the op under GA yesterday and they have managed to close it with stitches, without a graft. Thank goodness! The surgeon was very relieved too as he stated long term pred can thin the skin making taking a good skin sample for the graft much harder and prob why the fall produced such a large open wound.
The anaesthetist came to see me late night before the op to recheck what steroid dose I am on and added they may add more steroid in the anaesthetic. No idea if they did but I was babbling on to everybody in the ward when I came back to them! Very hyper
I had contacted my consultant through her staff, asking if I ought to up the pred but no reply a week later.
I ended up being starved for two days with snacks later in the first evening when I found out they had no space for me on their list, so woken over both nights for blood sugar readings which were fine.
Overall I’m sore of course but fine. Massive padded bandage thigh to foot to protect the wound and bruising all over leg. But I was intrigued about whether they did add a steroid to the GA. Nothing listed on discharge notes.
Funny story though. Taken by hospital bed through the hospital to op theatre. They decided I would have my GA on the operating table for my comfort, for me to walk in. Got in there but the table was so high I couldn’t get onto it. It was brand new rechargeable table, but the team had no idea how to work it. Even I was going round the table looking at buttons and the remote control! A chap in scrubs rushed in and pressed a button none of us had noticed and it was powered up and lowered. Being a shortie I ended up using metal steps anyway! The anaesthetic consultant wasn’t amused but I was! Really relaxed me! So despite 3 days of waiting and not knowing, it was a good experience and I’m home! Yay.
oh goodness, that sounds like a journey and a half. Hope you are on the mend soon.
You are right about the skin being thin and bruising easily. I gashed my leg a month ago, playing silly buggars with the kids next door. Forget that I am 66 not 6. It was nothing like as bad as yours, but it is still bruised and the scab just fell off today. So glad it didn't get infected.
Yes exactly so easy to do. I’m 67 so I understand. Luckily all the kids in the family are teens and above now so only want money 😂. Much easier! Yes I’m on second pack of co amox antibiotics now. Not allowed to unwrap my leg but I really want to!! Glad the scab has come off. Be careful!!
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