When should I increase prednisone for surgery?

[Paperroses]

I'm at 2 mg prednisone and have to have a thyroid lobectomy on Thursday Feb 6, 2025.

[PMRpro Ambassador]

You don't - you discuss it with the anaesthetist before the surgery as they have the task of keeping you alive and functioning in theatre. They will provide cover for adrenal function during the surgery and immediately post-op via an addition of hydrocortisone to your drip.

If you can speak to your rheumatologist, they may have a preferred protocol for post-operative recovery to reduce the risk of a flare or if one happens. It is a good idea to have that clarified before the surgery because nurses are unlikely to approve you taking more than your current dose and will probably also not be as helpful as they might be in giving you your tablets exactly when YOU want them!! I would keep a pack undeclared in my handbag!!

Otherwise, clarify with your anaesthetist before surgery who you can appeal to if you have problems. Are you also under an endocrinologist for the surgery?

[Paperroses in reply to PMRpro]

the doctor is an ENT .I no longer have a rhumi he retired.

[PMRpro Ambassador in reply to Paperroses]

Wonderful!!!! Not sure who to recommend to demand an audience with if you flare while in hospital!! But the hospital WILL have a rheumy around somewhere to get advice.

[Paperroses in reply to PMRpro]

its out patient surgery so i may not notice a change until after i get home but i do have a post op appt on the 11. they will most likely do blood work and i could mention if there is achange.

[PMRpro Ambassador in reply to Paperroses]

That's fine then - you will be in charge of your own medications!! I am here in hospital for the ones that matter!! They don't have them in the pharmacy so I need to keep them.

[Paperroses in reply to PMRpro]

thank you for your quick reply . its probably the middle of the night where you are.

[PMRpro Ambassador in reply to Paperroses]

Not me - I'm an hour ahead of the UK! DL is in the southern hemisphere at present - somewhere between NZ and SIngapore I think ...

[DorsetLady PMRGCAuk volunteer in reply to PMRpro]

Now halfway between Singapore and UK -finally got WiFi connection…

[PMRpro Ambassador in reply to DorsetLady]

So you are in good old Blighty? Welcome home xx

[DorsetLady PMRGCAuk volunteer in reply to PMRpro]

Am now -got in this afternoon (Tues)

[Stills in reply to DorsetLady]

Just in time for cold snap I’m afraid, hope you had a fabulous time

[DorsetLady PMRGCAuk volunteer in reply to Stills]

I did thanks.. ❤️

[Blackcat1M in reply to Paperroses]

When I asked at my post op appointment the nurses said they did not deal with that speak to the anaesthetist

[Rubha in reply to PMRpro]

Thanks for that info PMR Pro. As I’m due THR surgery in April (🤞) and not sure how low my taper will be , I like your comment re keeping a secret pack of pred 🤭. The thought of a flare after the surgery is not pleasant as it’s taken me nearly a year ,with one hiccup to get here.