Upcoming procedure

[Body_bonkers]

I have to have a hysteroscopy soon. I think it’ll be done under general anaesthetic as my recent smear test was so painful. Been advised to take paracetamol beforehand but given my stress response is still abnormal, wondered if I should also increase my steroids. I was thinking of adding 5mg to my morning dose on the day of the procedure - is that a good idea ?

[DorsetLady PMRGCAuk volunteer]

Something you need to discuss with your medical team, especially anaesthetist- and you will probably be given an IV dose of steroids during procedure, but you may need a slightly higher dose post op for a few days…

Not a decision you should be making yourself… and good luck with procedure.

[Gimme]

I had a hysteroscopy done under general anaesthetic recently and I was advised to take my pred as normal on the day of the op. Then I was given hydrocortisone(?) during the procedure, which I believe is standard procedure for most ops to manage any inflammation caused by surgery. I kept my steroid wrist band on for the op, so we had that discussion when I was on the trolley before they knocked me out. I have to say that I had two lovely days totally pain free after the op, so whatever they gave me must have been pretty long acting. Then I had a bit of a slump energy wise and it took me a couple of weeks to get over the anaesthetic completely, but I think that is a fairly normal reaction and not necessarily PMR or pred related.

As DL says, it is best to check with them if you are having a general anaesthetic, as you are likely to be nil by mouth for some hours beforehand. You should have a pre op assessment for them to find out what meds you are on, anyway. My op was scheduled for the afternoon, so I was able to have an early light breakfast and take my pred then.

[PMRpro Ambassador]

Hydrocortisone through the drip is normal for longterm steroid patients during surgery. It really is something to discuss with the anaesthetis at the pre-op talk you will have with them.

[Kendrew]

Hi there,Like gimme, I had a hysteroscopy last Aug and took my normal dose of 2mgs on the day but had discussed everything with the anaesthetist first, who gave me IV hydrocortisone during the procedure.

I was absolutely fine, no side effects and recovered well.

[Body_bonkers]

Thank you all for the comments and support - glad I asked. Suspect any chat with anaesthetist will be probably be just before the procedure so too late if I have food and extra pred in my system already !

Communication is awful. GP mentioned scan but nothing about sticking camera in and doing biopsy so appointment with gynaecologist was bit of shock. The pair of them are bullying me into having coil fitted too before any results. Found out I do have other options however - so much for shared decision making !

[PMRpro Ambassador in reply to Body_bonkers]

If you are having a GA. you must be fasting for (I think) 8 hours before - even water can be enough to cause aspiration. And you don't want that risk!!!

[Body_bonkers in reply to PMRpro]

Thanks - hopefully this information will be relayed in due course !

[Gimme in reply to Body_bonkers]

You should get a letter beforehand telling you about any precautions, such as fasting, and confirming the date and time of the procedure and what time you need to arrive at the hospital. I did.

[Sandmason]

Ask if they can do an epidural instead of intubation? I'm looking at diverticulitis colon resection and if they can do that, removing half your gut, surely its an option for anything below the rib cage.

[Body_bonkers in reply to Sandmason]

Thanks - I’m guessing there must be a reason why it’s not offered but think I’d prefer to sleep through it !

[Sandmason in reply to Body_bonkers]

Oh you would have IV sedation, definitely sound asleep just not intubated. I have a problem with my larynx being hyper sensitive so they avoid intubating me.

[Nanatoo]

I’ve had a few hysteroscopies over the years and was always advised to take paracetamol before the investigation which made the discomfort bearable but I’m pretty sure that would be no good for you after reading your post. I think it would be wise to phone whoever organised this for you to let them know you need better pain relief on the day as they may be unprepared and you’d end up having another appointment to have to build up to!! I’ve had mirena fitted for 12 years as I’m on HRT and pills and patches cause me more problems so a chat with your gynae might be worth it. Hope all goes well for you

[Body_bonkers in reply to Nanatoo]

Thank you. I think the adrenal impact worries me more than the pain - I feel so ill equipped to cope with life’s challenges now