i have been on pred since 2013, to treat pmr.
i need hip replacement, but my ortho wants me off my dose of 5 mg. Pred. I have tried numerous times to end this small (but consequential) dose of pred, and have always created a flare resulting in returning to the dose.
Any words of wisdom, or suggestions for dealing with this situation? Im seriously disabled by the hip degeneration, and need the surgery, but worried about the pred issue.
Thanks in advance, J
I had a surgeon like that. I was on 5mg and he wanted me on 0mg. I explained it wasn’t that easy and after some discussion he agreed to the 5mg. Is your surgeon private or NHS?
Purplecrow is in US….
Sorry I should have checked!
😊
I live in the US and I never heard of a surgeon telling a patient who has been on Prednisone, etc to get off it cold turkey. She needs to find a new doctor.
The trouble is in UK there are some surgeons who know very little about drugs. Perhaps doctors in the US have better training on drugs!! Also I have a surgeon friend who thought PMR and fibromyalgia were the same thing!
I had a knee replaced and my surgeon was ok with me on 3mg as I had to stop the Tocilizumab for 4 weeks. All the best for your surgery.
Many on here have had hip replacements [and other surgeries] on that and higher levels of Pred.
I can understand why surgeon is wanting you off Pred, they are always concerned about healing, but as piglette has said it isn’t that easy, especially after such a long period.. in fact it could be quite dangerous to get off, it could lead to an adrenal crisis.
You need to discuss with surgeon [finding another one if they aren’t prepared to operate at this level] and with input from an anaesthetist.
Good luck
I had 2knees and 2hips replaced while on 11mgs. Both my surgeon and anaesthetist were fine with that. I healed normally every time. You need the surgery!
I had a full knee replacement last year whilst on 3mg Pred and no issues. Fully discussed with surgeon and info provided on pre op and day of surgery. All went well 😊
I am having hip replacement surgery next month . I am currently on 5mg… surgeon explained there is higher chance of infection, but is happy to do the surgery.
I agree with the above, ive had 2 hips done on 7.5 of Pred. Talk again to your surgeon im sure he will understand .
Change your surgeon if you can as he doesn't understand PMR or steroids. I had a hip replacement last year and they temporarily increased my pred from 4mg to 9mg and in a few steps back to 4mg after the op. which is where my rheumatologist has said to stay for the foreseeable future (though have dropped to3.5mg recently). I had no problems and healed quickly although they did discover that I have osteoporosis probably due to 4 years of pred. But for the op it is not necessary or wise to drop from 5mg to 0 quickly
Find a different, realistic surgeon. This comes up repeatedly and yes, IDEAL is to be on no pred, but if you are on pred for another medical reason, and you are, for PMR and for adrenal insufficiency, then the surgeon has to accept that. If one surgeon won't budge, then you will find another who understands why you can't just stop it. One surgeon admitted they operate on patients on pred on a daily basis - it just requires more care on their part.
I had a total hip replacement over a year ago when I was on 12 mg. Of prednisone for PMR. My surgeon told me they have to do surgery on folks on prednisone all the time. Anesthesiologist gave me IV hydrocortisone during surgery and for several days after. They monitored my blood pressure and blood sugar closely while I was in the hospital. I was 77 when I had this surgery. Last June I had a shoulder replacement with no problems. You May need to find another surgeon who is willing to do it. Best of luck.
thanks everyone, your reassurance is encouraging. I have other doc options, will try to chat with current surgeon first.🙏🏽💜
Hip Replacement/Low Hemoglobin
steroids and hip replacement surgery 
Hip replacement and steroids
