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Reducing Prednisone for required surgery.

Posted , 16 users are following.

marla.090252
marla.090252

I ruptured my R. hand little finger tendon, over the ulna bone which requires surgery to repair.  My surgeon doesn't mind that I'm auto-immune with PMR as he said he's done many hand surgeries with people with these diseases.  He just doesn't like the dosage of Pred because it slows healing healing and possibly leaves me open to infection.  ( I don't get the infection part as they will be bandaging and casting frequently to watch for it) So I've started a reduction from 10mg, by the method here.  I'm down to 9mg as of today. (May 18, 2018).

Doc wants me to reduce Pred faster than the 1mg per "month".  I'm reluctant because I'm not sure I'm PMR symptom free. 

It's been about a year and half since diagnosed.  I really want to get off the Pred, as the side effects are driving me "crazy".  Weight gain, hair loss, sensitive skin (if i bump or scrap I get small hemorrhages under the skin) all sorts of side effects.  I am so done with taking Prednisone anyway.

If anyone has reduced their dosage faster, what schedule did you use?

Has anyone had surgery on Pred?  At what milligram was acceptable to your surgeon? Were there complications due to the Pred dosage?

Thank you in advance for your responses!  <3

0 likes, 29 replies

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  • ptolemy
    ptolemy marla.090252

    Posted

    I had a new hip recently and the surgeon wanted me on zero pred as he was worried about infection and slow healing. I did put up a fight and we agreed on 5mg. You could try and negotiate with your surgeon as to the dose he will operate with.
    • marla.090252
      marla.090252 ptolemy

      Posted

      Thank you ptolemy for taking the time to respond!  I'm still negotiating with my regular Dr. and the Surgeon.  They both want me on 5mg, and asked if I could reduce to 5mg alot faster.  I am uncomfortable with dropping from 9 mg to 5mg, in the time frame (a week or two) that they want.  It just scares me to decrease Pred, too fast.

      marla

    • ptolemy
      ptolemy marla.090252

      Posted

      I don’t think orthopaedic surgeons know a lot about pred. It is just another pill that you can take or not take. They do not understand the problems of reducing. I actually went up to 10mg the day after surgery as my CRP rocketed to 415. I think CRP tends to go up in most people after a hip op. I had to stay in hospital until it went down a bit. It got to 121 on day three thank goodness.
    • EileenH
      EileenH marla.090252

      Posted

      I'd say it is a no-no at that rate - that is putting you at risk because of reduced adrenal function and then being sent for surgery, they will HAVE to give you steroid cover for that. 

    • eddylynn36538
      eddylynn36538 ptolemy

      Posted

      The reason I was taken off for a month is they couldn’t get bleeding stopped. I was also taken off baby aspirin and had to have blood transfusions.  Although in pain for 3 weeks of the 5 all was fine as soon as I started back on 13. I was at 8 when I stopped. 
  • Harrie4
    Harrie4 marla.090252

    Posted

    That's so weird. I'm having carpal tunnel surgery in a month and my rheumy advised me to temporarily bump up to a 'stress dose' of 10 mg and then resume the taper.

    Hmmmm.......

    • marla.090252
      marla.090252 Harrie4

      Posted

      Thank you Harrie4 for taking the time to respond!  I'm copying all posts for my regular Dr and the Surgeon.

      marla

  • alley2
    alley2 marla.090252

    Posted

    Hi I've had 2 surgeries while on pred of 50mg and this was a major one with a serious Jaw infection and had 2 rear teeth removed and the second eye surgery and on 15mg pred with no prob healing or infection. Good luck with all I'm currently on 13mg pred from 15 a flare of now I have Fibromialga from GCA every two weeks been dropping 1mg been going to 10mg pred  not too bad sometimes cant tell if disease or pred withdrawal I just take pain kilers to get me through to ten and hoping wont need too many pain killers then I can feel the disease when its playing up.  Also I think doc thinks could have PMR also  not been fun.  

    • ptolemy
      ptolemy alley2

      Posted

      I think it depends on the surgery. I know granulation of the wound is very important and steroids can mess that up. If you are having a hip or knee done you have to wait six months if you have had steroid injections. I had a debridement operation under general on my leg and the pred dose did not matter in that case. 
    • marla.090252
      marla.090252 ptolemy

      Posted

      Thank you ptolemy for taking the time to respond!  I'm copying all posts for my regular Dr and the Surgeon.

      marla

    • marla.090252
      marla.090252 alley2

      Posted

      Thank you Alley2 for taking the time to respond!  I'm copying all posts for my regular Dr and the Surgeon.

      marla

  • r.d.s26296
    r.d.s26296 marla.090252

    Posted

    Oh dear, that sounds bad if it's true...

    I have to have a tooth pulled soon and implant and I'm on 25mg. 😳

    Good to know that , I may have to wait for the dentist.  

    👍

    • diana21296
      diana21296 r.d.s26296

      Posted

      Don't worry re having a tooth out.  I had a big double one out, discussed with rheumy and with dentist first and they both said stay on usual dose.  I was on 9mg.  I did and no problems at all.

    • ptolemy
      ptolemy r.d.s26296

      Posted

      Hi r.d.s., as long as you mention to your dentist that you are on steroids so that they know. It is bisphosphonates such as Alendronic Acid they seem to be wary of.
    • marla.090252
      marla.090252 r.d.s26296

      Posted

      Thank you r.d.s for taking the time to respond!  I'm copying them all for my regular Dr and the Surgeon.

      marla

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