Reducing Prednisone for required surgery.

Many people have reduced their dose faster - but they all had the same result: a return of the PMR symptoms.

PMR is not a one-off illness for which you take a dose of pred and then reduce to get off it. It is a chronic autoimmune vasculitis which has a median duration of 5.9 years and as long as the disease is active you will need some pred to manage the inflammation that causes the symptoms. You reduce slowly to identify the lowest dose that manages the inflammation as well as the starting dose did. 

Everyone wants to get off the pred - but when they realise the alternative is to return to the state they were in BEFORE the pred, they learn to make friends with steroids. I have had PMR for 14 years, I have been on pred for the last nearly 9 years. Nothing would persuade me to go back to that state. I have had awful side effects with one form of steroid - but they went when I was switched to another and changed my diet to low carb - that helps with inflammation and with weight management.

You are also at a dose where your adrenal function will have to take up the change in steroid dose - you need about 8mg of pred to replace the cortisol your body makes naturally. As you reduce below there your body has to make up the difference - and it takes a bit of time, it doesn't always happen immediately. This is particularly important in response to stress and an operation represents stress.

I think you need to discuss it with your surgeon and possibly get another opinion.

Marla, I am one of those person who followed their Rheumy advise and was rushing to get off Prednisone. I started on 20 mg and was feeling good after about 4 weeks. Rush down to 7 mg had a very bad flare, ended up in a wheelchair. It took 30 mg of Prednisone to get any relief, still tapering, but now slowly and PMR pain free. Take your time you will be better off in the long run. Good luck! ☺️

Last year I had right knee replacement on 6 mgs and was encouraged to not reduce until the surgery healed.  Three months before  a knee  operation, my surgeon gave me a cortizone shot in the soon to be repaired knee and also one for the bursitis in my left hip.  I was on 6 mgs for over a year and am currently on 7 mgs because of a slight flare when trying to reduce to 5 1/2 ms.   After the operation, perusing the knee forum has led me to believe being on prednsone helped me have less pain.

I also had teeth pulled and capped on 6  mgs Pred, before the knee replacement.

Hi Marla, I had hand surgery to free nerves and tendons whilst on 25 mgs of prednisone, surgery done and sent home straight away to reduce infection risk

6 months later whilst on 19mgs I had the first of 3 operations for cancer each 2 months apart. No mention of reduction of prednisone. In fact from memories I received injections of the drug to reduce swelling. In each case I was discharged from hospital within 48 hours to reduce the risk of infection.

​None of the surgeons requested reductions but did load me up with a good dose of antibiotics intravenously before discharge.

No problems.

​Good luck, hope you have a positive outcome.

 

Two years ago I had 3 surgeries on my leg for compartment syndrome the last a debridement for infection.  I had to go from 8 to 0 in a week because the surgeon said it wouldn’t heal.  I was sent to a plastic surgeon who agreed. Not bad for first two weeks but the next 3 were horrible.  Bottom line I started again st 13 and all was well. Currently at 6mg.   Good luck to you. 

I had a abscess on a broken off tooth root and the Dentist got me to double my dose of Prednisone 4 hours prior extraction.   The reason he gave was to stop my body going into stress.     You should check this out for yourself, after all it your body enduring.

I am in New Zealand.