Has anyone had surgery on high levels of Prednisone and/or in a flare?

I was in the hospital for 14 days and was not responding well to steroids. Under the suggestion of my doctors, I decided to do a series of 3 Remicade infusions to hopefully put me in remission and allow me to taper off of steroids for surgery. Though the Remicade worked, I had a excruciatingly painful reaction in my knees, elbows and hips a week later. Basically unbearable stabbing pains that are not relieved with pain meds. I am an artist and rely on my hands to carve intricate woodblock prints and did not want to take a chance at developing some long term pain that would never go away (which unfortunately it hasn't yet, but I am hopeful it will once the Remicade gets out of my system). So, I refused getting another infusion, especially considering I wanted to go the surgical route anyway and had no intention of being on Remicade long term. So now I am on 60 mg of Prednisone and the doctors want to start weaning me off of this. I am praying that my bloody diarrhea symptoms don't come back once I start tapering (and without the Remicade), and that I can start healing up for surgery. But what if my symptoms do come back? Can they do surgery anyway? How much does it affect the outcome? Any insights from folks that got surgery when they were on high doses of steroids and in the midst of a flare would be much appreciated. I am meeting with a very good surgeon next week and I know he will answer these questions, but I am trying to do a bit of research too.

I haven't talked to the surgeon yet (appt. next week), but I am 99.99% sure I want a permanent ileostomy after doing my own research and contacting lots of people (including someone who just climbed Everest with an ostomy). The emptying of the appliance is more in line with my lifestyle (rockclimbing, snowboarding, etc.) and job (park ranger... away from a bathroom for 2+ hours leading programs and hikes for people) than a j-pouch with more frequent and unpredictable bms. Plus I just want the one surgery (though I realize there are always chances of complications and needing more).

Post Edited (Blueheron) : 10/12/2010 5:43:38 PM (GMT-6)

I was on 60 mg of pred and recovering from a flare when my colon burst. I was kept on that dose for a few days after my surgery. They weaned me down to 40mg in just 5 days in hospital and I took it upon myself to got down 10 mg every week after I was released. My surgeons wanted me to go down faster (from 40mg to just 10!), but I would rather heal a little slower than get pred withdraw. I'm down to 10mg now and my symptoms have not come back (woot!) so I'm very optimistic that I won't need to take anything in the next few months while I heal before my next surgery. Before every time i dropped to 20mg I would flare back up.

I have heard that some surgeons will try to get you off steroids before surgery but if you're just going to flare back up and be sick again, what's the point? Tell your surgeon that you are concerned about flaring back up and see what they say. They may want you to still try it, but if symptoms return you can start back up. Either way, if you can lower your dose it will help speed up the healing process after surgery. So maybe you'll go down to 30mg and symptoms will come back. Then you start taking 40mg again, that's better than being on 60mg.

actually my GI wanted me off the pred, but my surgeon wanted me to stay on, he said it would be better to not be in a flare

I'll tell you my story....

I am 6 foot and 20 years old, I usually weigh about 165 and am a lean athletic build... well I went into my surgery at 118 pounds, VERY sick, and on 60 mg prednisone before hospitalized and on IV steroids for the week before I had surgery..

I'm now 4 months out and I have not had ONE problem.... the only thing the prednisone messes up is the healing of your incision/stoma area... nothing serious for me, my incision just wheeped a little longer and made keeping bags on a pain for about 2 weeks but other than that I've had a great recovery!