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High Dose of Steroid before surgery?

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Posted 11/25/2011 11:43 PM (GMT 0)
Right now I am in a horrific flare and awaiting my surgery on Tuesday.  My GI was planning on beginning to wean me off the drug before the surgery, but then said the surgeon would give me a very high dose prior/just after?  What is this about?  I am dying to get off this terrible drug and it's going to take me weeks now.  I was hoping to avoid the side effects, but it seems this disease is going out with a bang. :(((. 
Posted 11/25/2011 11:52 PM (GMT 0)
Ideally they would want anyone to be off steroids as it can make healing take longer and pred reduces immune system so can leave you prone to infections. However, this isn't always practical and I have had operations whilst still on high dose as there hasn't been enough time to wean off them properly.

Steroids have to be stopped gradually as whilst you are taking them they take over the role of the (can't remember name of thing it takes over, brain freeze moment!) and to get body to start producing again the steroids are reduced gradually to allow body to balance itself. Stopping them suddenly can be very dangerous.

I'm sure your doctor and surgeon are making their decisions for the best and quickest healing outcome for you. If there is anything you are concerned or not sure about make sure you ask them so you know exactly what is going to happen and why.

Good luck with your surgery, it's hard to be patient -excuse the pun!- when you're desparate to fell well again want to get off the meds but think of what things will be like once you are over the op and feeling much better. This is just a little blip.
Posted 11/25/2011 11:56 PM (GMT 0)
I had a high dose during surgery too. It's a "shock dose." When you've been on pred for a long time, your body isn't making cortisol (stress hormone) anymore -- that's why you have to taper to get off, so your body starts making it again (pred is the synthetic form of cortisol). Surgery is a huge stress on your body, and ordinarily people would make a lot of cortisol, and since you can't, that's why they give it to you.

I thought it was weird too, but don't worry about it.... it's a one shot thing and they know what they're doing. It doesn't change your taper.

I went from 40 mg to 20 in 2 weeks to get ready for surgery.... then I went down slower.... got an abscess and couldn't taper for a bit. You will get off of it, and believe me it's glorious.....
Posted 11/26/2011 3:54 AM (GMT 0)
With my step 2 surgery, I got the "stress dose" in the OR even though I'd been off prednisone since march (7 months). I did not have to take anymore steroids afterwards. With step 1 surgery, I was on prednisone (40 mg if I remember right) and I got the stress dose in the OR and then we went throu my normal taper after.

Don't let this worry you. It shouldn't increase your overall time on steroids unless you are barely weaned off before surgery and then they may want you to do a short taper. The stress dose during surgery is really important so that your body can respond to the physical stresses of surgery appropriately.
Posted 11/26/2011 4:27 AM (GMT 0)
I was on 40 mg/day of Prednisone for several weeks before my step 1 surgery (it barely took the edge off of the flare I was in.) I don't know if I got any sort of stress dose during surgery, but since I was released from the hospital I've been slowly tapering off, 5 mg at a time. Yesterday I took my last dose. Hoorah! It is annoying, but the countdown to being finally done gets exciting the last few days. Hehehe.
Posted 11/26/2011 9:03 AM (GMT 0)
I was on 60mg for a whole year before my surgery. I didn't get any kind of large dose right before I went in, but they did take me off pretty quickly. I think they went to 40mg, 20mg and 10mg in a matter of weeks. I didn't notice any crazy reactions.
Posted 11/26/2011 3:15 PM (GMT 0)
Any surgery you have within a year of your last red dose, you will need to have a red boost in the OR. This is normal.

Sue
Posted 11/26/2011 3:52 PM (GMT 0)
This boost you get for surgery is not pred, it is closer to the cortisone your body produces anyway, but may not produce in the face of pred therapy although you need it during your body's high alarm time, which surgery is. I freaked too, but they explained to me.
Posted 11/26/2011 4:46 PM (GMT 0)
I was on 60mg of prednisone, and in a severe flare before my surgery. After surgery, they dropped me straight down to 20mg then tapered off each week from there. I didn't have any bad reactions. I feel like my recovery period has been a little longer than others due to the prednisone and the flare of UC right before. It's not bad though. Good luck!
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