Is there a point waiting for surgery? Ulcerative Colitis - In Hosptial

Hello all


I have come to terms with getting the Jpouch surgery and I have a couple options.

I have been on Oral prednisone since February 2015, varying doses between 40mg and 0mg. I had the most relief when I was doing my Loading doses of entyvio, and also around 30mg of prednisone. I tapered the prednisone to zero a the beginning of November and by December 20th I was in a full blown flare again.

I came to the hospital to be put on IV steroids for the first time to help me get stabilized. After agreeing to the surgery here they said it would be somewhat beneficial to see if I can gain some weight, and lower my prednisone usage before the surgery.

Then the doctors come to tell me since I have been on prednisone for a year, that doing a taper to as low as I can (we figured maybe 20mg) then it would be best to do the surgery then (semi-planned). Now they are saying since ive been on it for a lengthy period of time - that tapering at this point wont really give me the benefit since ive already been on it so long.

So my question is did you all try to get to the lowest dosage of prednisone before surgery? I know it is ideal.. But the doctors think that in my case, that theyd rather do it now in terms of my colitis symptoms rather than in a month and risky flaring very badly again.

Thank you for all your imput.

PRED USAGE:

Feb 2015: 40mg
March 2015: 35-30mg
April 2015: 30mg-20mg
May: 20mg
June: 40mg-30mg
July: 25mg-15mg
Augest: 15-10mg
September:10mg-5mg
October: 5mg-0mg
November: 5-0mg
December 21st: Back at 40mg
January 7th: IV Solumedrol 60mg

THANK YOU

That is very encouraging.

Thank you for your positivity.

The surgeons here said that the only point of waiting would be to wrap my head around it mentally and be more prepped that way.

But all things are pointing not to leave the hospital and just get it done.

I had been on prednisone for a long time before surgery and was also on 40 mg when I saw my surgeon for the first time. She was ok with me doing it on that dose but since I'd been on it so long my gi thought I should go down to 20. I did a two week taper that was hard. I don't know what's best for you but I had an abscess a few days after I got home from the hospital. I spiked a high fever and my surgeon came in at night to drain it. She said without the pred it would have been an outpatient thing but on pred it was urgent. I was in the hospital a few days. I don't know whether it would have made a difference if I was on 40 vs 20.

The taper after that was not a big deal and I've had no pred since.

Hey HealthFreak, I see that it's been a while since you last posted - I hope you are doing better now. Others have answered, but from speaking with my surgeon, they of course would love for you to be on the lowest dose of steroids possible, but many many many people go through surgery on some amount of steroids, because the steroids were put there in the first place to try to help them out. The CRC surgeons are very experienced with this and take it into account, and you'll be given a "stress dose" during the surgery. Generally if you are going for jpouch surgery and are on steroids, they'll likely do your operation in 3 steps, and the first step will just be removing your colon so that you'll feel much better. Like other's have mentioned, depending on how long you've been on steroids, they can do a somewhat sped up taper after, since you no longer will have disease that bounces back as your dosage decreases.

Also from speaking with my doctor, they would rather operate on your when you are not flaring heavily, even with some steroids. The healthier you are going into surgery, the easier it will be for you in terms of recovery and any complication risk!