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Does lupus make surgery, or recovering from surgery higher risk or more complicated?
Surgery?
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Hi there.
I had a total hip replacement a couple of years ago. I think there are lots of different factors that may play into that answer. Immunosupressants may increase our risk of infection, and the physical and emotional stress may cause our lupus to flare. I don't have APS but I imagine that would likely be something to consider too as clotting may be an issue.
I had an pre-surgery appointment with an internal medicine specialist at the hospital before the surgery to go over my history and make sure he knew to keep an eye on my lupus bloods while I was in hospital.
My rheumatolgist's advice was to make sure I was as healthy as possible pre-surgery (eat well, get lots of rest, try to minimize stress) and make sure I didn't rush the recovery period. The surgery and recovery went fine for me, no complications to speak of. There was one med mix-up, but they sorted that out pretty quickly - my kidneys really don't react well to anti-inflammatories, and that's standard protocol post-hip replacement for most patients.
There may be other considerations I haven't thought of (just speaking from personal experience) I'm sure others will be along soon to share!
Lisa
I had a total hip replacement a couple of years ago. I think there are lots of different factors that may play into that answer. Immunosupressants may increase our risk of infection, and the physical and emotional stress may cause our lupus to flare. I don't have APS but I imagine that would likely be something to consider too as clotting may be an issue.
I had an pre-surgery appointment with an internal medicine specialist at the hospital before the surgery to go over my history and make sure he knew to keep an eye on my lupus bloods while I was in hospital.
My rheumatolgist's advice was to make sure I was as healthy as possible pre-surgery (eat well, get lots of rest, try to minimize stress) and make sure I didn't rush the recovery period. The surgery and recovery went fine for me, no complications to speak of. There was one med mix-up, but they sorted that out pretty quickly - my kidneys really don't react well to anti-inflammatories, and that's standard protocol post-hip replacement for most patients.
There may be other considerations I haven't thought of (just speaking from personal experience) I'm sure others will be along soon to share!
Lisa
I don't think it is possible to generalise and agree with Lisa that it depends on individual circumstances: how exactly lupus is affecting you plus any other health considerations and what medicines a person is on. Usually the rheumatologist will advise or even get in touch with the surgeon and anesthetist.
Don't forget to mention all medicines including OTC ones and any supplements you take as some supplements can affect blood clotting and anesthesia.
In my case the only recommendation has been to stop my meds 10 days before as they can all increase bleeding risks ( antimalarials, aspirin and to a lesser extent, Imuran ); other people will have different and additional considerations.
Clare
Don't forget to mention all medicines including OTC ones and any supplements you take as some supplements can affect blood clotting and anesthesia.
In my case the only recommendation has been to stop my meds 10 days before as they can all increase bleeding risks ( antimalarials, aspirin and to a lesser extent, Imuran ); other people will have different and additional considerations.
Clare
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Well, the reason I ask is because I've been considering a surgery which is questionably optional. (Breast reduction.) And I'm wondering if it would be a bad idea with lupus as a factor, or if maybe I ought to do it as soon as possible, before my condition deteriorates further, if it's going to.
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I've had several surgeries and have not had any problems with healing or surgery itself. I have a opposite problem of APS, my platelets don't work like they should and so I have a problem stopping bleeding.
I have usually gotten a bolus of 10 mgs of prednisone prior at the hospital, had to stop my nsaid for a few days prior, and kept up with all the rest of my meds. I do take my meds with as little water as I can to get them down, the morning of the surgery.
I always take copies of my med list, one for the chart, one for the floor clerk, one for the pharmacy in the hospital to have for their records, one for the doctor, and an extra copy for me to have for reference. That way, I can rest assured that there will not be any questions about what meds I take and when.
Good luck with your plans.
Sally
I have usually gotten a bolus of 10 mgs of prednisone prior at the hospital, had to stop my nsaid for a few days prior, and kept up with all the rest of my meds. I do take my meds with as little water as I can to get them down, the morning of the surgery.
I always take copies of my med list, one for the chart, one for the floor clerk, one for the pharmacy in the hospital to have for their records, one for the doctor, and an extra copy for me to have for reference. That way, I can rest assured that there will not be any questions about what meds I take and when.
Good luck with your plans.
Sally
I've had a few surgeries as well and have not had trouble recovering from them with lupus. It is important to discuss your condition & how it affects you, and what medications you take with the surgeon. The doctor will be better able to help you weigh the pros/cons better than anybody here.
Sometimes, some extra precautions are taken such as a bolus dose of prednisone prior to surgery if you've been on prednisone in the last several months at all, and I wore the air compression stockings for a day after surgery to help avoid blood clots since I have the clotting antibodies.
But a lupus dx alone is not a reason to rule out a surgery that may be helpful for you for a variety of reasons. If I was in your shoes, I wouldn't rule it out at least given you probably want the surgery to help with back and shoulder issues. (I know someone that had the surgery - a healthy person - and she was very glad she did)
PS I moved your post here because you're more likely to get more responses here and this is a topic better suited to Living with Lupus.
Sometimes, some extra precautions are taken such as a bolus dose of prednisone prior to surgery if you've been on prednisone in the last several months at all, and I wore the air compression stockings for a day after surgery to help avoid blood clots since I have the clotting antibodies.
But a lupus dx alone is not a reason to rule out a surgery that may be helpful for you for a variety of reasons. If I was in your shoes, I wouldn't rule it out at least given you probably want the surgery to help with back and shoulder issues. (I know someone that had the surgery - a healthy person - and she was very glad she did)
PS I moved your post here because you're more likely to get more responses here and this is a topic better suited to Living with Lupus.
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152 Posts
UGH. The more I learn, the more nervous I get about what the future holds for me. Right now I'm just fatigue, and joint aches. (I was diagnosed because I was sleeping a lot and I thought I was depressed... The doctor did blood work that I thought was completely unnecessairy because I was so obviously JUST depressed, and I was really cheesed off when they told me it was lupus, not depression.)
Does EVERYONE have some form of clotting disorder? The article about TIA made me super nervous. Should I avoid birth control?
Does EVERYONE have some form of clotting disorder? The article about TIA made me super nervous. Should I avoid birth control?
Hello,
I'm coming in a bit late on this but just wanted to say that NO, not everyone has a clotting disorder - basically, not everyone has everything. However, APS is relatively common among lupus sufferers (around 30%) and is always worth bearing in mind if you are suffering from certain symptoms.
As mentioned above lupus (and any auto-immune diseases) is very individual. Many many people will remain with a very mild level of lupus involvement life-long. There is no reason to believe at this stage that you will not be one of these.
Surgery would, of course, always be discussed with your docs. Pros and cons always have to be weighed up - for anyone.
Your surgery may be very important to you for many reasons. That element has to be considered along with others and discussed with your docs.
hugs :hug:
Katharine
I'm coming in a bit late on this but just wanted to say that NO, not everyone has a clotting disorder - basically, not everyone has everything. However, APS is relatively common among lupus sufferers (around 30%) and is always worth bearing in mind if you are suffering from certain symptoms.
As mentioned above lupus (and any auto-immune diseases) is very individual. Many many people will remain with a very mild level of lupus involvement life-long. There is no reason to believe at this stage that you will not be one of these.
Surgery would, of course, always be discussed with your docs. Pros and cons always have to be weighed up - for anyone.
Your surgery may be very important to you for many reasons. That element has to be considered along with others and discussed with your docs.
hugs :hug:
Katharine
Hi again WP - I do NOT have a clotting disorder, so no, not everyone with SLE also has problems with clotting. I'm also on birth control - I use a low-dose version, which everyone on my healthcare team has okayed, but your doc sounds like they are on the ball, so probably best to check in with them.
I know this may sound trite, but try not to worry too much about what the future holds. With SLE all you can do is take one day at a time and educate yourself so that you are an effective advocate for your own health. Once you've met one person with lupus... You've met one person with lupus. We're all different, and so your experience will be unique.
If you are learning from online sources, you should also keep in mind that many people posting are posting precisely because they are unwell and looking for answers, so it's not really a representative group, and a lot of the online stuff is out of date, and so a bit scary - the treatment options are really getting a lot better....
Cheers,
Lisa
I know this may sound trite, but try not to worry too much about what the future holds. With SLE all you can do is take one day at a time and educate yourself so that you are an effective advocate for your own health. Once you've met one person with lupus... You've met one person with lupus. We're all different, and so your experience will be unique.
If you are learning from online sources, you should also keep in mind that many people posting are posting precisely because they are unwell and looking for answers, so it's not really a representative group, and a lot of the online stuff is out of date, and so a bit scary - the treatment options are really getting a lot better....
Cheers,
Lisa
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