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Are there risks from surgery for people with Lupus?
MIBeth posted:
I need to have another surgery soon to remove a pelvic mass. I'm worried about infections. I had a lung surgery last year and ended up with pneumonia for a month. I think I'm starting a flare based on all the swelling and pain lately but I can't postpone the surgery. My surgeon knows of my diagnosis and doesn't seem too worried. Am I just being paranoid?
David Zelman, MD responded:
Good question with no simple answer. In lupus patients the usual pre-op evaluations would apply and patients with active disease especially critical organ should be delayed. If you are on steroids certain precautions and measures need to be done. It should be noted that SLE patients have a greatly increased risk of cardiac/ coronary problems that may be silent and become apparent under the stress of surgery.
David Zelman MD
redwingfan2010 responded:
Is your Rheumatologist aware that you're having this surgery and that you feel a flare may be coming on? If not, I'd give him/her a call and discuss it.

Over the summer, I needed to have oral surgery - and didn't think to clear it with my docs first. Got to my surgical appointment, the oral surgeon saw that I had been on steroids for half the summer and that I have Lupus. He stated that he would have to remove bone in order to get my wisdom tooth out and that he was not at all comfortable doing the surgery without talking to my doctor.

Sooo.... he called my internist. My doctor said "no way". He said if it wasn't urgent, he felt that I was not stable enough to have the surgery and that he was worried about my ability to heal as well as an increased risk of infection. I still haven't had it done, because my internist has yet to give me the ok.

Just make sure all your docs are on the same page... maybe they can do something post-op to minimize your risks.

Good luck and keep us posted.
MIBeth replied to David Zelman, MD's response:
Thank you for your time and prompt response. I don't really think I have a choice to delay the surgery as the mass has doubled in the last 4 weeks. I've been putting it off since August. My rheumatologist has been out of town for the past month and won't be returning until after the surgery is scheduled. I'm haven't been on steroids for about a year so that's one mark on the good side. I've had a stress test and I don't have any "active" coronary disease at this time, although I do have damage from prior bouts with pericarditis. I guess I just have to make sure that everyone is on the same page.
Thank you again for your time and expertise.

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