Systemic lupus erythematosus is a chronic autoimmune disease in which a person's immune system does not distinguish between foreign viruses, bacteria and microbes and healthy tissues of their own body. This causes the body to produce antibodies that attack and damage healthy tissue, causing inflammation, pain, and tissue destruction. Due to its autoimmune nature, lupus can cause additional complications during any, even simple, surgical operation. However, you can minimize the chance of complications by consulting a healthcare professional who can tell you what to expect before, during, and after your surgery.
Part 1 of 3: Preparing for Surgery
Step 1. You need to know as much as possible about the upcoming surgery, then you can properly prepare
It doesn't matter how complex the operation awaits you, you need to arm yourself with all the completeness of knowledge on this issue. Knowing all the details of the upcoming operation will help you psychologically prepare.
- Your doctor or surgeon should tell you as much as possible about the upcoming surgery, so that you do not have to worry and search for sources of information yourself.
- Usually, the surgeon or the attending physician discusses the details of the operation with the patient during the appointment prior to the operation.
Step 2. Get specific advice from your PCP for lupus to avoid complications
As an autoimmune disease, lupus erythematosus affects many systems and organs in your body. This means that if you are about to undergo surgery, you need to take into account other organs that may be indirectly affected. Your physician, whom you are seeing for lupus, is aware of the characteristics of your body and can give the surgeon additional advice that he considers necessary in connection with your chronic illness.
- For example, if lupus has affected your joints, a rheumatologist will make a report on all medications you are taking because some medications can interact with each other during surgery.
- With regard to other organs, such as the heart (cardiologist), kidneys (nephrologist), digestive system (gastroenterologist) and nervous system (neurologist), the doctor gives an opinion, where he writes down the results of all tests, prescribed medications and previous treatment.
Step 3. Make a list of medications you are taking and take to your surgeon
Some medicines can interact with each other, causing adverse effects both during and after surgery. Knowing about all the prescription and over-the-counter drugs you are taking will help your doctor monitor and be alert to possible drug interactions.
- All medications, including vitamins and dietary supplements, must be included in this list, where it is also necessary to write down the dosage and frequency of taking each remedy.
Also, write down information about any dietary supplements you are taking. They are often forgotten to be remembered because they are not perceived as medications.
- Vitamins and supplements such as vitamin E, ginkgo biloba, or garlic can increase the risk of bleeding.
- Herbal supplements, such as St. John's wort or valerian, can interact with drugs used for anesthesia.
- Stop taking NSAIDs 3-4 days before your surgery. These drugs can cause severe bleeding as they thin the blood. For this reason, doctors always recommend that you stop taking these medications at least three days before your upcoming surgery.
- Non-steroidal drugs include drugs such as ibuprofen (Nurofen) and acetominafen (Paracetamol, Panadol).
- However, some anti-inflammatory drugs can be continued as long as they do not thin the blood. These drugs include non-acylated salicylates, such as magnesium trisalicylate.
- Always follow the advice of your doctor and surgeon.
Step 4. Talk to your doctor about steroid use to avoid complications during surgery
Some steroids are used during surgery in so-called "stress doses" to avoid inflammation and tissue edema. However, if you are already taking steroids for the three weeks before surgery, your doctor may not prescribe stress doses to avoid complications such as acute adrenal insufficiency. You must inform the surgeon about the hormonal medications you are taking to avoid serious complications.
Long-term steroid medications can cause serious side effects, such as hypercortisolism syndrome
Step 5. Be sure to check which blood thinning medications are safe to take before surgery
Prescription anticoagulants such as warfarin, clopidogrel, apixaban, pradaxa, and arixtra can be used in people with lupus erythematosus if approved by their doctor and surgeon. The doctor makes the decision to take these drugs in the period before the operation based on the fullness of information about your condition.
The doctor who prescribed these drugs for you should definitely discuss this issue with your surgeon and decide exactly how to proceed with taking these drugs in the preoperative period
Step 6. If you are suffering from Raynaud's, be sure to inform your surgeon so that he takes this information into account
In this disease, a person experiences numbness in the fingers and toes, the tip of the nose or ears, especially at low temperatures. It is caused by narrowing of the small arteries, which interferes with blood supply to these areas of the body. Operating rooms are often kept at a low temperature, so Raynaud's phenomenon can interfere with normal blood flow through the arteries and veins, which can affect the course of surgery.
- If this is not taken into account, then the tissue of the fingers can become dead, which limits their functioning and can lead to the development of infection and even gangrene.
- If you inform your doctor about the condition, he or she may take special measures, such as maintaining a higher temperature in the operating room, or providing the necessary thermal protection for these parts of the body and keeping them at the correct temperature.
Step 7. Warn the surgeon if you suffer from Sjogren's syndrome to avoid dry mucous membranes
Sjogren's syndrome is an autoimmune disease that affects the body's secreting cells, especially mucosal cells and other secreting glands, resulting in a lack of saliva and tears and causing dry eyes and mouth. Low humidity, which is maintained in operating rooms, can provoke an exacerbation of the disease, which will lead to severe drying of the mucous membrane. It is very important to inform your doctor about this condition to prevent drying out and damage to the mucous membranes.
- To do this, during the operation, artificial saliva is injected into the oral cavity, and a special moisturizing gel is introduced into the eyes.
- You must take all the necessary moisturizers to the hospital that you will use to maintain moisture in the mouth and eyes during the postoperative period.
Step 8. Get a good night's sleep before surgery to reduce stress levels
Getting a good night's sleep before surgery can help you cope with anxiety and tension. Try to get at least an hour of sleep immediately before surgery and sleep at least 7-8 hours the night before surgery to relax tense muscles and stabilize vital signs.
To deal with stress, you can tell your family and friends about your anxious thoughts
Part 2 of 3: What to Expect During Your Surgery
Step 1. You should know that your vital signs will be measured before the operation
Nurses and other medical personnel will check and record all information about the vital functions of your body in order to judge on their basis the stability and dynamics of your condition during the operation. During the operation, these indicators will be monitored continuously. Such a procedure is necessary in order to timely detect any unexpected changes that may occur in the body during the operation.
Any unexpected condition will cause changes in the vital signs of the body, allowing the surgical team to immediately detect the problem
Step 2. You need to know that immediately before the operation you will be given anesthesia
The type of anesthesia is selected individually in each case. Anesthesia is used to create a hypnotic or pain-relieving effect during surgery. Thus, the patient will remain unconscious and will not feel pain during the operation.
- The anesthesiologist will decide which type of anesthesia will be used during the operation - general anesthesia, spinal or epidural anesthesia, or local anesthesia.
- In addition, the anesthesiologist will monitor the vital signs of the body during the operation in order to notice in time any unwanted effects due to the applied anesthetic drug.
Part 3 of 3: What Happens After Your Surgery
Step 1. After the operation, the patient is transferred to the intensive care unit
There he will remain under continuous supervision of medical personnel until he fully regains consciousness and vital signs are at normal levels.
- If the operation was performed without the use of general anesthesia, the nurse will monitor your condition until sensitivity is restored in the anesthetized area of the body.
- If your vital signs remain stable for several hours, the surgeon, anesthesiologist, and nurse decide that the patient can be moved out of the intensive care unit.
Step 2. After the operation, you will need to take pain relievers
Immediately after the operation, the patient needs to receive pain relievers, which are prescribed by the attending physician. Surgical intervention is a very painful procedure, because the skin and muscles are cut and various medical procedures are performed.
Pain medications must be taken periodically or at the request of the patient
Step 3. You need to know that taking certain medications must be coordinated with your doctor
Surgery usually causes an increase in the symptoms of lupus erythematosus. Since the body's systems will be involved in repairing damaged muscles and tissues, an inflammatory process is inevitable. In this case, steroids and other drugs are prescribed to cope with inflammatory processes in the body.
- This treatment must be prescribed by your healthcare professional.
- Your doctor can prescribe the treatment you need to avoid postoperative complications and unwanted symptoms.
Step 4. Do not hesitate to ask the medical staff any questions that concern you
You need to check with your doctor and nurse about all aspects that you do not understand and find out in detail what you need to do after you are discharged from the hospital. Feel free to ask them all your questions, as they can give you reliable information that will allow you to recover faster after surgery.
Knowing all the answers to your questions before leaving the hospital can help you avoid stress and cope with any difficulties
Step 5. Never miss a post-operative check-up with a doctor
Your doctor will schedule an appointment for you one week after you leave the hospital (or as soon as your condition permits) to check how you are doing. Such an examination will check your condition and find out what to do if any unwanted symptoms appear.