BETTER UNDERSTANDING HOW TO LIVE WITH LUPUS

Can I have surgery?

YES, it is absolutely possible to have surgery when you have lupus but there are 3 important precautions to know.

In case of antiphospholipid syndrome (with a risk of "clot"), you should be careful because you must stop antivitamin K anticoagulation (oral anticoagulation) just before the operation and resume it immediately based on the recommendations of your doctor. In case of stopping oral anticoagulation, the operation should be supervised by subcutaneous anticoagulation. Some "surgical" procedures can be done with moderate anticoagulation. Your referring doctor can put you in contact with the right people. Sometimes, people with antiphospholipid antibody syndrome (APS) may face damage of the heart valves that requires complementing the surgery with antibiotic therapy.

In case of immunosuppressive therapy and/or cortisone, there is a risk of infection after the surgery. If necessary, according to your doctor's recommendations, your treatment may be modified temporarily to reduce this risk of infection. You may also be offered antibiotics before the operation.

If you have been taking cortisone for a long time, it should not be stopped after a surgery as you would be at risk of adrenal insufficiency. Indeed, prolonged intake of cortisone can put your adrenal glands "at rest", so they are not able to produce enough cortisone to control the stress of a surgery.

Thus, any surgery is possible in lupus, but it is essential to inform the doctor and surgeon who will take care of you. Contact should be made with the doctor who is caring for your lupus to properly convey the important medical elements and the treatment you are taking. If you are considering cosmetic surgery, discuss it with your referring doctor for lupus. This is certainly achievable if you wish so, but without taking any risk (including no untimely stopping of anticoagulants !).

Takeaways

Surgery is possible provided you consider 3 important situations:

> If you have antiphospholipid syndrome

> If you have immunosuppressive therapy and/or cortisone

> If you have been taking cortisone for a long time.

It is therefore essential to inform the doctor and surgeon who will take care of you for the surgery, as well as your doctor who takes care of your lupus.

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