Suggest Treatment For Severe Allergy

Brief Answer:
Please have cautious pre-surgical evaluation

Detailed Answer:
Hello.

Thank you for asking at HCM.

I went through your history.

I would like to know more about you like -
a. What are your symptoms of allergy (nose symptoms, skin symptoms or asthma or other)?
b. Have you ever had respiratory symptoms like wheezing, breathing difficulty, etc?
c. Have you ever been tested with spirometry?
d. When did you finish the course of corticosteroids and in what dose?
e. Are you taking any other medications?
f. Do you have any other medical condition?
g. Do you have drug allergies so far?
h. Have you ever had any surgery before?
i. Have you ever required any general/local anesthesia so far?

I would be able to help you better after knowing more about above details.

In general, skin and nose allergies do not significantly cause problems for surgery and anesthesia. For allergy patients, use of oral steroids and asthma needs cautious pre-surgical evaluation by a team of surgeon, physician and anesthetist.

I would like to make following suggestions to you:

1. As you have recently had a 2 weeks course of prednisolone, there is a risk of what we call "adrenal crisis" during any major stress like infection, surgery, etc.

However, please do not worry about it. Such crisis can be safely prevented by using injectable corticosteroid like hydrocortisone before and after surgery.

This risk can be best judged by your physician and anesthetist who will evaluate you before surgery for your "surgical fitness". Please give both of them all the details regarding your steroid use and also other drugs that you have used recently. So that appropriate medicines can be chosen for you before and after surgery.

With such kind of evaluation and proper management, I would think you can undergo any surgery with the same risk as any other normal patient.

2. I also like to know whether you have had any time asthma/asthma-like symptoms. In that case, I would suggest you spirometry before going for surgery.

This will help your physician and anesthetists status of your lungs, which can be specially taken care of during surgery. Should they feel you are "at risk" of having an asthmatic episode, you may be prescribed corticosteroids before and after surgery in appropriate doses to prevent such risk.

3. If you have any time reacted to any of the medicines, please inform your doctors. This is important to avoid preventable allergic reactions by carefully choosing medications for you.

Hope above suggestions and information will be helpful to you.

Should you have any further query, please feel free to ask on follow-up. Please provide above details on follow-up. It will be my humble pleasure to help you with best of my knowledge and efforts.

Wish you the best of the health.

Thank you & Regards,

Dr. Parin N. Parmar

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Brief Answer:
Please do not worry, inform medications

Detailed Answer:
Hello.

Thank you very much for your follow-up.

I went through all your details and would like to suggest you as follows in addition to what I had mentioned in previous answer:

1. From your history, I get you are having allergic rhinitis/rhinosinutisis, which usually does not cause a significant problem in surgeries.

The only concern is recent prednisolone (prednizone) use. Please inform your doctors about this while pre-operative evaluation.

The decision regarding need of spirometry can only be taken after examining you personally by your physician/anesthetist.

2. Claritin is not a concern for surgery. In my opinion, you will be able to take it before and after surgery whenever you have symptoms or as suggested by your physician.

3. You also needs to inform your doctors about atenolol so they can be more vigilant for monitoring your blood pressure while surgery. Also, they need to be continued before, on the day and after surgery. Are you taking it for hypertension? Is your hypertension well controlled with it?

4. As per all your procedure/surgery-related risk, I would think you have no major drug allergies. So that's again a good indication.

To summarize, a careful pre-surgical evaluation and good monitoring before & during surgery as well as in post-operative period should not cause any specific problems to you, in my opinion.

Hope above suggestions will be helpful to you and solves your query.

Please feel free to ask, if any concern, on follow-up. I will also be happy to know your feedback on follow-up.

Wish you the best of the health and a successful surgery.

Thank you & Regards.

Dr. Parin N. Parmar

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