Adrenal Insufficiency Support Group

I have to have a couple of moles removed - I've had it done before pre-PAI and it wasn't a big deal. Go to ambulatory care and a quick snip snip and out you go. I'm a little nervous this time around. I probably won't be able to see my endo before having it done (he's away atm). I mentioned this to my family Dr. and he said he'd look into it for me, but I'd love to hear other experiences. Will stress dosing be enough or is it more likely that I'll need an IV/solu-cortef?

TIA1

do not have your pcp look into this for you. I urge you to have your endo or who ever is taking his calls to give you or your doctor doing the procedure a call and tell you how to dose up. Even though you may feel calm during the procedure, doesn't mean that your body isn't experiencing stress that MUST be handled.

There are certainly guidelines for this. Pretty sure mole removal isn't an IV level event. If you get an IV, 100mg isn't unusual in one hit.

I'd say at least an extra 10-20mg of HC (for you) about an hour before the procedure. Then watch for and act on normal updose prompting symptoms for the next 2 days. I doubt you'd need endo involvement, the ambulatory people should be smart enough so call them. They should be able to talk to an anesthetist to get the answer if they are lacking.

If the anesthetist says "don't" or can't give you a number, then you have cause for worry. Last procedure I had I chatted with mine and got all the right answers.

Bob

I agree with Bob. It's been years since I had a mole removed, but as I recall, it was a very simple and relatively painless procedure. Just as a comparison, I have to have dental work done quite a bit, and I will usually up-dose 10mg of HC for a root canal. Now, if I were not so USED to having root canals, I'd probably go 20mg, but for me they don't cause much stress. (Except when I pay, but that's different.)

I went to a podiatrist for the first time about a year ago to see about my big toe. It was ingrown again, and it was pretty bad. The next thing I knew, the guy was shooting it up with about 6 shots, which were not pleasant, then he cut the sides of the nail. He wrapped it up and pronounced me cured. Uh...okay dude. Thanks? I hobbled out, went home, popped an extra 10mg of HC, and all was well until the numbness wore off. Then I called him every name I could think of until I found an old bottle of Lortab.

IV Events are pretty rare. They usually reserve that for things like general anesthesia or trauma, broken bones, major stressors.

Like Bob said, though, if they say, "Oh, no, don't worry about it!" or "What the heck are you talking about?" run for the hills.

Are we having fun yet?

Cynthia

This is where you'll find some major differences between countries too. The "standard" here (Australia) for a gastroscopy/endoscopy (camera down throat) is 100mg IV before the sedative and another 100mg 6 hours later. From memory the largest dose I have heard of was 100mg every 6 hours. My Pulmo in East Texas, who was also an ER doc mentioned that to give me an idea of what I "might" go to on tablets. (He had suggested that for a bad lung infection I had at the time I should have gone to 4-5x dosing rather than triple)

I think it safe to say that its all a good guessing stab anyway. I mean if nothing else you can get patient weight ranging 1:3 yet the IV dose "standard" is still the same. I take the equivalent base of around 50-60mg of HC a day, simply because I am around 300lb and bicycle a lot! Sometimes I wish they were M&M's!

Bob

The app on my phone says that updosing for a mole removal is not required but you can double if you feel the need. I had lazer treatment and did NOT need to updose BUT I timed my dose to just before the procedure. Saying that...I am in pretty good health at the moment and when I first got diagnosed, I would have need to updose because even minor stress made me ill. Rather be safe...but be aware that 100mg is rater high and will have side effects if you don't need it. 10 - 20 mg should do just fine!

Thanks all for the reply's! I thought just a small stress dose would be enough, but just wanted to be sure.

Claire - app???? What app???

Deb