Surgery is scary time for any of us, but when you have Sjögren’s syndrome, there are some things you should know.
[editor's note: This Self-Help booklet was written in first-person by Sjögren’s syndrome patient Dona Frosio]
I encourage you to share these pages with both your surgeon and the anesthesiologist to open a dialogue about surgery and your special needs. I also want to thank the Jefferson Rheumatology Associates for providing us with this great information.
- Before surgery, remind all of your doctors and nurses that you have Sjögren’s syndrome, and share this information sheet with them.
- Give your providers a list of all medications you use, including non-prescription treatments such as eye and mouth lubricants, vitamin E, and anti-inflammatories (Advil®, Motrin®, etc.)
- Bring an adequate supply of your favorite tears, artificial saliva, and other treatments with you to the hospital or surgicenter on the day of your operation in case these cannot be provided to you.
- To ensure your safety and comfort, inform your providers of any arthritis-related problems, particularly those involving the neck, jaw, or back.
- Discontinue blood thinners such as vitamin E and aspirin at least two weeks before surgery; discontinue anti-inflammatories (e.g., Motrin®) at least 72 hours before surgery (unless instructed otherwise by your physician).
- Inform your healthcare providers if you suffer from Raynaud’s phenomenon.
medical provider information
- The most common postoperative problems in Sjögren’s syndrome patients include corneal abrasions, sore throats, dysphagia, and flares of sicca symptoms.
- If indicated, patients using vitamin E regularly should discontinue this treatment two weeks prior to surgery as it may have an anticoagulant effect.
- Patients on chronic steroids should receive perioperative stress doses of steroids until clinically stable.
- On the day of surgery, patients should be instructed to continue their usual eye/oral care and medication regime. Eye drops should be ordered before and after surgery per the patient’s routine. During surgery, the eyes should be lubricated every 30 minutes and taped gently, avoiding pressure.
- A humidifier should be added to the rebreathing system.
- Intubation may be difficult if the rheumatic disease involves the cervical spine or temporal mandibular joints. Endotracheal tubes and LMAs should be well lubricated and placed carefully. A dental guard may be necessary to protect carious teeth.
special nursing information
- Before surgery, patients’ eyes, mouth, skin, and mobility should be assessed. Continue routine oral and eye care.
- During surgery, observe careful movement and positioning of patients. Allow patients to transfer and position themselves if possible. Keep the operating room warmer than usual due to patients’ susceptibility to Raynaud’s phenomenon.
- After surgery, humidified oxygen should be used. The status of patients’ eyes and mouth should be assessed. Eye care should be resumed per the patient’s routine. Patients should be allowed ice chips, liquids or artificial salivas as soon as possible.