Medicines and long-term conditions

Blood thinners, steroids, heart and lung disease, liver and kidney disease, and weight-loss injections all change how surgery is planned. Start with these guides.

Key points from the guides

Blood thinners protect you from clots, but they increase bleeding during surgery. Every plan balances two risks: bleeding from the operation, and clotting if the medicine is stopped. The decision is made with the doctor or specialist who prescribed the medicine, and written down with dates. The golden rule: do not stop or restart any blood thinner on your own. Follow the written plan with your dates.
From the guide: Blood Thinners, Aspirin and Surgery
If you have taken steroid medicines for some time, your body may not make enough of its own steroid (cortisol) during the stress of an operation. Without enough, your blood pressure can fall dangerously — this is called an adrenal crisis. Extra steroid around the operation, called steroid cover, keeps you safe. The golden rule of this guide: never stop your steroid suddenly, and always tell every doctor and nurse that you take it.
From the guide: Steroids and Surgery: Your Steroid Cover Plan
Heart attacks, heart failure, abnormal heart rhythms, and lung complications are among the most serious problems that can follow surgery, and they are more likely if you have heart disease, a coronary stent, a pacemaker, high blood pressure, asthma, COPD, or sleep apnea, or if you smoke. Much of this risk can be reduced by preparation before surgery and simple actions afterward. The promise of this guide: we will check your heart and lungs carefully, keep the medicines that protect them, and watch you closely after the operation.
From the guide: Heart, Lungs, Blood Pressure and Sleep Apnea
Some long-term conditions change how surgery is planned, because they affect clotting, fluids, infection risk, and how medicines are handled. This guide covers four of them: liver disease, kidney disease and dialysis, sickle cell disease, and biologic or disease-modifying medicines. The right advice for one does not transfer to another, so each has its own section — and each plan is made with the specialist team for that condition.
From the guide: Liver, Kidney, Sickle Cell and Biologic Therapy: Planning Your Operation

Guides to read next

Go to the emergency room immediately, then call your surgeon, if you have severe pain, difficulty breathing, heavy bleeding, fever, or any warning sign in your guide.

This page gives general information and does not replace the advice of your treating team. Your own team's instructions always come first.