my surgeon that I'm consulting with now would like me off of prednisone but it's not the end of the world if I'm not. They would treat me with IV steroids if necessary for surgery and taper me off following that.

I take predsone all the time and iny ecperience u dont need to get off of it prior to surgery. They will give it to you in you iv solutions.

I read this...

 

"If you have recently taken a course of steroids or are on long-term steroid therapy, make sure to tell your surgeon and anesthesiologist. Steroid medications, such as Prednisone®, should be continued both during and after surgery. Most likely, your surgeon will give you additional doses at the start of your procedure. This is because long-term steroid therapy suppresses the adrenal gland, which manufactures the steroids your body needs. Inadequate steroid levels during surgery can lead to hypotension or low blood pressure."

My surgeon wanted me to taper down to 10 or less mg. of Pred prior to surgery.  Whenever I went below 20 mg I felt terrible so he told me to stay at 20 mg.  During surgery he had the anesthesiologist give me a boost of steroids.  I woke up looking like Humpty Dumpty!  It took about a month or more to taper off Prednisone but I did it and haven't looked back.  That was in 2001.

If you're on an *appropriate* dose of steroids for your pre-surgical condition, then trying to force a taper to accommodate surgery is likely to do more harm than good. Being sick at surgery is worse than being steroid-dependent at surgery. Yes, surgery without steroids is better than surgery with steroids, all other things being equal (they are *not* equal). Yes, you'll need a substantial dose for the surgery and immediate recovery. Yes, you'll have to taper very slowly after surgery (the safe speed of that depends on how long you've been taking steroids, and at what dose). 

 

I started my taper after the surgery, and it went very nicely.

I was on IV steroids and bowel rest with TPN that ended up with surgery that admit, and I did fine, even with steroids on board. They just began an appropriate taper as I neared surgery, and continued til I was off after it. 

Am presently on 25mg of pred and have been on various dosage for the last three years am on the list for pouch removal hopefully within the next couple months.  Surgeon said to get as low as I can and still feel well and they will deal with it better than for me to be really ill and face the surgery as well my big problem now is the stress fractures in my sacrum and how the pain will be as the pred is reduced!!!!

Prednisone is an issue, but I would also consider the problems with coming into surgery with Remi and MTX in your system. Your healing will be delayed.

 

The best solution in my opinion is to have a subtotal colectomy. It is much less intense than j-pouch construction (if you will still want to do that after enjoying great health with a stoma!) and will let you get off the meds in preparation for the next operation. By then all those immunosuppressants will be out of your system and your adrenals will be bouncing back (hopefully. You really have taken pred for a long time... you should see an endocrinologist).