Lyon wrote:
The difference of this situation with Cure is that steroid maintenance....keeping steroids in your system might nip inflation in the bud with the idea that it's easier to keep something from happening at all than to try to control the situation after it's gotten out of hand, and it will be interesting to see if that way of doing things does indeed reduce accumulation of disability.
Not that anyone knows how this system seems to work, but I do not see it personally as "keeping steroids in your system", if anything, the exact opposite.
When I first started using prednisone, I was prescribed 25mg / day, spread out over the day. After some playing with the dose, I found that it was MUCH more effective to do a short high dose pulse. The first technique would of simulated "keeping steroids in your system", and it basically was ineffectual. And even at the high dose, as I said above, I plateau'd in the long term (as well as reduced my bone density).
Lyon wrote:
At this point there is nothing hinting that it won't/can't
There was that one study that did, but I will have to find that link again later.
Today was my first day after a two day pulse of prednisone. I have noticed some fine motor control improvement. Previously when I tried prednisone not following a relapse, it didn't seem to help. But maybe now with more disability, its more noticeable. I will definitely be doing another pulse in 2 weeks.
Another extension of this I have looked into, is the use of oral dexamethasone. I have never had IV steroids.
http://cat.inist.fr/?aModele=afficheN&cpsidt=1970184Quote:
The objective of this study was to investigate the feasibility of treating relapses of multiple sclerosis (MS) at home with oral dexamethasone. Twenty-five out of 28 consecutive patients with MS who presented with a relapse of less than 2 weeks' duration were treated on an open basis with oral dexamethasone 16 mg per day (four divided doses) for 5 consecutive days. After one week, the expanded disability status scale (EDSS) had improved by one or more grades in 88% (22 patients) and after 4 weeks in 92% (23 patients). Treatment was well tolerated. We conclude that a course of oral dexamethasone 16 mg per day shortens the duration of an exacerbation in MS in a similar way as seen after high dose i.v. methylprednisolone. Although a randomized study is needed to test this treatment regimen against i.v. high dose corticosteroids, oral dexamethasone can be used in situations when i.v. therapy is difficult to apply.
I talked to my GP about it and he said that it was normally prescribed by neuro's for CNS inflammation, and that the dose mentioned was huge. He was not comfortable with prescribing it to me.
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