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Question re: when to get steroids

Posted: Sat Nov 05, 2005 7:50 am
by carolew
I would like your advice/opinion on this.
When do you decide that you will ask your neuro for steroids? I know they say that if a new or old symptom stays for 10 days, that this is probably a flare up.
But, I have had weeks in the past where my leg was not the greatest and then, things would get back to normal without treatment, like mini-attacks
I guess, by using just common sense, one could say that once the symptoms are very disturbing, it is time to ask for help.
How do you decide?? :?:

Posted: Sat Nov 05, 2005 9:52 am
by Melody
When the side effects no longer seem all that bad IMO.

Multiple Sclerosis Treatment
From Sarah Beaubien,
Your Guide to Multiple Sclerosis.
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Steroids for Acute Exacerbations
Overview of Steroids as Multiple Sclerosis Treatment
If a person is experiencing an acute exacerbation then a steroid infusion may be a suggested multiple sclerosis treatment. Corticosteroids relieve inflammation and close the blood brain barrier, which can often have a positive effect on the MS symptoms. (Corticosteroids are not the same as anabolic steroids often used illegally by athletes.)


Generally, doctors will recommend a four-day course of high-dose steroids such methylprednisolone given intravenously followed by a tapering of an oral dose as multiple sclerosis treatment. The most common methylprednisolone is Solu-Medrol. Recently, however, there is an extreme shortage of Solu-Medrol in the United States, so most medical facilities are using Decadron instead. The most common type of oral steroid for multiple sclerosis treatment is Prednisone.


Where is Multiple Sclerosis Treatment Administered?
Depending on the condition of the patient, steroids for multiple sclerosis treatment may be administered at a hospital or an infusion clinic. If treatment is given at an outpatient clinic, the patient should allot several hours: one hour for check-in and arrangements and another full hour for the drip. Bring a good book!


Side Effects of Steriods as Multiple Sclerosis Treatment
Before receiving steroids for multiple sclerosis treatment, patients should be aware of the side effects and should arrange to be under the supervision of a physician. Some of the side effects include difficult sleeping, mood swings, water retention, elevated blood sugar, acne, indigestion and acid reflux, and irritability.


To counteract these side effects, doctors may prescribe pills for insomnia and stomach difficulties before the multiple sclerosis treatment begins. During and after the treatment, it is also important to maintain a diet low in salt because the steroids cause water retention and a diet high in potassium because the steroids deplete the body of potassium. Additionally, the treatment may lower immunity, so it is critical to communicate if any infection is suspected.


Healthcare professionals claim that there are few differences between Solu-Medrol and Decadron. Patients who have received both types of treatment may notice that with Decadron there is less hyperactivity, less heartburn, and no metallic taste in the mouth. There is speculation that Solu-Medrol is a more effective, but the outcome depends on the person who is receiving treatment.


According to the National Multiple Sclerosis Society, “The side effects of long-term continuous steroid use are serious and well-documented. These include stomach ulcers, weight gain, acne, cataracts, osteoporosis (thinning of the bones), deterioration of the head of the thigh bone, and chemical diabetes.” Talk to your doctor about these risks and what habits will help prevent them before receiving multiple sclerosis treatment.
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Posted: Sat Nov 05, 2005 11:59 am
by carolew
Thanks Melody plus, that site is very interesting and had some good advice. Carole

Posted: Wed Nov 09, 2005 7:04 pm
by kareng7
BTW, if you decide to go on a steroid and need an infusion, ask your doctor to check with your insurance company (assuming you have insurance) or check with them directly to compare the cost of going into the doc's office or a clinic for infusion vs. having a hospice nurse come to your home to administer it.

When I had solumedrol for three days, my neuro recommended home care because she said, in her experience, it wasn't that much different cost-wise. And believe me, it was well worth it to be able to have someone come administer it in my own so I could just rest in bed.

Posted: Sat Nov 12, 2005 5:52 am
by carolew
I am very fortunate because I live in Canada so these costs are much less but thanks for taking the time to advise me. Carole