My Doctor said steroid packs don’t work for minor relapse?

[Sir-Voor]

Before I tell him that he is full of it, I like to get some feedback.

I know I have been wrong a time or two in the past, but I have used Medrol and prednisone for minor relapses before and they always worked.

Also (depending on the replies) I’m planning on calling my GP for ether a Medrol and prednisone prescription, I have had both safely in the past. So is there any reason I should ask for one over the other?

[Alicious]

Is it possible the doctor meant that the risks of the steroids weren't worth treating a minor flare (in the doctor's opinion)?

[cosake]

I am no expert, but it's my understanding that in order to help with a relapse, you have to have a very high dose of steroids - generally in IV form. My neuro also says that you have to start the steroids within 48-72 hours of a relapse or it won't help enough to be worth taking them.

In my case, I will save having high doses of steroids for when I have a bad relapse. This is due to the side effects and possible long-term effects such as bone issues.

I will be interested to hear from others who may use lower-dose oral steroids for relapses. It would be nice to avoid the IV if possible.

[Sir-Voor]

P.S. does anyone know a good neuro is the St. Louis area, I need a new one.

one that will NOT cause stress and make me have to fight for treatment during a relapse.


Hi Sir-Voor~ Your signature was removed per our Guidelines - No political statements, please. Thank you!

[Alicious]

I will be interested to hear from others who may use lower-dose oral steroids for relapses. It would be nice to avoid the IV if possible.

The only time I've ever taken them for a flare was at diagnosis. I was about 2 weeks into the flare when I saw the neuro, had little use of one hand, severe spasticity in one leg, and pretty much no sensation in the flesh of one side of my body. I was offered IV or oral and was told by my neuro that they are equally effective in the long run.

If I remember correctly it was 80mg/prednisone/day for a week, then 60, 40, 20, 10, etc. Horrible heartburn, but worked like a charm. Don't quote me on the dose, though--this was more than 2 years ago, but I do promise it was in tablet form.

I've been offered them for more mild relapses, but haven't personally wanted them.

[Ga dancer]

Interesting how different MS specialists treat so differently.

I had a major flare requiring a wheelchair and such severe pain. I also had visual problems, blurred vision with some kind of ferris wheel type of thing obscuring my right eye.

My MS doctor said that they do not use steroids for flares because there is no improvement in function just shortening of symptoms.

[lusciousleaves]

I'm having a flare and have been prescribed medrol dose pack, then switched to prednisone 40mg to start for a 12-day taper. It is helping. I can breathe, my nerve pain is clearing up, the vision blurring is clearing up and the tremors, twitches and muscle spasms are clearing up.

We've been hit with some crisis level stress here at home the last couple of days, so we'll see if the improvements hold or start to worsen again. My neuro has said to nip that stress in the bud because it can make this worse. We just have to wait and see what happens next.

My little anecdotal story means nothing to the docs who go by studies and numbers, but for the docs who are actually treating me, it means they've helped me feel and function better. That is the whole point of health care, is it not? And all of the docs who listen and care agree on how to treat this without a formal diagnosis. You go with what works.

[twisterred]

Steroids have always helped me with flares.

By day 1 and certainly day 2, I have felt immediate sensory improvement.

And, I really believe the exacerbation was shortened. If it wasn't, the flare wasn't bothering me and I wasn't feeling tingly, numb, etc. while the steroids were helping.

Prednisone steroid IVs have always been prescribed during my flares. It have it drip extra slowly into my arm, or I get a terrible headaches.
Taking an aspirin before helps some, but a slow, slow drip works best for me.

When the weather is cold, I get a warm blanket and place it over the arm with the IV in it. My body temp is normally lower than the standard 98.6 and the medicine in the IV actually hurts going into my cool arm.
Adding warmth to the arm helps tremendously for me.

The medication isn't the most fun, but has helped me a great deal.
I do need a script for that seek to help me sleep.
And, I do need Mylanta for an upset stomach.
And, my wardrobe that week is strictly comfortable.

I know many are different, but this is how they've worked for me. Within a week, I have always been able to function better. I know for certain I am much more comfortable because I'm not feeling such weakness and tingling.
I still will bump into a wall more than usual or feel not quite right, but over a period of weeks, I have always continue to discover improvements.

Like cosake stated, my MS neuro told me that treatment must happen within 48 hours max. He insisted that I call him any time new symptoms happen in 24 hours.

I've moved away from this Dr, but still tell any new MS doc about my treatment and they have followed this same method for me.

Between fast treatment and me being stubborn (ha ha), I've thankfully been able to recover very well.

[onlyairfare]

The "Medrol Dose Pak" and similar generics contain methylprednisolone, usually in 4 mg tablets to be taken in a tapered dose over 6 to 12 days, often starting with 6 tablets (24mg) the first day, tapering to one tablet (4mg) the last day.

When using methylprednisolone IV to treat an MS relapse, my neuro prescribed 1 gram (1,000mg) IV daily for 4 days. That is major order of magnitude difference in dosage!

When I was traveling overseas, my neuro prescribed oral prednisone 1 gram per day orally to use in the event of a relapse. Prednisone 5mg = methylprednisolone 4mg, still major dosage difference from the Medrol Dose Pak.

I also have asthma and keep prednisone pills on hand in case of a bad asthma attack. For that I will use maybe 40mg to 60mg of prednisone daily, tapered over 5 - 10 days, and that is considered a fairly high dose for asthma, but quite low for an MS flare.

FWIW, I have never noticed any improvement of my MS symptoms when taking prednisone for asthma, though your results could be quite different.

[Spydre]

P.S. does anyone know a good neuro is the St. Louis area, I need a new one.

one that will NOT cause stress and make me have to fight for treatment during a relapse.


Hi Sir-Voor~ Your signature was removed per our Guidelines - No political statements, please. Thank you!

The only other one that I could recommend would be Dr. Parks, at the Trotter MS Center. Or you could try the MS specialist at SLU. Dr. Parks is who I see. But, we don't always agree.

[Spydre]

For what it's worth, oral steroids can be prescribed for minor relapses. Yes, they help with the symptoms - but doctors don't like prescribing them frequently because the oral steroids raise your blood sugar. My mother in law has medication induced diabetes, because when she had breathing problems, her doctor would just put her on steroids again and again. Also, while you are on steroids, you don't absorb calcium as well, so it's a double edged sword, really.

[poohkers]

They work for me!

I just started a Medrol dose pack last night to treat severe leg pain, tingling and some numbness. Four years ago I did not get treatment early enough and ended up using the use of my legs for awhile. The MRI showed a new lesion in my spinal cord. I had the IV steroids at that time and it took about 6 weeks but I finally improved. I still have weakness and occasional pain in the left leg. This time when the pain lasted more than 3 days I called my Dr. and he called me in a dose pack. I pray it works quickly. I have used it in the past for severe headaches and slight vision loss. I do try to save the IV for really bad attacks. I have had them about 8 times. I would say try them, they just might work for you.

[Sir-Voor]

Update: He did give end and proscribe an three day high dose steroid but not Medrol and Prednisone.

During day one of three I started having hiccups; I thought no problem I take temporary over what a relapse can do prenatally any day.
Day two relapse systems gone but I also discovered hiccups and acid reflex to be a bad combo and stopped steroids by the end of the day.
Day three miserable
Day four hiccups finally over and recovery started.

Well that was not the fun product start to my staycation/vacation I had plan, but I’m a back to my normal now.
I like to look at events in my life a lesion, and besides the obvious fact that I/we should call our doctor when a symptom like hiccups first starts, I also learn that I should trust my instances.