Thread: cortisteroids
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Old 06-16-2009, 03:41 AM
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fmichael fmichael is offline
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fmichael fmichael is offline
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Join Date: Sep 2006
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Originally Posted by bobber View Post
thanks for the info,,,have you used them?if so how long,,of why not,, they make me feel weird,,,ive got my drs arent sure themselves if its a neuropathy or rsd,,, but as i told others,,,its n migrtaed to the other leg,,ive got another hip revision due in 6weeks,,,,is my failed surgery 9 weeks ago due to rsd migraated into the hip or is the cup loose,,,thats what in asking myself,,,talk about bad timeing,,,surgery is like pouring gas on an amber when you have rsd,,avoid it,,,,,,,,,,,,,,thanks mik,,bobber
Bobber -

No, can't say I have used either steriods or Infliximab for my RSD/CRPS. The rheumatologist who was the first to suggest an RSD diagnosis never even suggested steroids - because of the known issues with their long-term use - but was keen on doing Infliximab (marketed under the trade name Remicade) which he said had to be co-administered with methotrexate, a really nasty cancer drug, the 13 paragraph FDA mandated "black box" warning on the label can be checked out at http://www.nlm.nih.gov/medlineplus/d...s/a682019.html.

But that aside, I was in no position to take Infliximab in the first place, where there is a significant association - at least in children and young adults, for which I haven't qualified in a while - between TNF blockers and various cancers, and I already have a blood disorder that's an absolute prerequisite for developing multiple myeloma - bone cancer - with an average rate of "progression" of 1% per year, so that, roughly speaking, if someone lives forty years after being diagnosed with what I've got, the cumulative probabilty of developing MM is 40%, and that's without a TNF blocker! This was a point on which my internist was emphatic: an MM/CRPS combo was one daily double I didn't want to pull.

I hope that a low dose of prednisone really works for you. Having said this, I'm most concerned that with a very fresh case of RSD, your treating doc is apparently not recommending nerve blocks. This is exactly the time they have the greatest chance of success.

By way of example only, PLEASE look at "Efficacy of Stellate Ganglion Blockade for the Management of Type 1 Complex Regional Pain Syndrome," Ackerman WE, Zhang JM, South Med J. 2006; 99: 1084-1088, at 1087-88, free full text at http://www.rsds.org/2/library/articl...lion_block.pdf (patients who started SGB treatment within 16 weeks of onset of their symptoms had significantly better pain relief following SGB therapy):
We conclude from our study results that both increased and decreased vasomotor activity can occur with CRPS I depending on the duration of the symptoms. We furthermore conclude that SGB therapy is more efficacious with decreased vasomotor activity but becomes less effective with increased vasoconstriction. The mixed SGB efficacy results of our study are related to both the duration of the symptoms and blood perfusion in the affected hands. In summary, we feel that the early diagnosis and treatment of CRPS I should significantly improve patient outcome in the clinical setting.
Then too, I would join you in being hesitant to do anymore surgery at this time, unless you are working with an anesthesiologist who has experience with a technique sometimes referred to as "continuous regional anesthesia" in which local anesthetic is pumped into the site of incision during the surgery and in some cases for 2 - 3 days thereafter. Click on the RSDSA Medical Articles Archieve webpage at http://www.rsds.org/2/library/articl...ive/index.html then scroll down to open any of the 4 articles under the heading "CRPS and Surgery."

Finally, I am concerned about your report of pupils dilating at times in an uneven fashion. I would have that checked out by a good neurolgist on the sooner rather than later side of things, unless your doctor can tell you with certainty that's an established side-effect of the medications you're on.

Let us know as there's more information we can provide. (PMs are fine too.)

good luck,
Mike
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aj822 (06-16-2009), Dew58 (06-16-2009)