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Flare? or pseudo

Woke up with a UTI Friday morning. Called my doc's office, and got a Rx for an anti-biotic, after lab confirmed that's what I had. Was worried, because my UTI's have always triggered a flare in the past.

Went for 2 days with no symptoms of a flare. But, was dizzy during Saturday night, which, although it is not always how my flares begin, has always been a symptom of a flare when they occur.

Called the on-call doc at the hospital, because it was a weekend. I told her about my symptoms and my hx, and she prescribed exactly what I requested: twenty 50 mg prednisone pills for 5 days. (I don't do well with IV's, so that's the direction I've gone, instead, for the past few years.)

I remained mildly dizzy during church. 10:00 am - about noon. Sent DH to pharmacy at about 10:45 (the earliest they could get Rx ready) to pick up prednisone. He brought them to church, with a yogurt (good way to counter the bitter prednisone taste) at about 11:15 am, and I took my twenty 50 mg pills in the pew, between being pianist for worship band.

Continued with mild dizziness during church, but have not had any since then. To actually be defined as an MS flare, symptoms need to last a minimum of 24 - 48 hours, right? Mine started sometime during the night, after midnight, so lasted 12 hours or less. (Unless they return during the night tonight.)

I had originally assumed that it could not be a pseudo-flare, mimicking the symptoms of a flare, just caused by the UTI, because I'd already been on anti-biotics for the UTI for two and a half days, and, you'd think it should've already been working. (I remember, when the kids were little, they could usually return to school after 24 hours on anti-biotics -- that's where I came up with my logic.)

So, maybe this was a pseudo-flare, and not a real one?

Can't call my doc on Monday, cuz it's a holiday. And, only talked to an on-call doc today, since it was a weekend. She didn't know anything about me, or my MS or my hx, so I told her what to prescribe, and she did it.

But, I think I'll call on Tuesday. Not sure if I'll call:

* my former neurologist, who is more local (Wichita), and is really great at returning phone calls and is willing to continue to work with me on local issues (usually by phone, and with no charge!),
* or my MS Specialist Kansas City), who I've heard is not so great at calling back.

Might call both, and see what answers I get from two professionals.

~ Faith

no advice just hugs. :hug: UTIs can be miserable in and of themselves, let alone a flare to boot. hang in there. :hug:

Thankfully, I don't ever have pain or discomfort with my UTI's. Just urinary frequency, until I start getting treated.

Still no return of dizziness, or addition of other symptoms. My current theory has changed. Because I'd already been on ani-biotics for awhile, I don't think h UTI could have been causing a pseudo flare by then. It possibly was a real flare. But, I got on steroids less than 12 hours after it began, and I probably nipped it in the early stages. Don't think I've ever caught one that quickly before. I usually, even if I suspect one, wait around for at least 24 hours to see if it's "real".

Wow. after 8 1/2 years with MS, I'm still learning how to read my body and how best to treat stuff like this.

~ Faith

For me, having a UTI is a Flare and as soon as the UTI is gone, so is the flare.:)

Take lots of cranberry caps and drink plenty of water. :hug:

Sally, my understanding is that UTI's can affect my MS in two different ways:
it can mimic a flare with a pseudo-exacerbation, caused by the physical stress of the UTI:

Quote:

Pseudoexacerbations Temporarily Aggravate MS Problems
Sometimes an increase in symptoms has nothing to do with the underlying MS, but is caused by factors such as fever, infection, or hot weather that can temporarily aggravate MS problems. This is referred to as a pseudoexacerbation. Some patients report a worsening of their symptoms during or after periods of intense stress. Researchers are exploring the effects of stress on the immune system and its possible involvement in MS.

or, it can trigger a flare

Usually, for me, it triggers a flare, but, this time, I'm not so sure. One difference is that Copaxone seems to be working much better for me than Betaseron ever did, and it may have protected me from a flare this time. In the past, even when I catch and treat a UTI early, it does not seem to avert a flare.

~ Faith

Well, I contacted two of my docs -- and heard back from both of their nurses. Both advised to continue on the 5-day course of prednisone, so I'll do that. Neither one indicated whether they thought I was in an actual flare, or just had a pseudo. But, I'm guessing, if they want me to continue on the steroids, they are suspecting a flare.

No continued symptoms of dizziness, and, no additional symptoms. So, if it's a flare, it is certainly one of the mildest ones that I've ever experienced. And, if it's a flare, it's worth taking the 5-day course of steroids to keep it from blowing up into something more serious.

I only slept 20 minutes the first night on prednisone (Sunday). But, last night, I slept well. However, I'm requesting a Rx of Trazedone to help with sleeping, in case I have trouble the remaining 3 nights. Won't take it, unless I need it. But, 20 minutes of sleep in 24 hours just is not enough.

~ Faith

I hope you feel better soon, Faith. :hug:

Thanks, Sally.

I'm actually not feeling too badly.

The dizziness has been gone since Sunday around noon.
No new symptoms have started.
I slept well last night, which I'm glad about, and also was able to nap for an hour, and rest some today during the day, too. (Was glad, because I had a number of volunteer things scheduled today. Tuesday is actual one of my busier days. I "practice" piano at a friend's elderly mother's home in the morning. And play piano for devotions and "dinner music" at a nursing home in the afternoon. Had enough energy for all, in spite of Sunday night not getting much sleep.

My doc's office procrastinated on the Trazedone today. They say that Rx requests can take up to 48 hours for them to call the pharmacy, and, I guess they must have been busy today. Hopefully, I'll sleep well tonight, like last night, and, won't need it again.

~ Faith

I take 25 mg of Trazodone every night. Why do you hesitate to take it? It's a safe, old and cheap drug, often used for sleep for people with MS. I've take it for years with no problem.

Quote:

Originally Posted by ewizabeth (Post 692838)

I take 25 mg of Trazodone every night. Why do you hesitate to take it? It's a safe, old and cheap drug, often used for sleep for people with MS. I've take it for years with no problem.

I don't hesitate to take it at all. I requested it.

My doc's office didn't call it in to the pharmacy yet. So, I'm hoping I won't need it tonight, simply because I don't have any.

~ Faith

On day 3 of a 12-day taper, following my 5-day course at 1000 mg.

Have gained 7 lbs in those 8 days (the 7 lbs I worked so hard at losing the previous 3 weeks). But, I haven't put back any of the 2" that I'd lost in my waist, so, I'm hoping it will disappear after the prednisone is finished.

~ Faith