If you are having luck with voltran, you will LOVE Flector
I'll look into flector.
About that dead horse:
I was going to mention that one thing that I found almost non-existant was any study of the frequency of side effects of steroids. All that's out there are simplistic statements that such and such "often" occur or "may" occur or other weasel wording. I was able to find one simple survey of forty UC patients that asked how may had side effects and if they would take it again (and a few other questions). While not a statistically testable survey by any means I think it was still revealing. Of the forty, 37 said they had side effects and one said maybe. Asked if they'd take it again only five said absolutely. Eight said no way, ten said yes but they'd be scared of the side effects, and nineteen said maybe/depends on the situation.
So, out of forty 37 had side effects and only five said they'd definitely take it again. Twenty percent (8) said no way they'd take it again. Combined with the ten that said they'd take it but it would scare them that's basically fifty percent who were traumatized. Not a good bet in my book. Better be something really bad before you submit to put it another way.
Just sayin'.
tntlamb said:
If you are having luck with voltran, you will LOVE Flector
Thanks Laura. Some of that stuff seems eerily familiar......
The definitions BTW would describe what JMW was proposed to be low- medium dose pulse therapy. The incidence of AE (adverse events) was not statistically different than the Placebo groups.
That being said the higher the cumulative dose over time was the determinant. (not to mention dosing schedule and time of dose.)
There are three types taken Prednisolone has a biological half-life lasting several hours, intermediate between those of hydrocortisone (cortisol) and the longer acting glucocorticoids, such as dexamethasone. However as you probably know its plasma bonded so it takes several hours to reach its maximum levels, So you can figure it takes six hours to start to wear off.
here is an interesting read (the Brits are pretty conservative with this stuff: http://www.medicines.org.uk/emc/medicine/13149/SPC
How its used/taken has a huge effect on AE. Like most meds done right the effects are few. The problem is only sick people SHOULD be taking meds. Its pretty hard to seperate AE's from "being sick" A prime example is the whole issue of "insomnia" Inflammation makes people sleepy (really) eliminate some inflammation and they will be less sleepy, take the med in the morning and they should be "normal" by night not only not effected by the predi but having less inflammation as well. They will be less sleepy. So is it insomnia or getting to normal? Same with heart rate. I took massive doses of predi when I was in heart failure in order to get the dang thing beating "harder and faster" Inflammation can make the heart less efficient and increase fatigue. Are the changes an AE or getting back to normal?
I still don't like the drug avoid it like the plague. But personal experience is not always "dependable" Survey is the least dependable method of getting "data"
Thanks for the link, Laura. It was interesting and I hadn't found that one (probably because it isn't medication-specific).
It would have been useful if they had tabulated all the common AEs. What they did tabulate were only the "serious" ones like platelet loss. Some real numbers for all that other stuff would really come in handy in making a truly informed decision. Seems to me that as commonly used as prednisone is somebody would have done a good, statistically valid, survey and published the results. Very curious to me that that hasn't happened (or at least hasn't made it to the internet).
As to insomnia, tnlamb, what is usually reported is far beyond simply not being as sleepy as before medicating. People commonly report being very jacked up (like fifty cups of coffee) and unable to sleep or to only be able to sleep maybe two hours a night; that sort of thing.
Good little conversation here. Ya'll are way more talkative than the other arthritis forum I joined.
Laura E D said:
FWIW I found the EULAR evidence-based and consensus-based recommendations on the management of medium to high-dose glucocorticoid therapy in rheumatic diseases helpful.
Here's a good place to start: http://www.nlm.nih.gov/bsd/pmresources.html and then get a membership to pubmed. http://www.ncbi.nlm.nih.gov/pubmed
Of course its like 50 cups of coffee (or is it the first time they have moved off the couch in 10 years??) I'll say most anything to keep a real conversation going...... Everybody wallows once in a while, but gee it gets old you know???
Hey jwm,
There's a whole lot of science going on here. Not my strong suit. I'll stick to the personal truth side of things! I just did a 20mg tapered course 5 days on four pills, three pills etc. Previously I had been on prednisone for a LONG time because I did badly on MTX, and a bunch of NSAIDs didn't do anything. I've taken Enbrel which was great for a while and just started Humira which is why the recent 20 day prednisone was added to help reduce symptoms as the Humira kicks in.
So, long time use was not so bad and I had none of the typical side effects until about the seventh month when my hair started falling out. No weight gain, no moon face. This short burst was fine while I was in it. I've experienced a rebound on a taper before (I had a similar 20 day course prior to the long term dose) so I know that I need a long slow taper off the last 5mg. But this time I had a REALLY hard time feeling "normal" again. It took two full weeks after the last pill. I think my adrenal function was completely out of whack. I felt constantly too hot and then too cold and have had a touch time really relaxing so I didn't sleep much. I slept on the couch for several nights as I was a fidget machine. All better now.
I love prednisone and I hate prednisone. It really helps me but I reserve it for when I absolutely positively cannot function because I can't stand the taper. I can say that I will take it again, but I will have to be REALLY badly off to do it. These last two weeks I was pretty useless at home and at work.
I can't believe I'm saying this, but I've been on 20mg prednisone for 6 days straight. After life long effects from a year on prednisone at ages 8-9, I've never taken it for more than 2-3 days at a time, and then only once a year or so, such as when travelling. I hate the stuff.
HOWEVER, I'm between meds (waiting on my Stelara prescription to work its way through my insurance), my iritis has come back with a vengeance after 12 years, and I couldn't close my hands...at all. Each time I try and go to 15mg my eyes are inflamed and my hands swell to interesting proportions.
I'm not looking forward to the taper. I'm doing OK so far with less rage / depression / jitters / insomnia / appetite changes than I normally get even with 2 days at 5mg, so my body just seems to be reacting differently (and better) this time.
Better to be pissed off than pissed on......... (or blind in this case) It'll be okay........
Thanks lamb. Trying not to freak.
Sorry to the original poster for a bit of threadjacking.
tntlamb said:
Better to be pissed off than pissed on......... (or blind in this case) It'll be okay........
No problem Marietta. I don't mind sharing my threads. Your report is still helpful to me.
I do hope you'll be better soon and can get on with the taper.
Marietta said:
Thanks lamb. Trying not to freak.
Sorry to the original poster for a bit of threadjacking.
tntlamb said:Better to be pissed off than pissed on......... (or blind in this case) It'll be okay........
p.s. Marietta, just curious what your experience was two days out on your 20mg course. At what point did you start to have side effects and what were they ? Knowing those things would be useful to me. Thanks !