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Thread: Prednisone

  1. #1
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    Default Prednisone

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    Saw a sports doc today for low back disc injury/pain/irritation. He wants to put me on a 11-day Predisone taper. He said it should significantly reduce inflammation near the nerve root. I believe you are very critical of the use of Predisone. Can you or Sully provide some feedback on this use of it and what about the drug I should be aware of?

  2. #2
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    For some reason I do not understand, lots of doctors do not hesitate a microsecond to prescribe a catabolic steroid for orthopedic inflammation -- or even, around here, a snotty nose -- when they would die and go to Hell before prescribing an anabolic steroid for an indicated situation. Maybe it's the legal status shit. I don't take prednisone unless my brain is swelling dangerously, because it has systemic effects I don't like. But I'll defer to Sully, if he has time to post.

  3. #3
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    I had a very bad experience with prednisone last summer. After suddenly losing the hearing in my right ear I was given a tapered prednisone prescription "to cut down on the inflammation". As far as I can tell all it did was cut my appetite to the point where I had to force myself to eat anything and make me feel like hell. I've heard
    other people tell me that they can't take it because it makes them so jittery that they can't sleep.

    When I finally found an ear Dr. that was interested in something besides snotty noses and sore throats I had a whole battery of tests done including a cat-scan, mri, liver function etc and wouldn't you know it, some of my liver function was elevated. I told my dr. that the previous dr. had give me a prescription for prednisone and that I had
    finished taking it a day of the test. His response was, "we'll check it in a week. It will probably be fine then." It was.

    Based on my experiences I'd avoid prednisone if possible and be skeptical of the advice given by the dr. that prescribed it.

  4. #4
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    Quote Originally Posted by Mark Rippetoe View Post
    For some reason I do not understand, lots of doctors do not hesitate a microsecond to prescribe a catabolic steroid for orthopedic inflammation -- or even, around here, a snotty nose -- when they would die and go to Hell before prescribing an anabolic steroid for an indicated situation. Maybe it's the legal status shit. I don't take prednisone unless my brain is swelling dangerously, because it has systemic effects I don't like. But I'll defer to Sully, if he has time to post.
    That's interesting. What is your opinion on prednisone in case of Bell's Palsy?

  5. #5
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    Prednisone often gives people insatiable appetites. Not that your body does anything useful with the excess calories while on a lot of prednisone, but loss of appetite would be a very atypical side effect.

    Anyway, I think MDs have plenty of respect for the toxicity of corticosteroids, which are pretty safe for brief courses but awful for long term use. I can't comment on the ortho uses of it -- as with any drug, expectation of benefit has to be part of the decision. For asthma, for pneumococcal meningitis, for transplant rejection, etc the benefits are huge and we will accept the toxicity risk. For vertebral disc disease? I'd rather get an injection than take systemic steroids. But I'd take either over surgery.

  6. #6
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    I was given a course of prednisone for a severe case of poison ivy. I'd never been susceptible so I didn't think anything of weed-whacking some underbrush shirtless. I also didn't think anything of being covered from head to waist in mulched green plant pulp, so I didn't rush to wash off. A lot of people become gradually sensitized to urushiol, the chemical in the poison ivy/oak/sumac family that causes a reaction. I got sensitized all at once, a couple of weeks before vacation. Needless to say, I couldn't tough it out, and it took over a month for the rash to subside, even with prednisone.

    I don't know what other people experience, but I had a nagging case of stomach upset the whole time I was on it. It wrecked my stomach and made eating miserable. It also made me jumpy and just plain uncomfortable. I would take it again if I got another case that bad, but I'll be damned if I take it for anything that an NSAID will control.

  7. #7
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    Quote Originally Posted by TalEphrat View Post
    That's interesting. What is your opinion on prednisone in case of Bell's Palsy?
    How am I entitled to an opinion about this?

  8. #8
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    I did an 11 day prednisone taper after I ruptured a disc in my lower back. A max strength combination of Advil and Tylenol was working about as well as an M&M and Skittles combination. Prednisone worked wonders for the back pain.

    OTOH, I spent two weeks feeling like an over-caffeinated ADHD chipmunk on speed.

    It was later pointed out to me there's a book with the title "Coping With Prednisone: It May Work Miracles, But How do you Handle the Side Effects?", which is pretty much my experience with it in a nutshell.

    Shayne

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    Quote Originally Posted by Mark Rippetoe View Post
    How am I entitled to an opinion about this?
    While we are on the subject, a patient of mine was diagnosed with Amyotrophic Lateral Sclerosis, and I wanted to know your thoughts on.......Aw fuck, I can't even finish this.

  10. #10
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    Quote Originally Posted by TalEphrat View Post
    That's interesting. What is your opinion on prednisone in case of Bell's Palsy?
    We were taught that prednisone and acyclovir were fairly standard for BP if treated within 3 days of onset. Dr. Sullivan would probably have some insight on its usefulness.

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