How to Manage Multiple Sclerosis Relapse: The Use of Solumedrol

Hi Trish,

It's great to see you here.  Like you, steroids affect me for weeks afterwards.  I can count on being out of commission for at least 3 weeks.  They are harsh to the body, but I found that the times I waited for the relapse to fade on its own, my recovery was much slower even after doing the steroids.  If I acted quickly, the relapse resolved more quickly.

Absolutely, it is the patient's choice whether to use Solumedrol or not.  Some doctors prefer to use steroids and some prefer to wait and see.  It was very nice to see it written down that not all relapses require steroids.  I hope that that point spoke clearly in this piece because it is true.

Maybe you could share some of your dietary changes you've made.  I'm sure that folks would benefit from your experience.  Isn't it interesting that NOTHING with MS is one-size-fits-all.

Hi Lisa!  :-)

I have been recommending this book - the MS Recovery Diet, by Ann Sawyer and Julie Bachrach.  Here's a link:  http://www.amazon.com/MS-Recovery-Diet-Ann-Sawyer/dp/158333288X/ref=sr_1_1?ie=UTF8&s=books&qid=1242183120&sr=1-1

That will give one a good overview of the theory behind the diet changes, and some great stories about people who have tried it out.  From there, you can take a look at the MS-Diet.org site, based on the work of Ashton Embry, read Roger MacDougall's booklet http://www.direct-ms.org/rogermcdougall.html and see what makes sense to you.  I resisted it for YEARS!  But I have embraced gluten-free, dairy-free and a few other things and I am doing better than I have in years.   (I also thank Tysabri for half of it.  I've had no lesion progressions since I've been on it.)  The first two months I was not happy, but I did a lot of research and figured out foods that could make it work for me.  

I have written some about it in my blog as well.  http://trrisp.blogspot.com

I wish someone could have handed me the MS Recovery Diet book when I was newly diagnosed 10 years ago.  But it wasn't written until 2007.  I can't recommend giving it a try highly enough.

http://trrishp.blogspot.com

How long do you wait for symptoms to subside. 

Hi Helen,

When my vision is involved, I DO NOT wait!!  If my symptoms are confined to numbness or tingling in a small area and do not spread, I will usually wait at least a week to see what develops.  If the numbness spreads, say from my hand to up my arm, I will call the neurologist.  I've experienced a few relapses affecting this area and know that what follows soon thereafter is weakness and inability to use my hand/arm. 

Usually by the time I've called my MS nurse, she knows that I've given it some time to resolve on its own.  Except for my vision, relapses don't tend to come and go suddenly for me.  They tend to develop slowly.  At a minimum, I give it 72 hours before calling.  But, then again, I can get into my doctor the very next morning when I do call and plan to stay for Solumedrol before I leave.  It is very convenient.

How does solumedrol affect you? especially when it's completed?

Other than what I describe in this post - Solumedrol: It's All the Rage!! - I get very weak, fatigued, and emotional.  I will tend to sleep most of the time for about two weeks after IVSM.  My brain becomes very foggy and my body aches.  It usually takes me several weeks to truly begin to feel "normal" and better.  

Sometimes I will even experience a rebound of increased symptoms (if they had become less during the IV treatments) when I move to oral Dexadron (which is like Prednisone).  But that is temporary and doesn't last long, at least with me. 

Certainly call your doctor in the morning and report your new symptoms.  Only your doctor can help you decide what approach is best for you.  I wish you the best.

How long do you wait for symptoms to subside.

How long do you wait for symptoms to subside?  I had a flare /hospitalization in Mar 09.  They pumped me up with steroids and got me back on my feet (with a walker).  Upon going home I started PT.  Things seemed to be going well until the drugs wore off.  I became so stiff and weak that I asked  for and received more ste roids.  I felt better but knew it was really the drugs.

Since the steroids are completed, not only do I feel bad again, I  have had numb fingertips for the last week.  A couple of days ago I called the dr.  He made a note but did not rx anymore steroids.  I did not want any more.  My fingers are numb.and its affecting my limited ability.   It's been a week and I am scared.  Should I press the doc for something to help? (not steroids)

How long would you wait for feeling to return to your fingertips?  I just afraid that waiting might make this permanent

Helen,

It's different after you've already received the steroids.  They do not automatically fix everything and they do not change the course of the disease.  They just help to stop the inflammation and speed up the resolution of an exacerbation.

However, it may take days/weeks/months for those symptoms to resolve after a major flare.  Sometimes the symptoms do not resolve, but might become a bit more mild.  I have residual symptoms from every single major exacerbation I've ever experienced.

Be patient and give your body time to try to heal.  Follow the advice of your physical therapist.  A good PT is quite valuable in helping you to recover from a relapse.  At this point, listen to your body and try to be easy on yourself.  How is the PT going?  Is your strength and ability to walk improving?

My PT was interrupted due to insurance issues.  Will resume next week.  It was going OK; focused mainly on balance and walking.  When I go again I'll tellher about the fingers. I gonna to call the doc tomorrow to hear his opinion.  In the meantime I will continue exercising in the pool

thanx for your kind words.  I kinda scared right now  praying for a good outcome

I think the worst thing about waiting out the episode - whether doing steroids or not - is that feeling that you don't know if your current symptoms will ever go away.  I remembering wondering if being numb from my shoulders to my knees was going to be my permanent situation.  (I did take advantage of it and got a tattoo.  Still hurt like all get out).  it did eventually pass, which is the beauty, if you will, of RRMS.  I know that for some people, we do end up with permanent 'symptoms'.  It's hard not knowing which way it will go.  

Kelley,

I've been wondering how you are doing.  It's been a little while since I've seen you on the blogs.  Did your check up go smoothly?  Any changes in MS activity?  Inquiring minds want to know.  ;)

Lisa

Fatigue can be caused by so many things...but your Dr.s response surprises me. Best regards,

Pam, I'm so glad that your questions were answered.  That is what I hope to provide - the answers to unasked questions. 

So your neurologist did suggest the Solumedrol infusions but you went with the taper only instead.  OKay. If you still do not see any improvements in a little while longer, you might reconsider the IV.  It's a pain in the butt, but necessary at times.