Need advise after crazy Dr.s Appointment

[maria garcia]

Ok so we go to my daughters Pediatrician bcse of the coughing. I explained what she was taking 10mg of prednisone and the MTX . Dr. wants her to take 40 milligrams of Prednisone for 5days and antibiotic. I don't know if this is a good idea from 10 to 40 then back to 10 in five days. Please advise If she should do that. I called her rheumy and he thinks its fine. Next week is her eye Dr's app. and I don't want this dosage to mask whats happening.
Here comes the crazy Drs. Part!!
Pedi. told me she should stop the MTX and take anti-inflammatory supplements like garlic etc. She kept insisting that MTX was so bad for the liver etc. She has always been conservative but this was crazy!!!! I didn't want to argue with her because my daughter was there and I didn't want to get into how people in the past would (the d word) without meds for remision. This is the same doctor that wants Christina to take the 40 mgs of pred. that why im not trusting her judgement right now.

[Dryhill]

I am no expert but it has taken quite some time for me to go from 40mg down to 10mg of Pred and I understood that such a drastic reduction was harmful. However your daughter would only be on the higher dosage for a few days, so it might be ok to drop straight back down to 10mg. Personally I would seek another opinion, probably from my local pharmacist.

[Chris G]

I assumed the pediatrician told u to taper it from 40 ie...40...30...20...10. This is fine if she's not at 40 for more than a few days

[maria garcia]

I assumed the pediatrician told u to taper it from 40 ie...40...30...20...10. This is fine if she's not at 40 for more than a few days

Chris no she didn't she send us 40 for four days straight. I don't want to do it my husband does. My husband feels that after the cold she needs a push. This is so confusing. I will take her to the ENT. on Jan. I feel the cough is due to more than a cold and more like inflamation. she was doing so well only coughed a few times a day now its non stop. I think your dosage is more realistic.

[Al]

It is a horrible situation to be in Maria, when you have to decide which doctor's prescriptions to take. You must get them to agree, or decide which doctor you consider the main one.

I am not your doctor, but I can say this: Methotrexate is harder on the liver than no medicine at all, but active WG is very hard on the whole body. Taming down inflammation and keeping it from returning are immensely important. I personally think that the prenisone experiment is a good idea. If the cough is eased, then you know that the WG is involved. (It might be, even if the cough doesn't go away, of course, but you will have made a step.) Anyone taking MTX should have a liver panel periodically.

But the first thing is to resolve the doctor issue!

Al

[chrisTIn@]

Personally I would seek another opinion, probably from my local pharmacist.

This is probably a good idea, Maria Garcia!
Sometimes, when you talk to different doctors, it all gets so complicated.
A pharmacist can put all the information about medication together and can give you good advice at times. At least. MY pharmacist did...

[maria garcia]

I only got 40 mgs for 5 days. She has an opthamologist appt. next week and then rheumy the following week. I am going to wait until then and leave her on the same dosage so they can see her eyes with the current dosage. Im sure the cough is from inflammation and just got worse with the cold. Im going to the ENT on Jan. to see if the inflammation is on her trachea. Im really hoping they up her meds. but I will wait.

[onatreetop]

I have had up to 125mgs right before surgery then back to the normal dose the next day. When it comes to lungs though the mgs stayed high longer then tapered. Sometimes the z pack which was used with the normal doses. The docs are all different.

[vdub]

The increased pred for only 5 days isn't a big deal. The reason you sometimes have to taper off pred is because your adrenal glands react to the pred by thinking your body has all the cortisol it needs and therefor the adrenals tend to slow down the production of cortisol. The taper, then, is to give your adrenals time to wake-up and start producing cortisol. I'm not a doctor, but 5 days shouldn't be anything to be concerned about.

Garlic to replace the mtx? I would seriously seek another opinion if not another doctor altogeather.... Just my humble opinion....

[jola57]

The higher pred for a few days is not a big deal. Yes, mtx is hard on the liver, but I am sure your doc is taking frequent blood test to monitor the levels. As to stopping it, I suppose for a few days it will not matter but I do hope your daughter will be put back on it in a few days. Mtx suppresses the immune system and I suppose the doc wants to give your daughter a fighting chance to do battle with the lung cough with antibiotics. I would go with the doc's suggestion, after all if you notice anything bad you can start back on mtx. Really, lowering the pred from 40 down to 10 after a few days is not going to be bad. Just go in 10 mg per day.

[Al]

Maria, garlic and other anti-inflammatory foods are not--repeat not--alternatives for methotrexate or other WG drugs. There may be health benefits from using them, and they may be desirable for culinary purposes (I can't imagine a stew without garlic, for instance), but please do not think they can make the inflammation of disease go away.

Al

[maria garcia]

Maria, garlic and other anti-inflammatory foods are not--repeat not--alternatives for methotrexate or other WG drugs. There may be health benefits from using them, and they may be desirable for culinary purposes (I can't imagine a stew without garlic, for instance), but please do not think they can make the inflammation of disease go away.

Al


Al don't worry I know better. I was just disappointed on how little her pediatrician knows. I thought she was crazy in suggesting to stop. Christina we keep taking her MTX.

[Al]

Al don't worry I know better. I was just disappointed on how little her pediatrician knows. I thought she was crazy in suggesting to stop. Christina we keep taking her MTX.

I know you know better, Maria! It does show, however, that not every doctor is that smart about this disease!

Al

[annekat]

I know you know better, Maria! It does show, however, that not every doctor is that smart about this disease!

Al At least my PA knows that she doesn't know enough about this disease to treat it or tell me how to manage it. This is a disease where doctors and other health care professionals should just keep their mouths shut unless they have done their research and have some actual knowledge! Not to mention members of the general public who say things like "prednisone is bad for you, isn't there something else they could give you?"

[maria garcia]

I know you know better, Maria! It does show, however, that not every doctor is that smart about this disease!

Al

I know look at what the Pedetrician said. Obviously she has no idea how serious this illness can be. I have learned alot from you. Thanks.

[Rini]

OI don't know if this is a good idea from 10 to 40 then back to 10 in five days.
WOW! not all at once! i was a puddle on the floor when they tried to do from 60 to 40 over night and did not get through the day w/ out changing it up myself and taking a good 10...please please do not drop so fast, I was on to many narcotics in the hospital to explain well how they did a big drop but there was lots of check ups. I did up my dosage for a cough in the begging of all this...with 3 people in my house on Pred can say how much you can go down in a short time is different for people but should b done by @least only 10 a day....i am not a doctor & do not know all about your daughter so please confirm with more people

[NicShaf]

Maria,
if it were me, I would go to my Rheumy and get a new Pediatrician. I wouldn't let a regular doctor try and treat my Wegs. My PCP always refers me to my specialists, she will note my symptoms and order tests, but she lets my Rheumy and Pulmonary review them.
To suggest that anti-inflammatory foods would replace MTX is CRAZY! Even though you know better, this is a red flag that the Pediatrician would even suggest it as treatment. Did the Pediatrician say what made them think it was harming Christina's liver? I am not on MTX, and I chose Imuran instead, so I'm not entirely certain of the side effects, but I thought elevated liver tests were part of the medication? How elevated were they?
If she's having symptoms of Wegs, it seems appropriate to raise her Pred a little, I'm not experienced enough to know if 10mg to 40mg is too much or not. I started having some symptoms a couple weeks ago, and my Rheumy bumped me from 3mg to 5mg?

[pberggren1]

A fast increase like 10 to 40 is nothing to worry about. If you are on 40 for only a few days then u can drop quickly again back to 10. I have done this many times over the years due to infections and such.

[Sangye]

My two cents: I think the pediatrician is uninformed about both holistic and medical treatments. Probably not a good doctor to have on your daughter's team.

The combo of high dose pred and antibiotics is odd. If she feels better on it you won't know if it's infection or Wegs. I am not a proponent of doing high dose pred even for short bursts unless absolutely necessary, especially on a young person. The effects of doing that numerous times are serious. With a Weggie, you have to be very conservative with treatments like that.

[Kami]

I would not replace mtx with garlic, or anything else like that, I think that is crazy! I have seen a liver specialist because my tests were a little off (AST and ALT) and my Rhuemy referred me and the specialist said that being on the mtx for one year at 15 to 20 mg a week would not damage your liver. Damage occurs when you have been on it for much longer he said. Make sure your rheumy is monitoring your daughters liver and lungs while on mtx and you should be fine. (It also causes damage to your lungs) Your pediatrician maybe over reacting. I would not and do not let my regular doctor determine my medications, only my Rhuemy and who he decides to consult with. Good luck Maria!