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Thread: Medrol Pack - How long until it works if your pain is inflammatory

  1. #11
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    JanW, so glad you are feeling better. Keep us updated. Janw my sister took the highest dose of methotrexate 25 mg and then now she is on 18 mg of methotrexate. When she was taking 25 mg of Methotrexate it caused her more nausea. She is doing great on the 18 mg.

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    Quote Originally Posted by JanW View Post
    Well, I hope I'm just putting the wegs dog to sleep rather than having it wake back up on me! Already my ankle feels better though, so I'm thinking we have an answer. His solution if it is inflammatory is to move my mtx up to 20 mg, which is still in the standard dose range, according to the mayo rheumy that spoke at the conference.
    LOL-- I'm starting to think like a Wegs doc. I can hear the entire Chiropractic profession groaning in the background...

    I was thinking that's what they'd do--bump up the mtx a bit. It doesn't necessarily mean the Wegs is building, it might just mean that your current dose is subtherapeutic.

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    Quote Originally Posted by jola57 View Post
    JanW I will be monitoring how you are getting along with the recovery because my ankle has been in constant pain since the dropped foot almost 2 years ago. I had it xrayed and it showed up normal. I was on 60 pred and cytox and now I'm on 4mg pred and 10mg mtx. There was no significant change in pain between the two meds. I have finaly been so fed up with my docs not doing anything about it that tomorrow I am going to my family doc and request a visit with a podiatrist. I agree with you Sangye, docs realy pay no attention to this problem. I seem to be doing great in my blood work just my anca is high and it is only that one left ankle that is giving me greef. It is because of it that I use a cane in long walks. It swells up sometimes and is so puffed up that it looks like a scotch haggis in a sandal. When I sit or lie down it hurts even more before slowly relaxing. Simetimes it takes an hour before the pain is managable enough for me to go to sleep. Please keep me posted on how you are doing. Was your original xray ok or did you have to have CT and MRI before it showed the bone edema?
    Jolanta, can you see a chiropractor? I'm not sure a podiatrist is going to be much help. An MRI would be a good idea at this point, just to rule out some other issues. My ankles do the exact same thing. I've only been able to wear the same pair of sneakers for the past 2 years because of it.

    BTW, bone edema is a non-specific sign that usually just indicates developing osteoarthritis.

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    My original xray was just fine. The MRI and CT both indicated areas of bone edema. The ankle got progressively better with PT, but certainly hasn't completely healed, and it is, as you know very frustrating. Thank goodness I have no pain at rest, only with movement. Before PT I would also have pain with weightbearing, but that's all gone now. It's continuing to improve with pred, so obviously it's at least somewhat inflammatory.

    My podiatrist had no problem ordering a MRI, and later, a CT, because there was no improvement after he casted it for five weeks to rest it. I agree with Sangye that there's little that a podiatrist can be of much help -- he can send you for imaging, or prescribe PT, but there's probably little that he can do to improve the actual pain.

    Did WG cause the dropped foot?

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    Well, the medrol pack is working gang! Not even quite two days dose and my range of motion has improved dramatically. Things that would have had me wincing/screaming in pain (frex stepping on a very uneven surface) now ar dully painful but completely tolerable. So I think we know what I need to do. Hopefully an increase in mtx will have the same effect.

    Of course, the downside of the pred is that while I love the way it makes hurty things stop hurting, I hate the anxiety that comes along with it. I've already spent 10 minutes in the mirror looking at my nose, convinced that the bridge is collapsing down in front of my eyes (normally I only spend a few minutes looking at my nose per week -- it's not like you make a saddle nose any better by looking at it). I'm obsessing about my daughter's tooth extraction tomorrow (it just didn't fall out and duh, she's had this done before and it didn't even hurt) and my son's red eyes (that I'm taking him to the doctor for on Friday, and is not painful, pus-y or anything -- and yes, did I mention he's in the pool everyday and has allergies? I am convinced he is losing his sight and will have to have surgery and be unable to go to sleepaway camp on Saturday). Ah, pred.

    At least I knew what to expect. To paraphrase Rick James on Chappelle Show: "Pred...it's a powerful drug!"

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    That's interesting what you said, Sangye. I've been wondering if the dose was subtherapeutic (although my numbers went down dramatically), or that this inflammation was subacute and yet because of where it was located, extremely painful. I'm not sure if the distinction makes any difference. Is it important to treat subacute inflammation? Theoretically you could have it all the time, and without pain, and never know it.

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    The entire time I was on a subtherapeutic dose of Cellcept my inflammatory markers were in normal range. I had terrible joint pain despite my lovely blood work!

    Yes, it is very important to treat subclinical inflammation. Painless inflammation is at the root of many of the most deadly conditions and diseases. Heart disease is a good example. By the time the inflammatory markers increase, the heart disease is already quite established.

    I'm glad you're feeling better (minus the hideous pred side effects) and will now know exactly how to deal with it.

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    I'm on medrol. When I was diagnosed my pain was gone after a few days on it. (3-4 days)

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    JanW, that is good news. You will be straightened out in no time.

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