[Fwd: Eye Exam]

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--- [ ] Eye Exam

Date: Wed, 18 Aug 1999 19:47:26 -1000

From: Georgina <gmckin@...>

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Hi Everyone,

Today Josh had his 6 month check up with the eye doctor. Good news and

bad. Well, not so bad. He's been taking the Plaquinel/hydroxychloroquine

(in conjunction with the MTX) for the past 3 years. Every year he gets

the peripheral vision test and every 6 months the regular eye exam, the

dilation and the color test. It's extremely rare to get the retinal

damage that can sometimes result from Plaquinel use and even if you do,

if it's caught in time and you discontinue the drug, it's usually

reversible. So far, everything looks good in this regard. But..... My

son has been taking Prednisone daily for over 4 years. Due to the

steroids he had some slight, beginning cataracts that were first noted

two years ago. They were minimal, caused no effect on his vision. Well,

today the doctor said that there has been some degree of worsening. Not

too bad but noticeable. It's something we should be concerned about but

we don't have to take any action yet. He's familiar with Josh's medical

history and knows that he wouldn't be on steroids if he didn't need to

be. Decreasing the amount of prednisone to a safer daily dose has always

been one of our priorities. Josh's still's is severe and very reactive

and we haven't been too successful yet, in doing that. Lowest dose ever

was 9mgs but then he had a major flare and had to get boosted up pretty

quickly. One of these days his body will be more cooperative. For now,

this is just another warning and a reminder for us. For everybody

needing long-term, high dose steroids on a daily basis.

Josh is 10 now. We don't know how long more he'll be needing steroids.

According to the eye doctor, the lower the dose, the slower the

progression of cataracts. They're not reversible but they are treatable.

He says cataract surgery is very easy and usually has very good results.

He says it's very likely that Josh will need the surgery in the future

.... unless he's able to taper the dose or discontinue the steroids very

soon. He says at this rate, probably by the time he's 16 or 17 years

old. He was very matter of fact about it. Said it was important for me

and Josh to understand the issues. Best to be prepared, just in case, so

it wouldn't come as a surprise. So, that's the latest news. Tomorrow,

Josh gets his first injection of methotrexate. Maybe this will be the

boost he's needed to be able to taper down? I sure hope so. MTX has

helped so many people wean off steroids. Didn't work for Josh in this

regard, orally, but maybe this will do the trick. After we give this a

try, I guess the next step is to more seriously consider Enbrel.

Guess that's all the news for now. 'cept that Josh is feeling a little

nervous about his shot tomorrow

so if you can, send some positive mental energies :-) Thanks!

Much Aloha,

Georgina