Guest guest Posted June 28, 2007 Report Share Posted June 28, 2007 Well, the doc who ordered the Lumbar MRI and who (as I've learned here) apparently used " osteomyelitis " as a possible diagnosis has not sent me the report. In fact, we are parting ways completely which is probably as well. He was a control man, insensitive and a few others things I'll skip. But, my pulmo DID send me the report!!! Yea! Take that and that,ex pcp! The report just showed facet degeneration on the L5-S1 (if Im remembering it right) and no reason for the radiculopathy even though I sure do hurt!!! The weird part is that 2 years ago I had bulging disks, slight stenosis plus the facet degeneration!!! Do you mean to tell me that the last 2 + years of Advair and weight gain on my chubby little body made my spine BETTER ??? Bizzaro! I'm leaning more now towards what I've seen a couple others post about the pain being more like a nerve inflammation and wonder if that's happening to me? Someone else mentioned having an MRI and coming out normal even though they had a lot of hip pain. Something is going on! I don't think an MRI can show nerve inflammation. I really do feel the pain has gotten worse since on Xolair. I talked to the doctor's assistant (can't see the doc for a few more weeks) and explained that I would like the best of both worlds - freedom from allergies which hopefully someday Xolair will create, and freedom from this exhausting and almost debilitating pain. My legs ache too. The pulmo wants me to see a rheumy and I'm all for it - just caught up in pcp changes and insurance hassles. Also, trouble finding a good rheumy w/my insurance. I also asked the doc if I could be " addicted " to Advair. She said unequivocably NOT. What I really meant was rebound effect but was too fogged in to think of the word. I really wondered if the 4 (?) years on Advair might have leached into my body in general and affected other systems. Before that I was on another inhaled steroid. I'd like to hear more on this. Tomorrow I'm supposed to self inject 375 mgs. again of Xolair. The injections are pretty easy except for bending over to see the lower part of my fat stomach to check for bruises, irritations, or blood vessels before I inject. The last time, when I went up to 375 mgs for the first time, I felt a little weird right afterward but no breathing problems or swelling. I wrote it off to nervousness and being " scrunched " briefly. I think I can tell it's doing something to me but it's so odd I can't quite describe it and it seems to go away fairly quickly. --- In , " tiredofsteroids " <sitesee@...> wrote: > > Anybody on frequent or chronic steroids should have periodic bone > scans to check for osteoporosis. Adah, I think you said you had a > bone scan with a worrisome result. It's important that you have a > follow-up scan after a year to see where you stand. Treatment for > osteoporosis or osteopenia (thinning bones that are not yet > osteoporotic) should include daily 1200-1500 mg calcium with vitamin > D as well as Fosamax or Boniva. The latter meds slow down and can > even reverse bone loss. > > I developed osteoporosis in my 30s after only 3months of 40mg daily > prednisone. It definitely can happen even with just inhaled steroids, > although a lot of docs don't seem to realize that. If you're taking > high-dose inhaled steroids, enough can be absorbed systemically to > cause any or all of the common side effects of prednisone. For > example, for 6 years I was on baseline doses of Advair 500/50 twice > daily plus Flovent 220, 2 puffs twice daily. The amount of > fluticasone (the steroid in both Advair and Flovent) absorbed by the > body (not just the lungs) at that dosing is equivalent to 25 mg > prednisone daily. I'm extremely steroid-sensitive and that was enough > to worsen my osteoporosis, cause a 40-pound weight gain, worsen my > high blood pressure, cause suppression of my adrenal glands and > produce the bruising and susceptibility to skin tears that oral and > IV steroids can produce. In children, inhaled steroids alone can > cause suppression of growth. > > I don't say all this to frighten anyone, since there's no question > that steroids are life-savers for many of us, but it's important to > be aware that even inhaled steroids can cause serious side effects. > A big one that should be checked for because it is treatable is > osteoporosis - please, please get your bone scans! > > Fran > So...bottom line is please get your bone scans! > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 29, 2007 Report Share Posted June 29, 2007 I agree with you that the findings on your previous MRI are unlikely to have disappeared since your weight is now higher. And the spinal stenosis would be expected to be permanent regardless, although if was reported as " slight " , it was probably borderline and simply interpreted differently by the current radiologist as essentially normal. Sometimes two radiologists will read films differently - like much of medicine, it is mostly science and experience but is also partly art, not always black and white. Suggest you check the report to see of the recent films were compared to the previous ones. If it's not noted, it wasn't done (but should have been if they were taken at the same facility). If they were taken at the same facility, you could just go to the radiology desk and tell them that your recent MRI was apparently not compared to the previous one and you would appreciate a rereading of the new one alongside the old one, focusing on the previous findings. If the MRIs were done at different facilities, pick up the films from the first one and take them to the recent one for comparison. If they give you any grief about needing the doc to order the re-reads, then just ask your supportive pulmo to write the order. When you finally get to a rheumatologist, be sure to take both sets of actual MRI films, not just the reports, so the rheumy can see them for her/himself. An MRI may or may not be able to detect inflammation of a smallish nerve but if it doesn't, that doesn't mean the inflammation is not there. There just are limits to how much information MRIs can provide. Also, the technical aspects of the MRI method used to look for info about nerves are different than for seeking info about bones and joints. Your doc can speak with the radiologist if the MRI was adequate to evaluate both bones/joints and nerve tissue. I'm guessing it was, but it may not have been. Also, ifyou haven't been seen by and taken both sets of MRIs to a neurologist, you should do so. Can't remember - have you already seen a neurologist? You could, as you're considering, have nerve pain unrelated to the " hardware " (bones and joints)and have neuro review the films could help sort that all. I'm sure it seems strange for me to suggest taking the MRIs to different specialists in addition to the radiologist but each specialty has its own take on interpreting films. A rheumatologist looks at bones and joints all day every day, seeking often subtle clues relevant to his specialty that might be overlooked by a radiologist who looks at many, many different types of films every day without focusing on just one specialty. Similary for a neurologist. About the " addiction " to Advair, you are right in realizing that you asked the doc a question that was different from what you were really trying to find out Addiction has a very specific biological meaning in medicine (but not so in the general population of folks not in the health field). It applies to the way narcotics and other substances affect the brain at the biochemical and cellular level, and Advair does not fit that definition. The phrases you might use to explain your question include whether reducing steroid dosing while on Xolair could be resulting in pain symptoms that might have developed for whatever reason while you were on steroids but were masked by systemic (whole body) absorption of the steroid in Advair. I've mentioned in the past day or two on this board that inhaled steroids definitely get absorbed by the body outside the lungs and so can produce systemic effects, especially in patients who are especially sensitive to steroids and/or are on high- dose inhaled steroids, and in children in whom growth can be slowed when they're on inhaled steroids alone. Well, I think my brain is on empty for the moment...it's too late and I gotta go to bed! I hope this helps and doesn't read like gobbledy- gook. Don't hesitate to ask me to explain something better if you don't get any of what I've said here. Sweet dreams! Fran > > > > Anybody on frequent or chronic steroids should have periodic bone > > scans to check for osteoporosis. Adah, I think you said you had a > > bone scan with a worrisome result. It's important that you have a > > follow-up scan after a year to see where you stand. Treatment for > > osteoporosis or osteopenia (thinning bones that are not yet > > osteoporotic) should include daily 1200-1500 mg calcium with > vitamin > > D as well as Fosamax or Boniva. The latter meds slow down and can > > even reverse bone loss. > > > > I developed osteoporosis in my 30s after only 3months of 40mg daily > > prednisone. It definitely can happen even with just inhaled > steroids, > > although a lot of docs don't seem to realize that. If you're taking > > high-dose inhaled steroids, enough can be absorbed systemically to > > cause any or all of the common side effects of prednisone. For > > example, for 6 years I was on baseline doses of Advair 500/50 twice > > daily plus Flovent 220, 2 puffs twice daily. The amount of > > fluticasone (the steroid in both Advair and Flovent) absorbed by > the > > body (not just the lungs) at that dosing is equivalent to 25 mg > > prednisone daily. I'm extremely steroid-sensitive and that was > enough > > to worsen my osteoporosis, cause a 40-pound weight gain, worsen my > > high blood pressure, cause suppression of my adrenal glands and > > produce the bruising and susceptibility to skin tears that oral and > > IV steroids can produce. In children, inhaled steroids alone can > > cause suppression of growth. > > > > I don't say all this to frighten anyone, since there's no question > > that steroids are life-savers for many of us, but it's important to > > be aware that even inhaled steroids can cause serious side effects. > > A big one that should be checked for because it is treatable is > > osteoporosis - please, please get your bone scans! > > > > Fran > > So...bottom line is please get your bone scans! > > > Quote Link to comment Share on other sites More sharing options...
Recommended Posts
Join the conversation
You are posting as a guest. If you have an account, sign in now to post with your account.
Note: Your post will require moderator approval before it will be visible.