Guest guest Posted December 15, 2002 Report Share Posted December 15, 2002 Hi, Elaine: I have a question regarding " hot " stage of TED. In your book you say it " ...characteristically worsens over an initial period of three to six months, followed by a lengthy plateau that may last several years. " Does this mean that it won't get any worse than they are after 6 months and then possibly stay the same for several years? Also, by taking steroids when the eye problems first begin, such as double vision looking upwards and sore eyes, can proptosis be prevented by toning down scarring or are the steroids only reserved for moderately bad cases? Thank you for all your help over the past few months. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 15, 2002 Report Share Posted December 15, 2002 Hi , Yes, typically the hot phase lasts for 3-6 months although it can last longer. This is followed by a plateau phase in which the symptoms won't worsen although fibrosis or scar tissue can form. In many cases, symptoms resolve during the plateau phase, and during the plateau phase treatment aimed at the immune system, like steroids or orbital radiotherapy, is not effective. Because studies show that the outcome is often the same whether treatment is used during the active phase or not (and the available treatments have side effects) treatment is usually withheld unless their are vision threatening complications or the active phase is particularly progressive. Treatment used during the active phase addresses the immune system so it can reduce inflammation and proptosis. The dilemma though is that the effects of prednisone subside and symptoms return in full force when the drug is withdrawn. And only about 2/3 of patients respond to treatment. Inflammation can also be inhibited by stress reduction, avoiding sugar, saturated fats and iodine and by adding antioxidant vitamins. Many patients avoid water, thinking this will reduce symptoms, but this only makes symptoms worse. The edema is often worsened when dehydration sets in. Take care, Elaine Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 15, 2002 Report Share Posted December 15, 2002 Hi , Yes, typically the hot phase lasts for 3-6 months although it can last longer. This is followed by a plateau phase in which the symptoms won't worsen although fibrosis or scar tissue can form. In many cases, symptoms resolve during the plateau phase, and during the plateau phase treatment aimed at the immune system, like steroids or orbital radiotherapy, is not effective. Because studies show that the outcome is often the same whether treatment is used during the active phase or not (and the available treatments have side effects) treatment is usually withheld unless their are vision threatening complications or the active phase is particularly progressive. Treatment used during the active phase addresses the immune system so it can reduce inflammation and proptosis. The dilemma though is that the effects of prednisone subside and symptoms return in full force when the drug is withdrawn. And only about 2/3 of patients respond to treatment. Inflammation can also be inhibited by stress reduction, avoiding sugar, saturated fats and iodine and by adding antioxidant vitamins. Many patients avoid water, thinking this will reduce symptoms, but this only makes symptoms worse. The edema is often worsened when dehydration sets in. Take care, Elaine Quote Link to comment Share on other sites More sharing options...
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