Guest guest Posted May 30, 2004 Report Share Posted May 30, 2004 Hi Alia, had a VERY resistant lft ankle even after 25mg MTX,200mg Plaquenil,900mg Ibuuprofin and yearafter months of steroid use. About drainage and steroid injection in the joint,here is my experiance. We went to the ER also,because all the equipment is there,incase something happens. A IV line was inserted in s hand but no IV bag,just a way to get to the vein.A lengthy consult with the anasthesiologist(sp).Monitors on his chest and the oxygen thingy on his finger.They had videos and mini bubbles and he was so comfortable and happy and not worried at all. They did inject several drugs in his IV for concious sedation.Some to sedate,some for side effects and some for memory loss.IT took less then 5 minuites for the ortho to do his thing.Less then 30 minuites later he was fully concious and had no idea what had been done.He kept asking about the 4 big scabs on his ankle.He felt like a million bucks. The biggest con being is the child feels great and has no pain and does not understand why they can't bareweight on the joint for atleast 48 hours(can take 2 weeks).The second time around a month later was put in a hard cast for 2 weeks and weaned from an orthopedic boot for another 4 weeks. By biggest question would be what type of steroid,Aristopan is the BEST,but a HUGE shortage for about 2-2.5 yrs.I would recomend a brace for atleat 2 weeks to resist movement of the knees,if not a cast first,then a brace.The longer you keep the knee from moving the better.Weight isn't the problem, got to participate in gym class with his cast,walking shoe and then the boot.Motion is the biggie. s ankle was turned completely inward the secong time.The injection kept us from having to go to 30mg pred for such a long time.We got to reduce quickly,and for the first time he made it to 4 mg with no trouble. It could realy help Caroline with pain relief and less oral steroids which have a body wide effect.It can also help pull her through the time it takes for the MTX to kick in.When was finaly at his max dose of 25 mg it took 6 weeks to watch dramatic swelling reduction go down in a matter of days. It is a difficult decision to make but my best advice ,due to age is atleast some sort of casting or brasing for atleast 2 weeks. One more thing,many 2 yr olds take their MTX as an injection,no fun but there is Emla and it could keep Caroline from experiancing severe Gastritis like .Less then 2 weeks from the switch from Zantac to Prevacid and all tummy aches are gone.He spent more then 3 months on Zantac due to 3 weeks on MYX pills. Make some calls and think about about it.Just don't let them do Verced alone. got that before his tonsilectimy and was one happy camper as he was wealed off to the or to get his real IV. Love and Hugs Becki and 5 systemic JRA Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 31, 2004 Report Share Posted May 31, 2004 Wow Becki. Thanks for all the advice . You gave me lots to consider. Dr. Akin would be using Artiospan if she does the injection. I have heard so many good things about that so that gives me confidence. Our rheumy didn't push the injectable. She was willing to try to oral and see if it works although she doesn't have much confidence that it will. We are trying it. I just gave her 20mg orally about 1/2 hour ago and see seems ok. We'll see how the rest of the day goes. We already have her on Zantac so I am not sure if that will mask any additional side effects the increased MTX will have. Our rheumy told us EMLA cream in no longer available, but I spoke with the pharmacist yesterday and she confirmed that it is available again. I think if Dr. Akin will write a precription for the cream then we would consider the injectable. If not, I don't think we could do it ! Thanks again Becki! Alia and Caroline, age 2, poly and uveitis > Hi Alia, > had a VERY resistant lft ankle even after 25mg MTX,200mg > Plaquenil,900mg Ibuuprofin and yearafter months of steroid use. > About drainage and steroid injection in the joint,here is my experiance. > We went to the ER also,because all the equipment is there,incase something > happens. > A IV line was inserted in s hand but no IV bag,just a way to get to the > vein.A lengthy consult with the anasthesiologist(sp).Monitors on his chest and > the oxygen thingy on his finger.They had videos and mini bubbles and he was > so comfortable and happy and not worried at all. > They did inject several drugs in his IV for concious sedation.Some to > sedate,some for side effects and some for memory loss.IT took less then 5 minuites > for the ortho to do his thing.Less then 30 minuites later he was fully concious > and had no idea what had been done.He kept asking about the 4 big scabs on his > ankle.He felt like a million bucks. > The biggest con being is the child feels great and has no pain and does not > understand why they can't bareweight on the joint for atleast 48 hours(can take > 2 weeks).The second time around a month later was put in a hard cast > for 2 weeks and weaned from an orthopedic boot for another 4 weeks. > By biggest question would be what type of steroid,Aristopan is the BEST,but a > HUGE shortage for about 2-2.5 yrs.I would recomend a brace for atleat 2 weeks > to resist movement of the knees,if not a cast first,then a brace.The longer > you keep the knee from moving the better.Weight isn't the problem, got to > participate in gym class with his cast,walking shoe and then the boot.Motion > is the biggie. > s ankle was turned completely inward the secong time.The injection kept > us from having to go to 30mg pred for such a long time.We got to reduce > quickly,and for the first time he made it to 4 mg with no trouble. > It could realy help Caroline with pain relief and less oral steroids which > have a body wide effect.It can also help pull her through the time it takes for > the MTX to kick in.When was finaly at his max dose of 25 mg it took 6 > weeks to watch dramatic swelling reduction go down in a matter of days. > It is a difficult decision to make but my best advice ,due to age is atleast > some sort of casting or brasing for atleast 2 weeks. > One more thing,many 2 yr olds take their MTX as an injection,no fun but there > is Emla and it could keep Caroline from experiancing severe Gastritis like > .Less then 2 weeks from the switch from Zantac to Prevacid and all tummy > aches are gone.He spent more then 3 months on Zantac due to 3 weeks on MYX pills. > Make some calls and think about about it.Just don't let them do Verced > alone. got that before his tonsilectimy and was one happy camper as he was > wealed off to the or to get his real IV. > Love and Hugs > Becki and 5 systemic JRA > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 31, 2004 Report Share Posted May 31, 2004 Has anyone had wrists injected? n's wrists are becoming troublesome. (n,15, systemic) Alia,joint injection Hi Alia, had a VERY resistant lft ankle even after 25mg MTX,200mg Plaquenil,900mg Ibuuprofin and yearafter months of steroid use. About drainage and steroid injection in the joint,here is my experiance. We went to the ER also,because all the equipment is there,incase something happens. A IV line was inserted in s hand but no IV bag,just a way to get to the vein.A lengthy consult with the anasthesiologist(sp).Monitors on his chest and the oxygen thingy on his finger.They had videos and mini bubbles and he was so comfortable and happy and not worried at all. They did inject several drugs in his IV for concious sedation.Some to sedate,some for side effects and some for memory loss.IT took less then 5 minuites for the ortho to do his thing.Less then 30 minuites later he was fully concious and had no idea what had been done.He kept asking about the 4 big scabs on his ankle.He felt like a million bucks. The biggest con being is the child feels great and has no pain and does not understand why they can't bareweight on the joint for atleast 48 hours(can take 2 weeks).The second time around a month later was put in a hard cast for 2 weeks and weaned from an orthopedic boot for another 4 weeks. By biggest question would be what type of steroid,Aristopan is the BEST,but a HUGE shortage for about 2-2.5 yrs.I would recomend a brace for atleat 2 weeks to resist movement of the knees,if not a cast first,then a brace.The longer you keep the knee from moving the better.Weight isn't the problem, got to participate in gym class with his cast,walking shoe and then the boot.Motion is the biggie. s ankle was turned completely inward the secong time.The injection kept us from having to go to 30mg pred for such a long time.We got to reduce quickly,and for the first time he made it to 4 mg with no trouble. It could realy help Caroline with pain relief and less oral steroids which have a body wide effect.It can also help pull her through the time it takes for the MTX to kick in.When was finaly at his max dose of 25 mg it took 6 weeks to watch dramatic swelling reduction go down in a matter of days. It is a difficult decision to make but my best advice ,due to age is atleast some sort of casting or brasing for atleast 2 weeks. One more thing,many 2 yr olds take their MTX as an injection,no fun but there is Emla and it could keep Caroline from experiancing severe Gastritis like .Less then 2 weeks from the switch from Zantac to Prevacid and all tummy aches are gone.He spent more then 3 months on Zantac due to 3 weeks on MYX pills. Make some calls and think about about it.Just don't let them do Verced alone. got that before his tonsilectimy and was one happy camper as he was wealed off to the or to get his real IV. Love and Hugs Becki and 5 systemic JRA Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 31, 2004 Report Share Posted May 31, 2004 , I have had my left wrist injected with cortisone multiple times. It is not a major undertaking (as long as you aren't afraid of needles) and requires nothing more than a little local anesthetic. It is best to keep the wrist splinted for a day or two after injection. It will feel like there is pressure in the joint when it is being injected, and it may ache a bit strangely the next day, but after that the results are great. My injections have lasted up to a year, but as little as a few months, so it probably depends on a number of factors, including use of the wrist and the level of arthritis activity. I definitely recommend injection for troublesome wrists, because it results in greater usage of the hands and therefore more independence and general well-being. Hope this helps! Elisheva > Has anyone had wrists injected? n's wrists are becoming troublesome. (n,15, systemic) Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 31, 2004 Report Share Posted May 31, 2004 Elishiva, Thank you so much for the info. This list is great. I have been on it for nearly five years now. I read all of the posts, but don' t chime in too often. n took a down turn in January and had to go on prednisone. Her abdomen and chest hurt her pretty bad. She is now down to 2mg and I am trying to get her off by the end of June. Her wrists have been troublesome though. The school year has flown by. She finished her first year of high school. She went out for track in March and the school was great with working with her. She couldn't run, but she would walk the treadmill or work out with weights. All n did was high jump, and she ended up number one on varsity. She took first at six meets, and third at the other three. She went to districts and came a fraction away from making it to state. Only the top two go on to state meets, and she took third and jumped a personal best. We are really proud of her . She wants to do more events next year, but I tell her let's wait and see how her arthritis is. Anyway, that is the quick update on n. (n,15,systemic) Re: Alia,joint injection , I have had my left wrist injected with cortisone multiple times. It is not a major undertaking (as long as you aren't afraid of needles) and requires nothing more than a little local anesthetic. It is best to keep the wrist splinted for a day or two after injection. It will feel like there is pressure in the joint when it is being injected, and it may ache a bit strangely the next day, but after that the results are great. My injections have lasted up to a year, but as little as a few months, so it probably depends on a number of factors, including use of the wrist and the level of arthritis activity. I definitely recommend injection for troublesome wrists, because it results in greater usage of the hands and therefore more independence and general well-being. Hope this helps! Elisheva > Has anyone had wrists injected? n's wrists are becoming troublesome. (n,15, systemic) Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 31, 2004 Report Share Posted May 31, 2004 Alia, was using Emla when it went off the market because it didn't come in a child proof container.Sooo stupid,some kid must have ate some.It came back on the market a few months ago but if you have any trouble and/or your generic copay is cheaper we get a tube of 2.5%prilocaine/2.5%lidocaine made by some company called Fougera.It's a yellow and whilte box and works just the same because it is the same.You can also get a liscenced pharmacy in compounding to make it for you. I hope Caroline responds to the 20 mg MTX,it could take a few weeks but hang in there.She is so young and so beautiful it just breaks my heart. Lots of prayers and love Becki and 5systemic Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 1, 2004 Report Share Posted June 1, 2004 Alia, I hope you feel comfortable with whatever decision you've made about the joint injection. About the EMLA cream, the last time I asked for a new prescrip for it, I actually got " lidocaine 2.5% and prilocaine 2.5% cream " which is the exact same thing as EMLA. It comes in one 30gram tube instead of EMLA which comes in tiny 5mg tubes. So for the same $10 co-pay, I get 6 times the medicine. Also, it works great. I leave it on Hunter for 1 1/2 to 2 hours before injections and bloodwork. I hope Caroline is pain free soon. Stacia and Hunter,8,systemic,iritis Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 2, 2004 Report Share Posted June 2, 2004 Thanks Stacia. I will definitely check into this Alia and Caroline, age 2, poly and uveitis Re: Alia,joint injection Alia, I hope you feel comfortable with whatever decision you've made about the joint injection. About the EMLA cream, the last time I asked for a new prescrip for it, I actually got " lidocaine 2.5% and prilocaine 2.5% cream " which is the exact same thing as EMLA. It comes in one 30gram tube instead of EMLA which comes in tiny 5mg tubes. So for the same $10 co-pay, I get 6 times the medicine. Also, it works great. I leave it on Hunter for 1 1/2 to 2 hours before injections and bloodwork. I hope Caroline is pain free soon. Stacia and Hunter,8,systemic,iritis Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 2, 2004 Report Share Posted June 2, 2004 Hey , I was really excited to read that n did track this past school year. It's really awesome, and cool that she was able to get awards at it. I know it must be great for her to feel like she's good at something in spite of her arthritis. I personally have always loved to run. I ran when I was a kid, and then I ran off and on depending on the arthritis. Like in middle school the arthritis wasn't bad at all, so I was able to run in track and cross country, and I ran my first year of high school but couldn't after that. After a while on the Enbrel I was so happy to be able to run again. The rheumy said that was fine as long as it wasn't causing me pain. I'm not on the Enbrel anymore, and I haven't actually run since I've been off, but that's mainly because I've been busy with getting married and being a newly-wed! I'm trying to start back running this summer, so we'll see how it goes. I don't know, it's hard for me to stick to any other exercise or sport because I just don't like it the same, so I'm just stubborn about the running even though it might not be the best possible activity. I think being in shape is better than not doing anything, though. Thanks for telling me about n. In a funny way, it made me really proud! Good for her! Elisheva > Elishiva, Thank you so much for the info. This list is great. I have been on it for nearly five years now. I read all of the posts, but don' t chime in too often. > n took a down turn in January and had to go on prednisone. Her abdomen and chest hurt her pretty bad. She is now down to 2mg and I am trying to get her off by the end of June. Her wrists have been troublesome though. > The school year has flown by. She finished her first year of high school. She went out for track in March and the school was great with working with her. She couldn't run, but she would walk the treadmill or work out with weights. All n did was high jump, and she ended up number one on varsity. She took first at six meets, and third at the other three. She went to districts and came a fraction away from making it to state. Only the top two go on to state meets, and she took third and jumped a personal best. We are really proud of her . She wants to do more events next year, but I tell her let's wait and see how her arthritis is. Anyway, that is the quick update on n. (n,15,systemic) Quote Link to comment Share on other sites More sharing options...
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