Tips for an Easier Round of Solumedrol
Living with relapsing MS can be challenging and unpredictable. Relapses can be extraordinarily disruptive. One treatment prescribed to help speed recovery from a relapse is a 3-day or 5-day round of intravenous glucocorticoid steroids known as Solumedrol (methylprednisolone), or IVSM for short.
Glucocorticoid steroids are not the same as anabolic steroids which are sometimes used to enhance athletic performance. Solumedrol is similar to predisone which is an immunosuppressant drug with powerful anti-inflammatory properties used to treat a variety of conditions. High doses of Solumedrol (1000mg) help to halt the acute inflammatory process during an MS relapse but do not significantly change the outcome.
Since my first event of optic neuritis in 2000, I have undergone more than 7 rounds of IVSM to treat severe MS relapses. Sometimes the negative effects of the treatment can seem almost worse than the relapse, but I’ve learned a few tricks to help avoid some common problems and to make the experience more tolerable.
1. Tiny Veins, or a Hard Stick. Since I have small and hard-to-find veins, I drink plenty of water to stay well hydrated. My infusion nurse may use a heating pad to help “plump up” the veins so that it is easier to get an IV line started, especially since it will need to stay in place for several days. Be sure to protect your IV line by not getting it wet or dislodging it from your vein.
2. Metallic Taste. Solumedrol can cause a really yucky, penny-like taste in the mouth. I recommend sucking on hard candies or mints during the infusion. Jolly Ranchers and LifeSaver Mints are quite effective. I have been told that drinking chocolate milk helps as well.
3. Avoid Headache. Some patients may get a headache during or after the infusion. If you get a headache, ask the nurse to slow down the drip on following days. An infusion over 60 minutes is too fast for me, but 90 minutes helps to avoid a pounding headache later in the day.
4. Protect your Stomach. Solumedrol can increase stomach acid production resulting in severe heartburn and gastritis. Rather than let this excess acid eat away at your stomach lining, take Zantac as a precautionary measure before each meal and each infusion.
5. The Cookie Monster. Steroids will make you hungry!! Be careful what you eat. Solumedrol causes water retention, so avoid salty and sugary foods. It can also increase blood sugar levels while it depletes potassium levels. Increase potassium-rich foods, such as bananas, apricots, lima beans, beets, and baked potato with the skin. If you have diabetes, you will need to closely monitor your blood sugar levels.
6. Anxiety. Many folks report feeling a surge of energy, so much so that laundry gets done, the house gets cleaned, etc. Be careful. The steroids are putting a huge strain on your body and you need to rest and recuperate. It’s tempting to be an Energizer Bunny for a few days, but you’ll just end up paying for it later. Some patients will experience severe fatigue instead. Listen to your body and try to take it easy.
7. Insomnia. Each time I’ve undergone a round of IVSM, my heart races, my mind wanders, and I can’t sleep. Rather than suffer with less than 3 hours of shut-eye each night during treatment, I’ve taken advantage of sleep medications such as Ambien and Rozerem.
8. Mood Swings. Mood swings and increased irritability are very common side effects during IVSM treatment. My family and I have learned that I need lots of patience and gentle understanding while I’m temporarily not in control of my emotions. I may even feel cognitively deficient, almost downright dumb. This is NOT the time to make big decisions, but it is a good time to avoid confrontation.
9. Depression. Corticosteroids may aggravate existing emotional instability or psychotic tendencies. If you suffer from depression, keep a close eye on your mood. Knowing in advance that your depression might become exaggerated helps tremendously when you feel the tug of that dark hole. Reassure yourself that it’s just a temporary condition and will soon pass.
10. Weakened Immunity. Solumedrol is a powerful immunosuppressant and your body will be vulnerable to infection during and after treatment. Avoid contact with people who are sick and absolutely do not receive any vaccinations. If you do begin to see signs of infection, such as increased fever, chills, rash, and respiratory distress, contact your doctor immediately. I will avoid public places to help protect myself as well.
What are some of your tips to make the IVSM experience easier?