Category Prednisone Taper

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I’m starting to lean in towards the gca being under treated. When the first rheumy kept tapering me I’d tell him about what I read here. He wouldn’t get on board. That’s when I searched out and found the best man I could find. He is more symptom oriented inn his approach to treatment. I will call him today and tell him I have the head ache. That’s classic GCA after all. He will likely raise it… Has any one ever had break through headaches while on prednisone? Sometimes I’d have a headache and other times not. This is so “too much.” I’m feeling quite overwhelmed.

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Valtrex – Uncomfortable side effects, Makes use of, Dosage, Overdose, Pregnancy, Alcohol

<h1>Valtrex – Uncomfortable side effects, Makes use of, Dosage, Overdose, Pregnancy, Alcohol</h1>

Valtrex – Uncomfortable side effects, Makes use of, Dosage, Overdose, Pregnancy, Alcohol

by GastonMoffet on 9 minutes ago 2 views http://dirtyearth.com/wp-cron.php?doing_wp_cron=1553833456.6562480926513671875000 http://dirtyearth.com/wp-cron.php?doing_wp_cron=1553833456.6562480926513671875000 . Normally if no difference is noted, albuterol will be the drug of alternative. A literature review printed in Human Reproduction thought of several research on Clomid. While taking Prozac, it’s best to see your physician recurrently in order that he/she will be able to monitor your response to the drug and modify the dosage accordingly. A structured literature overview. I had a fast look online to see whether there were any uncomfortable side effects and initially found that diarrhea, free stools, fatigue, and muscle soreness have been generally experienced. Most of these contact lenses might be referred to as decorative, plano, Halloween, or particular results lenses, and are designed purely to change the appearance of the eye. Utilizing marijuana and the antidepressant Prozac at the identical time can lead to a condition known as hypomania. Metformin can also be used to treat gestational diabetes – diabetes that occurs during, and because of, pregnancy. What are you able to anticipate if you take Metformin? Listed here are things to know if you’re on Prozac. Albuterol is also helpful for patients with emphysema because it helps within the lung spasms. Individuals know we’re a enjoyable place. There are a number of exceptions (that are outlined at the tip of this page) and as at all times it’s best to consult your physician before switching from a brand name medications to a generic or vice versa. JANUVIA is contraindicated in patients with a history of a critical hypersensitivity reaction to sitagliptin, reminiscent of anaphylaxis or angioedema. Moreover, the effects of alcohol can mask the doable unintended effects brought on by amoxicillin which might result in potential health dangers. One, if Clomid hasn’t helped you conceive after six months, the percentages of it engaged on month seven or eight are very low. Working with outdoors physicians, the corporate quickly acknowledged it would aid fertility and launched a study, Adashi writes. In patients with COPD, the prolonged publicity to tobacco causes permanent inflammatory modifications within the air passages. Hyperinsulinism will be caused by negative feedback caused by resistant cells. In keeping with the fabric of the changes in the eighteenth and nineteenth centurys craftsmen, cotton and silk to create Bihar decals. A national Tv ad campaign is working for one among the 2 reputable hair restoration products: Propecia (Finasteride) or Rogaine (Minoxidil) that states “85% of men successfully grew hair. Docs have warned about the overdosing of Statins for girls, noting that there is no conclusive evidence that it even helps girls who do not already have coronary heart disease. For the study, researchers randomly assigned the participants, who were aged between 18 and 35, into two groups. How does Propecia work? The assessment additionally checked out data on the interaction between ibuprofen and low-dose aspirin when the latter is taken to reduce the risk of heart assaults and strokes. As an alternative, attempt taking the aspirin early in the morning, and wait a minimum of an hour or two until you’re taking your NSAID. Does a single dose of ibuprofen actually have the prospect to hurt the beans or make you bleed profusely from your intestine? ” WOW, 85% sounds Great doesn’t it? Ibuprofen (model names: Advil, Motrin) lasts up to eight full hours and usually works somewhat faster. Longer doses of as little as 5-10 mg daily of prednisone require a taper to keep away from the chance of adrenal insufficiency. If you are taking any of those medicine, separate them from this medicine by a minimum of four hours. There have been times I’d lay in mattress to sleep at night, and would find myself gasping for air. The absorption of metformin is also increased by taking the medication with meals, which leaves less of the drug remaining in the gastrointestinal tract to trigger irritation and diarrhoea. However, do not use more than four instances a day. Celadrin, a cellular lubricant, is a brand new joint well being breakthrough that uniquely gives fast, long lasting joint consolation. At all times shut the cap after each use. This data shouldn’t be specific medical recommendation and doesn’t exchange data you obtain from your well being care supplier. This way, you will get pleasure from peace of thoughts realizing that nothing might go mistaken. Type 2 diabetes, once often known as adult-onset or noninsulin-dependent diabetes, is a chronic situation that affects the way the physique metabolizes glucose. WHAT THIS Treatment FOR? All components can have drugs patients. Be aware: This medicine is only for you. After you think twice, put the bottle of ibuprofen or aspirin back in the medication cabinet. Additionally, if you’re on Metformin, you have to be cautious whereas drinking alcohol. Normally there won’t be any adverse response however it is advisable to take your medications nicely upfront of drinking alcohol as this permits the drug to be totally absorbed into the body earlier than the introduction of alcohol. In the event you suspect you could also be pregnant, there are a amount of approaches to find out your anticipated due date. The difference between the teams was not important, meaning that there was no statistical difference between the 2 teams. If the patient is tested with spirometry for Xopenex and if there may be little or not distinction between their previous results, they’re going to get albuterol unless they’ve terriffic insurance coverage and insist on Xopenex.

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I’m 2 years on Entyvio and living as if I don’t have UC!
I also noticed subtle changes early on. Others will mention that Entyvio is slow acting and it is but along that slow journey are many small improvements. I was able to start a prednisone taper with my first infusion and by the time I was done with the taper had only small occasional symptoms. That was the first time without prednisone in a year. So while I say it was 4-5 months for complete symptomatic remission, I was MUCH better after The loading doses, managing symptoms with suppositories and rectal steroid foam, and continued to improve from there.

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Oh my…. Thyroid checked regularly. Ayear ago I was started on 60 them tapered down throughout a nine month period. Got tapered off completely..with difficulty… Last Feb…but had immediate relapse….saw the specialist for consult and back on 25’to see how I do symptom wise. I’m supposed to call him this week to report how I feel and he will advise what to do with prednisone. Up/steady/down

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Topcat, I don’t know how much Mestinon you are taking, but you may need to increase if you are very weak. That depends on how much you are taking, I really like the idea that you are tapering off of Prednisone with the Cellcept, but since you are still weak, it doesn’t sound like your MG is under control right now. Since that is the case, I wouldn’t expect you would taper off Steroids until you are stable and it will take many months for Cellcept to work, IF it works and I sure hope it does for you. Up to one year should be ample time to indicate if Cellcept is working. Being able to get off of the Steroids would be great, I think your first steps with this plan would be to eliminate Mestinon first and then the steroids. I wouldn’t expect to see any kind of results from Cellcept for at least a few months.

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Thankful for My Breath

<h1>Thankful for My Breath</h1>

Thankful for My Breath

Thankful for My Breath April 1, 2019 by cheriswalwell
Last fall, the day before Halloween, I got sick. I felt fine all day and then wham … about 4 PM it hit me. I felt miserable for about 1-2 weeks. I slowly improved, except for a lingering cough that I couldn’t shake. Unfortunately as someone who has developed weather and exercise-induced asthma in her adult life, coughing seems to be the norm anywhere from November through February – or all of November through February, so I didn’t think much about it.
It was affecting my work, my worship (I couldn’t sing at church without stopping to cough more often than singing), my relationships, and my health . I coughed all the time and so hard it literally hurt my ribs. I would use my inhaler and it would help some … but not enough. I even had two instances where I couldn’t catch my breath for about 5 minutes. That’s just plain scary .
Before you think I was just being irresponsible, I would have moments, or days, where I felt like I was improving, so it seemed silly to go to the doctor when I was “on the upswing.” Only I wasn’t.
Finally, after disrupting everyone around me for about 8 weeks, and growing steadily concerned myself because I realized I was getting worse, not better, and it was getting harder and harder to breathe regularly, I went to the doctor. I was diagnosed with an asthma exasperation that had gotten quite serious. They prescribed steroids and my inhaler, with the concern that if this didn’t clear it up, I would have to go on daily maintenance medication. (I really hate taking medication if I don’t have to, so to hear that was quite disheartening.)
The first dose of prednisone worked, while I was on it, but the day it was finished, I was back to not being able to catch my breath and coughing continuously. So I called and they did another round, this time a taper which lasted longer and along with my inhaler, and plenty of rest, it reduced the inflammation that had grown out of control for 8 weeks. In the meantime, my husband bought me a natural remedy to use as needed if I started coughing again, before things got out of control.
I am happy to report it’s been about 3 months now since I’ve been off the steroid. I’ve only used my inhaler maybe twice and the natural remedy about five times total. (It’s a twice daily medication when asthma is at its worst, so five times in three months shows how much my breathing has improved.) I used it again yesterday at the beginning signs of discomfort and within 15 minutes I was breathing calmly and the coughing had stopped.
I say this to give God all the glory, honor and praise for healing me. Every Sunday when I enter into praise and worship at our church and sing as loudly as possible, I thank Him for every inhale and exhale of my lungs that is done without coughing and without discomfort.
I have stopped taking my breath for granted. Every time I sing at home or in the car, I’m reminded of 8 weeks of coughing, stopping and starting, and hoarseness from an inflamed, raw throat. And I praise God for His healing and the ability to sing again.
May I never take His blessings for granted again …
What is one thing you’re praising God for today? One blessing He has given that maybe in the past you never really thought about? Advertisements

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Acute Eosinophilic Pneumonia (AEP) Caused by Clomipramine

<h1>Acute Eosinophilic Pneumonia (AEP) Caused by Clomipramine</h1>

Acute Eosinophilic Pneumonia (AEP) Caused by Clomipramine

Acute Eosinophilic Pneumonia (AEP) Ca utilize by ClomipramineClomipramine-induced peachy eosinophilic pneumonia-like syndrome leading to acute respiratory failure a report of kickoff described caseDrugs are well- cognize causes of eosinophilic lung complaint and uncomplainings with drug-induced eosinophilic lung ailment can have variable clinical presentations. Clinical features may range from asymptomatic eosinophilic infilt prizes to acute eosinophilic pneumonia (AEP)-like syndrome leading to acute respiratory failure. This report describes the first case of clomipramine-induced AEP-like syndrome causing acute hypoxemic respiratory failure which was treated successfully. In conclusion, considering the change magnitude use of tricyclic antidepressants, physicians should be aware of this very rare and life-threatening complication of clomipramine.KeyWords Clomipramine, acute eosinophilic pneumonia-like syndrome, treatmentINTRODUCTIONMany drugs have been associated with pn eumonic complications of various types with an increasing number of the therapeutics. Respiratory system is a target for a pastiche of drugs because of its large spot surface and acting as a metabolic process site for drugs. The patterns observed in drug-induced pulmonary toxicity are highly variable and depend on the localization of adverse reaction. Since most of the drug-induced pulmonary toxicities involve the lung parenchyma, the most common form of drug-induced lung toxicity is interstitial lung disease (1).Drugs theoretically can produce all histopathological patterns of interstitial lung disease, including hypersensitivity pneumonitis, organizing pneumonia, bronchiolitis obliterans organizing pneumonia, acute respiratory distress syndrome, granulomatous pneumonitis, and eosinophilic lung disease (2).More than 350 drugs are known to cause acute eosinophilic pneumonia (AEP)-like syndrome (3, 4). However pulmonary complications related to tricyclic antidepressants are uncommo n. To our knowledge, only one case of AEP associated with the usage of clomipramine has been reported in PubMed in 1999, and in the aforementioned case clomipramine had been used not totally but with sertraline (5).This report describes the first and successfully treated horrific case of AEP-like syndrome associated with clomipramine treatment alone. Written informed consent of the participant persevering was obtained for the publication of this case report and any accompanying images.CASE invoiceA 38-year-old female was referred to our clinic from psychiatry department of an early(a) hospital. She had been newly diagnosed with panic attack attack and anxiety disorder one week prior to the fashion of respiratory symptoms. After admission to psychiatry polyclinic, clomipramine therapy was prescribed at a dose of 75 mg/day. After 6 days of clomipramine therapy, the patient exhibited dyspnea, increasing shortness of breath, dry cough, chest pain, and fever up to 39.20C. She was a housewife and had no work-life memorial. there was no past history of a chronic disease and her smoking history was 16 packs/year. She had never consumed adulterous drugs, had no allergies, and had not visited a foreign country during the previous 5 years.On admission, the patient was in a respiratory distress, with a respiratory rate of 35 breaths/ s, a blood pressure of 110/70 mmHg, and a heart rate of about 140 beats/minute with sinus tachycardia. Examination of blood samples revealed only anemia (haemoglobin9.4 g/dl). calculate of leukocytes, thrombocytes, and results of blood chemistry were inwardly normal limits. Erythrocyte sedimentation rate was 40 mm/h and serum level of C-reactive protein was 4.5 mg/dl. step of arterial blood gas analysis on room form revealed pH 7.44, PaCO2 32 mmHg, PaO2 49 mmHg, HCO3 27 mmol/L and SaO2 86% which was harmonious with hypoxemic respiratory failure. Laboratory results including HIV testing, serological screening for vasculitis auto antibodies to deoxyribonucleic acid (DNA), mental image stranded DNA, proteinase-3, myeloperoxidase, rheumatoid factor, and circulating immune complexes and various pulmonary pathogens were negative. pee-pee tests for ova and pulmonary parasites were normal. The level of total serum immunoglobulin E (Ig E) was within normal limits (65 IU/ml) and antigen-spesific Ig E against Aspergillus fumigatus and Candida was negative.Her chest radiograph revealed a homogenous dense shadow located especially in the trim down field of the right lung and some additional reticular opasities in the reject zone of the left lung (Figure 1). Computerized Tomography (CT) (Brilliance Philips Medical System, Eindhoven, The Netherlands) of the thorax demonstrated patchy areas of ground-glass, thickened interlobular septae and homogenous consolidations with air-bronchograms especially in the middle and light zones of the right lung (Figure 2).The patient was admitted to the intensive care unit because o f the need for non-invasive robotic ventilation. She underwent bronchoscopy (Aquilion Toshiba, Tokyo, Japan) with bronchoalveolar lavage (BAL). During the bronchoscopy procedure the bronchi appeared inflamed and contained increased secretions. Gram stain and cultures of the bronchial washings did not reveal any infectious organism. Total cell count on BAL was 182 cells/mL with 30% eosinophils, 8% neutrophils, 55% macrophages, and 7% lymphocytes. Special stains and cultures for mycobacteria, Pneumocystis jiroveci, fungi, legionella pneumophila were negative. Serology testing for cold agglutinins were negative.Intravenous methylprednisolone 60 mg/day (1 mg/kg/day) was initiated on admission. Then dose of the methylprednisolone was gradually tapered and methylprednisolone was discontinue after 4 weeks. The chest radiograph of the patient cleared markedly within 15 days of the treatment (Figure 3). The patient was decampd 18 days after admission. Follow-up examinations one and four we eks after boot out revealed normal laboratory results and a normal chest radiograph. Pulmonary knead tests 3 months after admission showed no ventilatory defect. Last contact with her was a polyclinic visit for control one year after discharge and she was free of respiratory symptoms.DISCUSSIONThe eosinophilic lung diseases are a assorted group of pulmonary disorders characterized by increased numbers of eosinophils in the air hose or lung parenchyma, and drugs are well known causes of eosinophilic lung disease (6). Patients with drug-induced eosinophilic lung disease can have variable presentations, ranging from asymptomatic transient eosinophilic infiltrates to AEP-like syndrome leading to acute respiratory failure, depending on the drug involved.AEP is described as a clinical entity which involves acute onset of symptoms within 5-7 days, fever 37.20C, hypoxemia, two-sided alveolar or mixed alveolar and interstitial infiltrates, and lung eosinophilia (percentage of eosinophil s 25% in BAL and/or predominance of eosinophils in open lung biopsy). In addition, without any history of hypersensitivity to drugs, no evidence of infection, and no other known cause of eosinophilic lung disease (7, 8).Similarly, patient in this case had newly onset respiratory symptoms, fever and mixed alveolar and interstitial infiltrates suggesting an interstitial lung disease. In addition, a bronchoscopy with BAL revealed presence of importantly increased percentage of eosinophils (30%) in the lavage fluid. Based on the results of BAL, radiological features and her clinical course, she was diagnosed as potentially having an AEP-like syndrome related to clomipramine.Unlike patients with other eosinophilic lung diseases, most of the patients with AEP have normal peripheral blood eosinophil count (8). The level of total serum IgE can be elevated, however it is not used as a diagnostic legal document (9). In this case, the patient had both normal peripheral blood eosinophil count and normal level of total serum Ig E.The diagnosis can easily be obtained with BAL and lung biopsy is not an obligation for the diagnosis of AEP in most cases. If needed, the purpose of lung biopsy is to exclude other diseases that can mimic AEP. When lung biopsy is performed, the histopathological features are characterized by diffuse alveolar damage with interstitial and alveolar eosinophils (10). There was no need for lung biopsy in this case and diagnosis could be formal with the help of BAL cell count.In some cases discontinuation of the drug is generous for resolution of the radiological features. However, some patients experience a severe disease and require corticosteroid treatment. Generally, response to corticosteroids is rapid and most of the patients have evidentiary clinical improvement within 24 to 48 hours. The optimal dose and duration of corticosteroids have not been determined exactly (8, 10). Commonly used doses of intravenous methylprednisolone in case series range from 60 to grand piano mg per day until respiratory failure resolves. Thereafter, the patient can be switched to oral prednisone, and the steroids can be tapered off over 2 to 12 weeks. In this case, 60 mg/day intravenous methylprednisolone was administered on admission and dose of the corticosteroid was regulated according to resolution of radiological findings. Corticosteroid treatment was terminated after 4 weeks.In conclusion, physicians should be aware of rare, life-threatening and treatable AEP-like syndrome because of clomipramine.

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In my case, I think the infection triggered a flare, although it is so hard to differentiate infection symptoms from U.C. symptoms. I noticed some improvement after about a week on Vanco, but I plateaued at that point and didn’t feel better until the prednisone (which I stared once it was clear that the ABX wouldn’t be enough on its own) started to kick in, which was about 3 or 4 days. Then my symptoms disappeared rapidly and I was able to taper from 40 mg pred to 0 in less than 2 months with no return of symptoms. I probably could have tapered faster, but staying in remission was more important so I took a cautious approach to tapering. That was about a year ago, and I have enjoyed an excellent remission since. I have also reduced my intake of carbohydrates significantly which seems to be helping a lot, but that is a different issue.

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Before You Go Cold Turkey on an RX, Read This!

<h1>Before You Go Cold Turkey on an RX, Read This!</h1>

Before You Go Cold Turkey on an RX, Read This!

by Health Experts · March 27, 2019 STOPPING CERTAIN MEDS ABRUPTLY CAN BE DEADLY
Have you ever had a friend tell you that they stopped taking their anti-depressant because they feel happy now? Or what about the hubby or boyfriend who stops taking his high blood pressure meds because, “everything is fine, and he’s working out and eating right?” Lastly, have you ever suffered from anxiety and been prescribed Valium or Clonopin and abruptly stopped taking it because you were no longer anxious? If any of these are familiar scenarios, know that abruptly ceasing certain medications at best, can make you sick, and at worst can cause death.
We turned to Dr. Niket Sonpal an NYC Internist and Gastroenterologist and Dr. Duy Nguyen, a Psychiatrist at Beachway Drug and Alcohol Center in Florida. With their combined expertise, they explain the prescription drugs that are dangerous to stop without consulting a doctor and tapering down. See if one your meds is on this list! Blood Pressure Medications
Medication to control high blood pressure only works if you take it. If you stop taking anti-hypertensive medication without discussing it with your doctor, you put yourself at risk for a stroke. High blood pressure is the most important preventable risk factor for stroke, according to the American Heart Association (AHA) and the American Stroke Association (ASA). Dr. Sonpal says that “The higher the blood pressure, the higher the risk for stroke and other health consequences such as brain aneurysm.
Unfortunately, some people with high blood pressure stop taking their medication. If their blood pressure returns to normal, they may feel that they no longer need the medication. But normal blood pressure means the medication is doing its job; halting medication will allow blood pressure to rise again, putting the person at risk for stroke and other complications of hypertension.” Antidepressants
Dr. Duy Nguyen has seen many a patient stop taking drugs such as Prozac, Wellbutrin, Celexa, and Zoloft without first consulting with him. He is adamant that patients don’t go this route. He says, “Withdrawal from antidepressants can cause insomnia, confusion, anxiety, panic, agitation, nightmares and worsened depression. People may also experience fatigue, nausea, vomiting, dizziness, muscle spasms, headaches and loss of coordination. If you wish to be off of an anti-depressant or switch to another, speak to your doctor first and have them devise a safe schedule to titrate you down and/or replace with another.” Benzodiazepines
You are likely familiar with these under the brand names Valium, Clonopin, Xanax, and Ativan. These are most commonly used to treat anxiety and panic. For people who only take these once in a blue moon (for fear of flying or public speaking), the body and brain are not addicted. For those who take one or more of these medications daily, they cannot be stopped cold turkey! Dr. Nugyen strongly cautions that, “ Benzodiazepine drugs can cause serious withdrawal symptoms including seizures, tremors, hallucinations, heart palpitations, insomnia, nausea, and increased anxiety.
If you wish to stop or reduce your intake of these drugs, consult with your doctor to develop a titration schedule. If you have been taking high doses of these drugs over a long period of time, you may need more supervised medical support such as a drug detox program where you are monitored 24/7 by nurses and given supplementary non-benzo medications to ease withdrawal symptoms.” Prednisone and other steroids.
Prednisone is prescribed as a potent anti-inflammatory for a variety of conditions, including asthma, allergies, hives, inflammatory arthritis and gout. If you’ve been taking prednisone for more than one to two weeks and just stop it, you may get into trouble. Dr. Sonpal explains that “When you are taking prednisone tablets, your own adrenal gland production of cortisol declines. When you abruptly stop taking prednisone, the result may be low cortisol. This causes weakness, nausea, vomiting, diarrhea and abdominal pain. It’s not fun and can be very serious. Wean off of it under the schedule determined by your doctor” Antibiotics
Too often patients with a bacterial infection begin a course of antibiotics with every intention of following their doctor’s orders, then cutting their treatment short when they’re feeling better. “What they don’t realize is that this can cause problems in the future. Antibiotics are prescribed in the dose that ensures every last bit of the targeted bacteria in your body will be destroyed,” explains Dr. Sonpal. He adds. “If you stop taking your antibiotics a few days before you’re supposed to, any remaining strains of the bacteria, the ones that were already strong enough to make it through the first few doses of the medicine, will survive in your system, and will be resistant the next time you take those same antibiotics.” Opioid pain medications
Opioids are prescription analgesics like codeine, morphine, and hydrocodone (an active ingredient in Vicodin), and if you’ve been taking any of them long term, abrupt discontinuation can cause symptoms like diarrhea, generalized pain, restlessness, and anxiety. “Withdrawing from opioids is no joke,” says Dr. Nguyen. He adds, “Depending on your level of addiction, a patient may need in-patient medical detox followed by a drug rehab program, the latter of which will deal with the emotional aspects of eliminating the addiction.” Diabetes Medication
When your blood sugar seems to be under control, you may decide you want to stop taking your diabetes medications. Dr. Sonpal explains that “If you’re a type 1 diabetic, your body will never be able to create its own insulin, so it’s pretty clear that you can never stop taking insulin. But if you’re a type 2 diabetic, you may be able to explore alternatives with your physician. Since this type of diabetes evolves and changes over time, you need to consistently evaluate your treatment plan with your doctor.” This could involve reducing the dose of your current medication or trying newer medications. But it’s imperative that you not take any action on your own with regard to adjusting your medication without first consulting with your physician. Thyroid Medication
If you have hypothyroid—whether due to Hashimoto’s, Graves’ disease treatment, thyroid surgery, or congenital hypothyroidism—failing to take your thyroid hormone replacement medication can pose many risks to your health. If you don’t feel better after taking your medication for several months, you may need a dosage adjustment or a change in medication—not a complete stop of your regimen. Dr. Sonpal explains that “There isn’t a natural or herbal replacement for thyroid hormone. Much like patients with type 1 diabetes and their need for insulin, your system needs thyroid hormone for survival. But there are no natural substitutes for antithyroid medications.”
Some Risks of Ceasing Thyroid Medicine Include: Blood pressure irregularities Elevated cholesterol, including treatment-resistant high cholesterol and increased risk of heart disease Low body temperature; feeling perpetually cold Fatigue, muscle weakness, or joint pain Depression Memory problems
About Dr. Niket Sonpal:
Dr. Niket Sonpal is an Adjunct Assistant Professor at Touro College of Osteopathic Medicine and Clinical instructor at Kingsbrook Jewish Medical Center, Brooklyn who specializes in Gastroenterology. He is the co‐author for the best-selling Master the Boards: USMLE Step 2 CK, Master the Boards Step 3, And Master the Boards: Internal Medicine.
About Beachway Therapy Center:
Beachway provides a continuum of care, from PHP (Partial Hospitalization Program) to Outpatient services. The facility offers a fully individualized treatment plan that meets the clinical and medical needs of each client usually lasting between 30 and 90 days. Beachway provides an extremely low client to therapist ratio and under high-level professional supervision, clients can begin to recover in a safe, residential-like environment. CBT (cognitive behavioral therapy) motivational interviewing, addiction counseling, 12-Step orientation, DBT (dialectical behavioral therapy,) trauma-informed practices and a wide variety of supportive group therapies are offered.
About Dr. Duy Nguyen, D.O.
Dr. Duy Nguyen, D.O. is a Board Certified Psychiatrist in General Psychiatry who has experience with providing psychiatric care in a variety of settings including residential drug and alcohol rehabilitation, inpatient and outpatient mental health, and the VA Medical Center. Dr. Nguyen is committed to providing a high level of evidence-based psychiatric care in the drug rehabilitation setting in addition to having a holistic focus on healing and recovery.

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Oh the fun of an IBD disease huh!!!! 🤪😱🤡
Nana — Entyvio is a very quick infusion as the others have said. 30 minutes and it’s done so not as much wear and tear on veins , imho. I have really small veins that roll so the longer an IV is in the worse for me.
Medicare does not require pre-approval. It’s my understanding that some dr offices will administer Entyvio infusions? Mine is done by the chronic disease center which is part of our local hospital. Technically it is outpatient and the office is a block away from the hospital itself but since the hospital name is on the billing (?) Medicare considers it as a Medical procedure and any medications given in a hospital are covered under medical not prescript ion. I have the plan F supplemental which picks up the 20% that Medicare doesn’t pay.
I do worry often that Medicare will consider this a loophole that needs closing but consider myself very lucky that it works in my favor as it stands. Again key is that a hospital administers the infusion (I think that’s the key — it’s sometimes very hard to pin down Medicare rules).
I think Remicade would be under the same rules. Entyvio’s advantage for me and my touchy veins is the much shorter infusion time. I used to be in and out in 45 minutes but now it’s about an hour due to the “new improved” 🤨 computer and check-in system. Entyvio is slow-acting. I did see improvements right away tho and was in symptomatic remission at month 4. Steroids and Canasa helped bridge that time. A few minor hitches during the first 6 months maybe but nothing to raise a fuss over and I was able to successfully taper off prednisone by month 3 for the first time in a year.
In a month I will have my 16th infusion (I think tomorrow may be my 2 year anniversary on it). My colonoscopy 6 months ago showed no inflammation. No side effects or dietary restrictions. Life is once again good!

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