Kickas.org Forums Ankylosing Spondylitis General Discussion #1 AS Web Support Group docs on melb australia that prescribe steroids?

My current rheumy told me last time my as was bad that nothing works except biologicals. Anyone see a rheumy in melb who is willing to try other meds or steroids? Thanks

steroids are definitely not a good long term option. Have you gone through the usual NSAIDs already? DMARDs don't seem to be proven to have any impact on spinal disease, though can help a bit with peripheral disease in some folk. I'm not sure what other meds there would be?

Does sound like it would be useful to try and have a longer conversation with your rheumie about exactly how much damage you have, what you have tried, and what else there is available.

the only reason i'm doing steroids now instead of a biologic is because i flare every few months and a 6 day taper usually knocks it down for a few more months. more than once every 2-3 months and definitely we'd be talking biologics. and in fact, we're probably going to have that conversation anyway.

i'm sure you can find a doctor with a different philosophy in how to proceed; good luck!

Have you given the No Starch Diet a good try??? It's made quite a difference to me...after 4 years, I eat a little rice and a few other "fringe" foods.

I think the 'order of the day' is NSAIDs,DMARDs if you have some peripheral disease and then Biologics - there aint' nuthin else....

My rheumy is very supportive of the low / no starch diet as an effective way of modulating the disease in many folks. Sometimes not enough, but it's a great start.

I have also been prescribed steroids to knock flares, but they are not a good long term option.

Have you tried Melrose Fish Oil (helps me...) or Boswellia (frankincense) It is used in Ayuverdic medicine and some studies in Germany have put it on a par with NSAIDs for effectiveness.

another thought. while my LDN doesn't solve all my problems, it has made my enthesitis a lot better. Molly says it also helps her GI stuff. For my GI, staying away from dairy and taking probiotics has been the answer. I think my vitamin C supplement (500-1000 mg a day) helps as well. still, all of this, plus what else i wrote below my name helps but is not enough.

Hi - yes im on a low starch diet most of the time, dont want to take biologicals because they may make my other condition worse. ive taken steroids before because i only flare twice a year or so and they worked a treat but the doc moved away.

Ive been on NSAIDS for ten years on and off and my stomach is struggling.

If you only flare a couple of times a year, then short course of steroids do seem like a rational idea. At the moment short courses of steroids are my only treatment option (not eligible for biologics and can't take NSAIDs) but its just my GP who prescribes them, and it doesn't seem a big deal to her to give me up to 14 days at a time, maximum starting dose 20 mg (usually do 15 mg a day for 7-10 days then a fast taper of just one or two days at 10 and 5 mg). GP will do this up to four times a year for me.

If you have had this before and its worked, then I'd just try asking your GP.

i agree with CEMC.

right now that's part of my plan.

for me its a 6 day medrol dose pack (well a script of lots more pills, but i follow the dose pack instructions): 6 on day 1, 5 on day 2, etc. 4 mg pills. Could see that 2 weeks instead of 1 could be helpful sometimes, the way cemc explains it.

steroids are a funny thing; had one doctor who told me flat out i couldn't even try them (to help prove its inflammation); way too dangerous he said! my current rheumy and GP are much more rational about the whole thing. used judiciously and monitored, they can be an important tool, at least for some.

LDN could be a partial answer if that other disease that you don't want biologics to flare is MS or cancer.