As a Doctor myself I think drugs are NEVER the answer except in E...

But, sometimes doctors make big mistakes and sometimes wrong dosages are given and sometimes death is the result. In my case I feel medical malpractice attorneys have been worthless in helping my family find answers. Unless a case is worth millions they lose interest. I have used the almighty internet for the past 23 months. I can not find where 1000mg oral Prednisone (50 pills per day for 14 days) for treatment of possible optic neuritis is considered standard care. Can you help me find answers?

Try these sites....
http://en.wikipedia.org/wiki/Optic_neuritis
http://www.emedicine.com/Radio/topic488.htm

The Standard of care according to Epocrates is methylprednisolone 250mg Q6hours X 12 doses then prednisone 1mg/kg/per day once a day for 11 days then decreasing dose taper for the next 2 weeks.... This hastens recovery but does not affect long term viisual outcome.... This disease is associated with MS and if you have MS or suspect you do you will need futher workup.... Hope this helps!!!!!

Kindly,

Mike Gorman, MD, DC, MS, BS, ASA, ART

Here is one more site I found on optic neuritis...

http://www.otmagazine.co.uk/articles/docs/94cec0713880553d747024b024f9e8ef_chhabra20031031.pdf

Feel free to ask more questions as I am here to serve....

Mike Gorman, MD

Thank you.. I am still somewhat confused concerning the dosage or 1000mg oral for 14 days. It appears someone got their decimal point in the wrong place. Do you agree?

250mg x 4 times a day for 12 days IS 1000mg a day for 12 not 14 days .... Check your math ... Buts thats the protocol dosage...

Thank you again for your time and willingness to help. The death of my father has been difficult for our entire family.

My dad was 75 years old and believed to be in fair health. He had a routine check-up in September 2006. On Oct. 10, 2006 he was on the golf course which was not at all unusual. On Oct 11, he complained of blurred vision in right eye. The following day he was prescribed the massisve dose of Prednisone. On Nov. 7, 2006 he died of multiple organ failure.

Kindly,

Kay Birkla

Kay,
I must express my sympathy... It hurts to lose a loved one so close but remember he will ALWAYS live in your Heart and the Hearts of All who loved him and all he loved... Do your best to remember to keep his love alive in you and he will live forever in your soul.... Thats what he would want from a loving daughter as you.... You both are indeed Blessed...

mike

Thank you Dr. Gorman for your condolences. I am doing my best.

I have gained much knowledge from this web site, however it will not allow me to ask questions concerning the dosage of 1000mg oral Prednisone.

Methylprednisolone and prednisone. According to Epocrates, it appears to me there is a difference.

Are the dosages equivalent?

Kay Birkla

2 Different drugs 2 different dosages.... Your 1000mg dose is prednisone not methylprednisolone which comes in dose paks with tapered dosing built in and is not used for neuroma and MS... I suspect your Dad may have had Perhaps a Guillian-Barre' syndrome ?

mike

I am not sure what the advice on people needing less drugs is about unless in an emergency, it can all be cured and helped with diet and lifestyle, but isn't that a bit irresponsible being a dr.? Don't get me wrong, I too believe that meds are over prescribed in many cases, but I have a combination of illnesses and meds I take for them. And granted I did not read this entire site post, so I may have missed something and if I did I apologize, but it is exactly things like the net (and posts like that) that mislead people into thinking and acting very dangerously.

If I were one of them I might take what you said and suddenly stop all my meds and just go it alone to see what happens. Luckily I AM an informed and educated person when it comes to my health, my conditions and my meds and know if I did that... I would die.

Rheumatoid Arthritis for 10 years, Polycystic Ovarian, Trigeminal Neuralgia (without the meds for that, I would have prolly done myself in just trying to escape the pain) asthma, and not the least of which I was recently diagnosed a year ago with Addison's Disease.

So in your best advice which of these do you figure I could control with a simple lifestlye change and how? And how would you advise one to stop these medicines? Just curious.

I was ONLY speaking in a General Sense in regards to the OVER use of medications... Doctors AND patients INSISTING on more additions to the medication list without a review of the medications that are absolultely Necessary... Review's that provide Insight into drug Interactions and dangerous effects of polypharmacy...

After a careful review of my comments your quoting at the top of the page I am hard pressed to find the Word ALL .... Please Re-read my passage and take the responsibility to assertain the Quality Information you have acsess to on the internet and use sites that provide Statistic Peer reviewed information such as Emedicine, Epocrates and Up to Date... Most Physicians CONTINUE to practice as they did when they finished their residency and fail to keep up with or Change the style .... Its not blame seeding as the demands of Medicine are ENORMOUS and take Significant toll on the physicians OWN health and Psyche' ....

Dr. Gorman,

I appreciate this service and again I thank you for your time.

I have researched Guillian-Barre' syndrome and PERHAPS , but most likely this was not an issue.

Medical experts hired through med mal attorneys will only go as far as saying high dose steroids are considered standard care for treatment of Optic Neuritis. Over and over again I read where high dose oral Prednisone is considered somewhere betweeen 60-100mg per day. I can not find evidence where 1000mg ORAL Prednisone is standard care for anything.

It appears ophthalmology has quirky standards .PERHAPS it worked one time and now it is considered standard care so don't question it.

What nags me is the FACT the a RN from the ER where my dad was treated came to the funeral home and told me and another family member the dosage of 1000mg oral Prednisone was wrong.

I pray this never happens to another family.

Kay Birkla

OK as I said I may have missed something previous that the comments referred to. I agree with you 100% on the mis use on both Dr and Patient sides of medicine. I apologize if I offended you, that was not my intent, I was just not clear on your point.

I think the internet has become both a positive and detrimental tool in the medical world. It certainly is a great tool to find information and research things that are of interest to ones health. However, many people are self diagnosing because if the internet as well and that has become dangerous and must make you job as a Dr. VERY difficult at times.

Well if you look up the dosage on the sites I posted for you the dosages are correct at 1000mg X 12 doses ... Thats the information I found ... I just don't know what caused his death as people just do not die from optic neuritis alone... He must have had another problem with it... I know that the malpractice lawyers MUST be on top of it as they smell money like a shark senses blood in the water....

Please feel free to provide me with MORE information and I'll help all I can for you ....

All the Best,

Mike

Dr.Gorman,

The prescription was 1000mg oral Prednisone (50 pills per day.) Not methylprednisolone 250mgQ6hoursx12.

2 different drugs 2 different dosages. Is that correct?

KB

YOUR not reading it right .... 1000mg of prednisone IS correct as mentioned as methylprednisolone is a MUCH stronger steroid and the dose is lower... Please examine your statement again WITH CARE and my response .... The answer you seek is there as long as your ASKING the proper question... All the Best...

my bad ... the standard of care that I listed is correct... I just think that they may be referring to the generic term prednisone... In order to know for sure is to see the order sheet and determine the dose of WHICH drug... You can use PREDNISONE in many ways for many things and there seems to be NO max Dose.. check this link carefully and let me know what you think, http://noairtogo.tripod.com/prednisone.htm#Dosage

Dr. Gorman.

The order sheet read Prednisone 1000mgx14. In fact the pharmacy could not fill this order on first visit.

The link you suggested I have been to before. MANY times, at your suggestion I carefully re-read it again.

I have no medical background. ZERO!!
Alot of what I read is foreign but I alot I do understand.
My research leads me to believe that optic neuritis is basically a condition without treatment and that in general that's how steroids are used.

A terribe mistake happened. This dosage was wrong. The 1000mg should have beeen IV or else it should have read 100mg oral.

I agree, there seems to be NO max dosage so HOW can Medical Malpractice Attorneys react.

KB

Optic Neuritis can and is treated with steroids but Methyl no plain prednisone... IF THEY MADE THE DIAGNOSES correct as they might not have it for sure ... The real problem is that steroids have no MAX dose and our own bodies can make it in HUGE amounts, far more than the 1000mg your Daddy was getting and therefore wherein the Quandry lies... I wish I knew more but people just don't die from optic neuritis or 1000mg of prednisone... All the Best... ask away I wiil keep trying to help...

Mike

Often I have questioned the diagnosis of optic neuritis. I realize anyone can suffer but dad just did not fit the mold. For one, there was no pain or discomfort involved and MS was later ruled out. An MRI was ran, twice, but no CT scan. Had there been perhaps I would not be sitting here and dad would be on a golf course somewhere. Also, I read optic neuritis listed as a possible adverse side effect of prednisone so I do not understand why it is considered standard treatment. It really doesn't matter anymore, just curious.

KB

Well a CT is WAY less sensitive than an MRI ... Its so sad that you have no answers and as I know MYSELF its very frustrating .... But for me to consider that I should know everything and should be able to heal ALL, would be EXTREMLY Egotistical and Godlike .... That which I am not... Every day I realize just how humbling an experience it is... All I can do is, "cure sometimes, relieve often, & comfort always," a quote from the 1800's Dr Trudeau... All the best blessings Kay...

mike

Dr. Gorman,

I don't want you to sign off here without me getting the last word, and that is to say "Thank You", for your time and knowledge. I can just hear my dad asking, "Well, did you thank the man for helping ya out some?"
If that sounds hillbilly, well thats because we have lived our entire lives right here in the hills of southern Indiana.

And when I said it didn't matter anymore, that was a lie. It will always matter and I will continue on to the best of my ability with research and questions.

Your kindness has been a blessing.

KB