Does anyone on steroids have a Blue card?

[Niao]

I read this

If you take prednisolone for more than 3 weeks, or you're on a high dose, you'll get a blue steroid card. Show this card to your doctor or dentist before any treatment, so they know you're taking prednisolone.

I asked the nurse at my Gps but she said the pharmacy were responsible for giving them, asked the pharmacy and they were clueless!

Also read this on BRS,

The Society for Endocrinology has produced guidance for management of patients with adrenal insufficiency who have COVID-19. This guidance applies to any patient who has been taking 5mg prednisolone or more for four weeks or longer, as this may cause adrenal insufficiency.

As noted in the British National Formulary, adrenal insufficiency due to steroid therapy can persist even after a patient has tapered their prednisolone dose below 5mg, so many rheumatology patients currently taking <5mg prednisolone are also at risk of adrenal insufficiency (see paper published in European Journal of Endocrinology).

Patients with adrenal insufficiency need to temporarily increase their steroid dose if they have any significant intercurrent infection. Patients with COVID-19 may have high fever or other systemic symptoms for many hours of the day. In COVID-19, therefore, the standard advice to double the prednisolone dose in the event of significant intercurrent illness may not be sufficient. This can be applied to rheumatology patients as follows

Patients on 5-15 mg prednisolone daily should take 10 mg prednisolone every 12 hours

Patients on oral prednisolone >15 mg should continue their usual dose but take it split into two equal doses of at least 10 mg every 12 hours

Patients with COVID-19 may have large insensible water losses, and should be advised to drink plenty of fluids especially if they may have adrenal insufficiency

Patients can be issued with the new NHS emergency steroid card which signposts healthcare providers to the latest guidance on management of adrenal crisis

I am not sure if it applies only to those with adrenal insufficiency, but it does suggest it applies to all on steroids because of the risk , and mentions the NHS emergency steroid card. Was just wondering if anyone had been told anything by their Rheumatologist?

[springcross]

I did have one when I was on it Niao - I was started on 7.5 mg reduced to 5 mg after a depo medrone shot and was given it by the rheumy nurse. xx

[Niao in reply to springcross]

Thank you, I'll the rheumy nurse on Thursday at my appointment. x

[workwell2 in reply to Niao]

pharmacist gives these out on repeat of your meds

[Niao in reply to workwell2]

Thank you. Supposedly so, but not mine! Hadn't a clue! I just had a Rheumatology appointment and asked but have just come away realising I didn't get an answer as we were sidetracked by something else! Not to worry, I,m going to ask in another pharmacy.

[KittyJ]

Never had one in the 25 years I was on it 🤷🏻‍♀️

[Niao in reply to KittyJ]

Thought that may be the case for many.

[Niao in reply to KittyJ]

I just reread your reply, 25 years, goodness! I hope you are doing well on whichever meds you're on now.

[KittyJ in reply to Niao]

Biologics enabled me to finallly come off pred but it took a couple of years to taper 😊

[Niao in reply to KittyJ]

I'm sure it did! Great you're getting on with biologics, am sure it can't have been an easy journey to get where you are now!?🙂

[allanah]

I just tell them I'm on steroids. And your rheumy will check you for side effects of steroids and hopefully not overload you to the extent they can harm you . It is very important however to follow advice about tapering off steroids to avoid adrenal insufficiency problems and let your body work properly again. However steroids are for me magic in rhrumatological treatment.

[Niao in reply to allanah]

You're right there, the remarkable affect I had when on the 20mg , starting 4 hours after the first dose, amazing! Now on 10mg, not so much. Will be down to 5mg next week ongoing.

[helixhelix]

I used to have one when I was taking steroids, but no longer take them. I have a list of all my drugs on my phone, and carry an alert card for biologics. Most doctors, particularly in A&E will know about this.

But generally I just tell people, and my OH obviously knows.

[Niao in reply to helixhelix]

Thank you. I will make sure I do this too.

[charisma]

Never had one. Just told other health professionals (dentist, physio, podiatrist) what drugs I was taking.

[Niao in reply to charisma]

Thank you. Yes, guess I was just overly worrying and thinking of worst case scenario, where I might not be able to tell them ,or was alone!

[Pinkypie2018]

The pharmacy provided my blue card for me when I'm on steroids.

[Niao in reply to Pinkypie2018]

Thank you, yes that's what I was told, asked today and they had no idea!

[Ruth12345]

I asked surgery about 3 years ago regarding carrying a card because I'm on steroids, they said that they don't do them anymore as there is no need. I wasn't sure that was the case but accepted that. Well 3 weeks ago I got a letter from gp practice explaining as I'm on prednisolone I need to carry a card at all times. I'm tapering and on a low amount. I found that very odd if not annoying. Decided to chill and accept. Put card in my purse.

[Niao in reply to Ruth12345]

Interesting! I'm not surprised! I wonder if it is to do with the new guidelines to Rheumatologists, that I put in my post, and the fact you have been on them long term?

[Lolabridge]

I was given a card when I started on Prednisolone and I carry it all the time. I have also put details of all my meds on my phone.

[Niao in reply to Lolabridge]

Thank you, yes I will do that too. Being new to steroids, just on my 5th week, I was quite ignorant to the fact that I may have to be on a lower dose for longer than I'd thought. I was also a little concerned as it was previously thought I could have Addison's disease, and was unaware of the whole risk of adrenal insufficiency even on the lower doses.

[happytulip]

Blue steroid alert cards are important. I had 15 years working in Emergency Medicine. If for some dreadful reason you turned up to an A&E department unconscious then a member of the team would look for any medical alert bracelets and then look in a purse/wallet for medical cards. These could contain blue steroid cards with the doseage on or anti-coagulation cards etc.

Many people also carry a business card sized list of their conditions. It can be immensely helpful.

If you did suffer the "getting hit by a bus scenario" and went without the steroids that your adrenal glands are so used to then you would be in a worse situation. But if the medics know that you are on pred, a shot of IV hydrocortisone could be a life-saving therapy to avoid an adrenal crisis on top of your unfortunate presentation to A&E.

All medical info helps when it's carried upon you and an In Case of Emergency number for Next of Kin is also helpful. As is your NHS number. Not necessarily your local hospital number, but your NHS number means they can look at any digital records very quickly.

It's a situation that no one wants to be in. But if you are in that situation that information can save a life.

[Niao in reply to happytulip]

Thank you, my thoughts entirely! It's all very well when you're able to tell someone your history/meds, but in a worst case scenario! I will definitely ask again.

[happytulip in reply to Niao]

Most pharmacists will give the blue cards out, you don't have to go to your regular one.

[Niao in reply to happytulip]

Thank you, I'll try another one. 🙂

[Ruth12345]

You may well be right. I alao have my meds on my fone.

[Niao in reply to Ruth12345]

Yep, I'm going to do this too after everyone's good advice.

[Lizard28]

My pharmacy gave me one when I was on them, I had to put the date and how much I was on.

[Niao in reply to Lizard28]

Thank you. I'm going to ask in another pharmacy, as happytulip advised.

[sebbydog]

And then be prepared for breaking bones!

[Niao in reply to sebbydog]

Yep, and a few other things too no doubt! Already worrying about that after being on omeprazole for many years!Hoping I won't have to be on them too long,ignorantly hadn't thought I would, but now realise that's not the case for many!

[DenMum]

HI. I was given a blue card a year ago. I was on Prednisolone for eight weeks while Methotrexate kicked in. And it says on the card to keep it for a year after stopping the steroid.

[DenMum in reply to DenMum]

Just to add The pharmacy at the hospital gave it to me

[Niao in reply to DenMum]

Thank you!

[Niao in reply to DenMum]

Thank you! That's very helpful. 🙂

[Niao in reply to DenMum]

Meant to say, thank you for telling me about keeping the card for a year after! As I just said in another reply, this is something people may not have been aware of if they didn't have a card, the need to inform of having been on a steroid even if it was a few months ago!

[Swimming20]

Hi ..l got a blue card when l was put on steroids about 18 months ago from my consultant and one for my biological Injections..ask again if l were you ..take care x

[Niao in reply to Swimming20]

🙂 I will, thank you. x

[sylvi]

I have a blue card and i got mine from the hospital.xxx

[Niao in reply to sylvi]

Thank you, will try there. x

[Joanneforbes]

I have blue cards always given from hospital pharmacy need carry it for 1 year just finished a 6 week reducing course ... x

[Niao in reply to Joanneforbes]

Thank you, yes quite a few have said the hospital pharmacy so I'll definitely ask. And it's good to know you need to carry it for the one year after, if you didn't have the card you may not know that you should still advise people that you had been on a course previously! Yes, I will get one!

[Hidden]

I’m currently on a 6 week course of oral steroids for the first time ever and got given a completed blue card by the hospital pharmacy who dispensed my steroids x

[Niao in reply to Hidden]

Thank you. Me too, first time! x

[helenlw7]

I’ve been on steroids for several years and am on my second blue card. It was given to me by the hospital.I now have adrenal insufficiency because I was unable to reduce my steroids to less than 7.5mg. I was given a leaflet by endocrinology which basically tells me to double my steroid dose if I’m ill enough to stay in bed. Incidentally my husband was given a blue card by our gp when he was put on a steroid inhaler.

[Niao in reply to helenlw7]

I'm really sorry to hear you now have adrenal insufficiency and are unable to reduce your dose. This is something that worries me, especially as I've had some investigations into my adrenal glands and suspected Addison's disease, thankfully it wasn't.I really hope you are on a regime that works and that everything is being managed as well as can be.

You are the first person who has said about being told to double the steroid dose, I expected to hear this from more, given what I had read.

I am going to ask again for my blue card, think it's sensible.

All the very best.

[kittypebbles]

Hi Naio - I have a blue card - have had many short/sometimes long courses of steroids for both RA and asthma. It was given to me by the Practice Nurse at an asthma review. XX

[Niao in reply to kittypebbles]

Thank you. I really can't understand why my pharmacy hadn't a clue what it was! I hope both your RA and asthma are under control at the moment and you're doing well. x

[kittypebbles in reply to Niao]

I know, I would have thought all professions involved in patient care would have at least heard of them, but maybe it's because most things are digital now. i'm still a bit old fashioned, I'm afraid. My RA is good just now thanks, asthma not so great, but also have some scarring in lungs due to a previous RA flare up. I hope you are well too and your RA is under control. Steroids are such a life saver at times! Take care. xx

[Niao in reply to kittypebbles]

You too, take very good care and I really hope you are able to find something to help more with the asthma. XX

[kittypebbles in reply to Niao]

Thank you. xx

[lifeboatann58]

Hya Niao . Yes I've got the Blue Card, plus was sent a letter and NHS Steroid Alert Card, got to keep it with me at all times. I've been on 40mg Predinstone tapering down to 20mg then staying on that until I get tests and the results, then maybe go onto some new meds, as had to come off my Methoraxate injections and Benepali. Starting back up in my Benepali next week though. I'm also on Alendronic Acid to help my Bones. Hope that helps. ☺️

[Niao in reply to lifeboatann58]

It certainly does, thank you!

You're the first to mention the Steroid Alert Card, I was surprised no one else had! You are on a quite a high dose so it certainly makes sense you should have one.

Sounds like you've had a tough old time?! I really hope things get a bit easier!

🙂

[Niao in reply to lifeboatann58]

Goodness. Just looked at your previous posts, you have been going through it!

How are you now?

I am going to have to be more on the ball now, as having had Fibromyalgia for more years than I care to imagine I am always putting any strange pain down to that, will not be doing that anymore!

[lifeboatann58 in reply to Niao]

Trying to stay positive. Just hope to get these tests done quickly so I can get the results. Xx

[Niao in reply to lifeboatann58]

🤞keep us posted. Xxx

[Mmrr]

I've been on prednisolone for approaching 3 years. My pharmacist provides a blue 'steroid treatment ' card with each new prescription I receive, which I complete myself if I have a change of dosage.

[Niao in reply to Mmrr]

Thank you. Yes that was what I was expecting to happen but our pharmacy looked at my OH like he had 2 heads when he asked on my behalf, hadn't a clue!

[lucymead]

Go to your local Chemist they have the cards in stock. You do have to ask for most things nowadays Drs and other medics presume we have been given them.

[Niao in reply to lucymead]

Thank you. Yep, you would think they would have them but ours had no idea what they were! Will try elsewhere.

[Plumcrumble]

Yes, my doctors pharmacist told me every time you receive a prescription for steroids you get a blue card, even if your on them long term, getting quite a collection now 😁

[Niao in reply to Plumcrumble]

Thank you.What a cuty! Doggy I mean! I'm sure you do have quite the collection, seeing from your previous post, 40 years now is it? That's tough going for sure ,but you must have a wealth of information to share! I wish, of course, you hadn't had to suffer to get it!

I hope things are under control for you at present. All the best. xx

[Plumcrumble in reply to Niao]

Aw thanks, he's a very naughty pug 😁 yes it's 40yrs with lots of experiencessome good some bad, but yes my first steroid card was in 1981 but they've only just started to give then out again thank goodness 😂 best wishes Sarah

[Niao in reply to Plumcrumble]

He is adorable! I want him!I totally admire you, going through all that , and at such a young age, and coming out the other side smiling, and now doing all you can to help and cheer up others who are struggling with your posts/replies well done you!

As I have said before on this group, I think people like yourself are invaluable and should be celebrated!

[Plumcrumble in reply to Niao]

Thanks so much, I know it's hard but keeping positive has kept me going through other things aswell lymphoma being the biggest 7yrs ago, I do think the mind plays a big part in getting better, wishing you well Sarah

[Niao in reply to Plumcrumble]

🙂

[EricaN]

No, never even heard of it.

[Niao in reply to EricaN]

Nobody told me either, I just read about it.It is a card you can carry, advising you are on steroids and, I think the dose you're on, like a medical alert card type card.