Prednisone and Kenalog 40 mg. injection question

[Abikitty]

This week I went to my Orthopedic Surgeon for follow-up on a long standing right shoulder issue (DJD) and he recommended an injection of Kenalog (40mg). I contacted my Rhumy who confirmed going ahead with this procedure. Could this interfere with my taper, as I am presently doing very well and am at 3mg of my taper. Please advise if it does affect my taper and any information you might have on how I should/should not alter my present plan? I still have not received an answer from my Rhumy.

Thank you all, as always, for your incredible advice,

Carol

(GCA, diagnosed 6/24/2022)

[piglette]

Kenalog is a corticosteroid.

[Hidden]

Morning, this is a tricky one. Many yrs ago I had a Kenalog injection to help with my allergies, but of course no PMR in those days. If I were you I’d just risk it and continue as you’re. After all it’s extra steroid and not less, so shouldn’t interfere with your taper. (but I’m certainly no expert) Again, many yrs ago I had a steroid injection into my elbow for tennis elbow, it worked and pain never returned. You’ve done brilliantly to taper to 3mg. How long have you been taking Pred? Good luck with your shoulder.

[Abikitty in reply to Hidden]

I just wanted to thank everyone for your answers. I think I was over-stressing, thinking that introducing more steroids would fool my adrenals into not “sputtering” into their starting process, when dropping to 2mg in the next few weeks. I will keep everyone posted on how the “adventure” turns out.

[Hidden in reply to Abikitty]

They now may take a while longer to start producing the cortisol needed. But the very best of luck, I’ll be thinking of you. Currently I’m taking 6.5 most days introducing 6 on the other days. Slowly does it…..I’ve learnt that for sure !

[DorsetLady PMRGCAuk volunteer]

No need to do anything different with your normal taper, I had similar for my knee when still on oral Pred.

The injection is localised pain relief.

[Koalajane]

good to hear this as I am having one for my macular oedema and wondered how much it would affect things

[Hidden in reply to Koalajane]

Macular Oedema…..what’s that? Hubby gets his 5 weekly eye injection for macular degeneration

[Koalajane in reply to Hidden]

it is when there is swelling in the macular, I have been having Eylea drops every 8 weeks and having this as my consultant thinks it will help more as it is a steroid injection yo combat the inflammation

[Hidden in reply to Koalajane]

Wondering why the Pred hasn’t got rid of the inflammation. Strange how it works for PMR/GCA but not other things. Good luck

[Koalajane in reply to Hidden]

the steroid injection is around the eye, she was going to give me a steroid implant but I was concerned about it as it dissolves over 5 months and can be visible to the patient all the time.

She is doing it at the same time as she does my cataract surgery and promised to be gentle! The implant was supposed to have been done over a week ago but nobody had ordered it when I went so it wasn’t done!

[Hidden in reply to Koalajane]

Sounds awful. My husband has now got to have cataract surgery. We take him on 10 Feb. Clinic ‘phoned me this morning taking all his details. When we go it’s going to be a 2 hour consultation…..whatever is going to take that long. Have you had to do that too ?

[Koalajane in reply to Hidden]

I had my pre op assessment that certainly didn’t take that long.

Visual acuity first, measured my eyes with machine and checked euphemism pressure. Then looked at prescription I had taken, checked what meds I was on, did blood pressure. I hate that as I have white coat syndrome and checked my blood sugars as I am type 2 ( in remission). Then in to see doctor for a few mins about the operation and telling me I would have the implant 2 weeks before the cataract op. He said I would need reading glasses and that was it! Shame the appointment for the implant wasn’t made as I had to chase it up and then it wasn’t ordered. I was due to have the op this coming Monday but it was postponed due to the consultant who was doing it not being trained in injecting!

My pre op was on a Saturday and hardly anybody there so no waiting around so took about half an hour at the very most

[Hidden in reply to Koalajane]

Husband always has his MD injections he on a Saturday. A lot less busy clinics on a Sat. I feel so sorry for hubby, he has so much going on right now, he could do without more surgery. We’re hoping his second hip replacement surgery will be done at sometime this year…..just hoping his femur is healing well enough for it to be done. Unfortunately, his kidney function has dropped and hope that won’t prevent surgery. Seeing his kidney specialist soon. So many appts again. Hope you get on alright for what you have to go through.

[Koalajane in reply to Hidden]

thankyou and I hope you and your hubby have a better year than last year x

[Hidden in reply to Koalajane]

Thank you and so do I…… fourth year no holidays.

[PMRpro Ambassador in reply to Hidden]

Because AMD is a complicated disease process - it isn't just inflammation which the pred does help with but also blood vessels grow and that isn't stopped by the pred.

[Hidden in reply to PMRpro]

Understand now.

[PMRpro Ambassador]

It tapers itself over a period of a few weeks at most. It is only the same as it is for anyone else having an injection but your baseline is a bit higher. You might find it helps with a taper step at the time but as it wears off you haven't got as much of a cushion but it is minimal.

Used for a joint it doesn't affect the systemic level of pred very much. when it is administered as a deep intramuscular injection it can be used to manage PMR and it has a systemic effect that fades over a month.

[Solstice85]

Dear Abikitty,

This is a little out of my experience with the Kenalog, but I have had that shot in my knee. I wouldn't think it would interfere with the taper, but check with your rheumy to be safe. I hope everything works out for you. Always available , bless you.