By Julie Stachowiak, Ph.D., About.com Guide
Updated March 10, 2010
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When I was going through my Solu-Medrol treatments, I found remarkably little information besides the usual all-inclusive list of side effects. Therefore, I have compiled this list of tips from my own experiences and from seeing others go through their Solu-Medrol journeys, with the hope that I could give you a chance to make your experience as comfortable as possible.
I should also add that many of the side effects mentioned last through the “taper” treatment with oral prednisone (usually lasting 6 days, using a Medrol Dose Pack), so don’t panic if you are still feeling “off” after your infusions end. All should be pretty much back to normal a week or so after you are off corticosteroids altogether.
Before Infusion Starts
Be Well-Hydrated: Drink lots of fluids before you go for your infusion. Being well-hydrated makes your veins larger and easier to find, which makes insertion of the IV line a breeze.
Protect Your Gut: Solu-Medrol causes gastritis and heartburn if administered on an empty stomach. It is wise to eat a large meal before your treatment. Treat yourself to your favorite foods and fill up -– food will taste strange for a couple hours after your treatment, anyway. Make sure that you take a Zantac an hour or two before getting your infusion.
Request Paper Tape: Ask that paper tape be used to secure the IV line, at least on the first layer next to the skin, which can then be covered with standard tape or a bandage for protection. Solu-Medrol makes your skin very fragile, especially around the area where the IV line is inserted. Paper tape will come off much easier when it is time to remove the IV.
Choose Your Hand: Decide ahead of time which hand you prefer be used for the IV. The line may be kept in place for up to five days, and I find that it can be annoying to have it in the hand that you use for holding a book or using a computer mouse. Of course, the placement may be decided for you when the nurse looks for an “easy” vein to use, but you can state your preferences.
During Infusion
Have Mints Handy: During the infusion, you might experience a metallic taste in your mouth. It is helpful to have strong mints or gum to use, as water doesn’t help and other beverages or foods taste terrible.
Try to Relax: Bring your iPod or Walkman with music or a book on tape to listen to during the infusion. Books and magazines are also good, but there is always a chance that the IV line will make these awkward to handle, plus I like closing my eyes to avoid staring up into the inevitable fluorescent lights. Try some deep breathing exercises –- count each breath up to ten, then count back down to one. I have fallen asleep this way during an infusion.
Slow Down: If your face starts feeling hot or if your heart starts beating fast, ask the nurse to slow down the rate at which the medicine is being infused.
Flush With Saline: Make sure that the nurse flushes your line with saline after each infusion. Some nurses may scoff at this, but I have noticed a huge difference in the number of infusions I can use each line for and also a decrease in the bruising and thinning of the skin in that arm.
Following Infusion
Eat Comfort Food: As mentioned, food will taste strange for a couple hours after treatment, so bland is good. However, you will want to avoid anything greasy, as this could aggravate heartburn. Also, limit sweets and things with high sugar content, as Solu-Medrol will increase blood sugar levels. (If you are diabetic, get specific instructions from your nurse or doctor on monitoring and regulating your blood sugar during treatment and the day after.)
Avoid Salty Foods: Solu-Medrol causes water retention. This can lead to feeling bloated all over, as well as to swollen feet and ankles. Avoid salty foods and drink lots of water to minimize this effect, which should disappear within a week of the last treatment.
Be Quiet: Solu-Medrol makes most people feel anxious and agitated. During this time, it is best to stay home and be calm and quiet. Do not try to go to work –- you will not be productive and your interactions with your co-workers may come back to haunt you.
Don’t Drive: You may have a hard time concentrating, may be nervous, or your perception may be “off.” Even if you think it will be okay to drive, it is a good idea to have someone drive you home after each infusion. Leave the worries about traffic and the quick decision-making needed for driving to someone else.
Troubleshoot Insomnia: Solu-Medrol causes insomnia, which some people call a “welcome” side effect, as they end up cleaning house, balancing checkbooks and answering e-mails. However, you need your rest during this time –- this treatment is putting a huge strain on your body. Try different techniques to help you sleep, but don’t hesitate to ask your doctor for medicine for this purpose.
Other Tips
Use Herbs with Caution: Solu-Medrol side effects may be exacerbated by some herbs, including aloe, Asian ginseng, bayberry and licorice.
Protect Your IV Line: If you need an MRI during this time, do not allow the MRI technicians to use your IV line to administer the gadolinium. While this saves them time, the gadolinium is caustic and could cause your vein to collapse, meaning the IV line will have to be reinserted for your next Solu-Medrol treatment.
Avoid Infections: Steroids greatly reduce your immune system’s ability to fight infection. Avoid any contact with people who have symptoms of colds or other viruses. If you have not had chickenpox, it is extremely important to avoid people with chickenpox or shingles. If you had chickenpox in the past, you will be more vulnerable during your treatment to developing shingles. Notify your doctor immediately if you develop a fever, chills, respiratory symptoms or a rash.
Avoid Vaccinations: It is a good idea to avoid all vaccinations during this time. It is especially important to avoid getting the smallpox vaccine (this probably won’t inconvenience anyone too much). I would also not get the flu shot right now, but you should especially avoid Flu-Mist, the flu vaccine that is administered as a nasal spray, as that is a live vaccine. (Actually, as a person with MS, you should really never get Flu-Mist.)
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