Still strongly considering meds

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Beth
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Still strongly considering meds

Post by Beth »

Hi everyone,

I've done the reading on taking prednisone and/or entocort while breastfeeding, and it seems like a fairly benign thing to do, especially with the entocort. Since breastfeeding is so important and my daughter throws up formula, I'm going to try to keep going with the meds. In my opinion, it's worse to give formula than it is to take these meds and pass a little on to my daughter. I was at 40 mg of prednisone for about a week, but with the terrible headaches I went back down to 30 mg last weekend, and yesterday the D and cramping promptly started right back up. I'm going to work on my diet and just do the chicken/squash/potato thing. But I am not willing to do this only via diet right now. It's too hard with trying to get enough nutrients and calories while nursing. Plus, it's too hard emotionally.

I contacted my GI yesterday, and he wants to do a colonoscopy to see what's going on with the inflammation. He also said it's fine to stop the prednisone at 30 mg and start the entocort, 2/day. I always thought you had to taper down more slowly on the prednisone. What have others done? I'm concerned the headaches might get even worse if I just stop.

Also, regarding the mast cell issue you mentioned, Tex. I did have the LEAP testing done, and it wasn't helpful for me at all. I haven't tried an antihistamine because benadryl and other otc meds like it make me incredibly jittery, to the point that I can't sleep and feel like I can't breathe. Are there other antihistamines I might try that don't have that same effect? Is claritin supposed to be better in this department?

This is making me want to get pregnant again - and just stay pregnant! "~

Thanks,
Elizabeth
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tex
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Post by tex »

Hi Elizabeth,

I agree with you that as long as you keep the dosage within reasonable limits you probably won't be exposing your baby to any significant risks, especially if you allow at least 3 or 4 hours after taking your dose, before nursing. As far as I am aware, your doctor is correct about substituting Entocort for prednisone. Unless you have been taking prednisone for at least a month or more, stopping it and substituting Entocort EC shouldn't cause any withdrawal symptoms or any other problems.

If I recall correctly, 40 mg of prednisone is roughly equivalent to 9 mg of budesonide, so 6 mg of budesonide should be close enough to 30 mg of prednisone for all practical purposes. (I'm not certain about that conversion rate, but I believe it's somewhere in that neighborhood — Joe did the math and figured it out and posted about it sometime last spring, as best I can recall).

You are apparently allergic to something in Benadryl, because the normal effect on most people is to make them drowsy. Some people take it as a sleep aid, rather than taking a "sleeping pill". Various types of antihistamines are based on different active ingredients. Benedryl is an "old" antihistamine. The newer antihistamines are less likely to cause drowsiness for most people.

Personally, Claritin doesn't do much to restrict my allergy symptoms, so I take Allegra. They are both relatively recent meds, compared with Benedryl. Benedryl has 22 inactive ingredients, which makes it much more likely to cause an allergic reaction for some people. Allegra has far fewer inert ingredients, (10), and Claritin has the fewest (8).

I checked and found that most antihistamines are transmitted in milk, at levels approximately equal to blood levels. Whether or not that could have any adverse effect on an infant's health, I have no idea.

Tex
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It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
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Beth
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Post by Beth »

Thanks, Tex! I've been taking prednisone for 3.5 weeks, so I'll switch over to entocort tomorrow, hopefully without any ramifications. I think I'll start at 9 mg because 40 mg of prednisone is what was working for me, and 30 isn't doing a thing.

The diphenhydramine that's in benadryl and tylenol pm acts as a stimulant on my nervous system, and I just read that Allegra D and Claritin both have pseudoephedrine, which also makes me very jittery. I'm disappointed because I would love to try this out! But I'll see what kind of luck I can get with the entocort.

Thanks again,
Elizabeth
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Post by JenniferS »

Oh, Elizabeth, what a challenge! I didn't gain as much weight as the doctors thought I should when I was pregnant (fifteen years ago), and I remember being so worried my daughter would not come out healthy. She did. :) But I can imagine how you must feel battling mc and trying to grow a healthy baby to term. It sounds like you have a great doctor. What a blessing!
jmayk8
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Post by jmayk8 »

Beth,
Are you still seeing Dr Hamilton as your GI? If he does your colonoscopy, he is super smart in the mast cell dept so I am sure he will look to see if you have an abundance.
Good luck with the med change, hopefully you'll start to feel better soon!
Jenny
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Beth
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Post by Beth »

Yes, Jenny, I'm still seeing Dr. Hamilton. But after looking at what's involved with the prep for the colonoscopy, I've decided to wait. There's no way I can do all of that with a newborn while I'm trying to pump (which I've been doing exclusively because of some complications with nursing) and trying to reteach my daughter to nurse. So, I guess I'll just try the entocort and see what happens. Thanks for the good wishes!
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Gloria
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Post by Gloria »

Beth,
My daughter used an artificial nipple until her son learned to nurse. I suggested it to a teacher at my school and his wife was finally able to nurse their daughter. Eventually, they stop needing the artificial nipple. The nipple is available at Baby's R Us and other places. Good luck! It can be frustrating to nurse at first, but you seem very determined to do it. It sounds like she nursed well before, so I'm sure she will again.

Gloria
You never know what you can do until you have to do it.
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