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Dexamethasone/Meningioma - Osteonecrosis

Dr. Joshua,

I hope all is well with you. I want to ask you something. I was diagnosed with a meningioma after a gran mal seizure in March of 2006. I was in the hospital for 5 days because I was still having seizures and my neurosurgeon was trying to get my seizures under control. Now in the meantime I was put on Decadron/Dexamethasone 4mg 3x a day. Within 2 weeks I started having a significant amount of pain in my joints. I would wake up crying it would hurt so bad. My doc put my surgery off for 1 more month due to insurance reasons so unfortunately I had to continue taking it for an extended amount of time. So within 1 1/2 months I would have the most excruciating pain in my bones. It would happen in "episodes". In total I was on the decadron for 2 months 6 days. I tapered off with the prednizone pack. However at the last day, my eyes hemorraged and the Opthamologist had never seen anything like it, and the only thing to link it to was the possibility of tapering off the decadron too fast.

I had to learn how to use my left leg again after my crainiotomy. During my course of treatment on Decadron my ankles and knees were constantly swollen with fluid (paticuarly the left).

I lost a tremendous amount of muscle in that leg as well.
I developed Cushings
Lost my periods
Grew Hair on my face
Steroid Acne on Chest, Shoulders
Massive Weight Gain, and now stretch marks on Arms, Sides, and back.
Lots of side effects

The main problem is my bones now. I have developed Steroid - Induced Osteo Necrosis in the following joints which were definitively diagnosed with MRI's this past month.
Both Ankles, Knees, Hips, and Elbows.

2 Questions and maybe I can settle my mind

1. Have you ever heard of patients having problems with their eyes after tapering too fast off Decadron?

2. I don't see too many cases found on the links between steroids and necrosis and the proof that it is caused by very short term usage. Is it possible for cases such as mine to be entered into Medical Literature for other doctors to read and consider so that they are aware of the consequences of prescribing such a strong medication.

I only took this medication for 2 months and I am now facing orthopedic surgery in March. I am too the point that walking is almost impossible and I am very healthy 28 year old female (even after brain surgery :-)

10 months brain tumor free, full resection and benign! I am very thankful. I thank you for any words of thought on these 2 questions.

Answers:


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