Dear XXXXXXX

Thanks for your concerns. The notable issue is that your wife was on a very high burst (dose) of steroids to help with her MS flare, and most of the side effects that you are mentioning can be seen due to steroids themselves; if you read the original descriptions of Cushing's disease (patients with exaggerated endogenous production of steroids) or the way that cortisone was discovered and started on patients with RA here at the Mayo Clinic you can identify those common symptoms: bruising, insomnia, euphoria, abnormal deposition of fat and so on; less likely but still a possibility that it was the other gastric preventive medication given.

Hope this brings some insight, wish you the best,

Dr Brenes-Salazar MD
Mayo Clinic

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thanks for the follow up XXXXXXX usually, acute steroid toxicity tends to gradually resolve in 2-4 weeks after the big burst; you have a goid observation, no taper or wind down was done; usually we dont if we provide steroids continuosly for less than 9 days; after that the risk of adrenal insufficiency increases.

so, all in all, side effects from steroids should gradually improve within weeks once high doses have been discontinued

hope this is helpful yours truly

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dear XXXXXXX

those doses are high but standard for flares of conditions such as ms, lupus and others. yes, those side effects should get better within 1-2 weeks of discontinuation of the medication; nevertheless, all discharged patients from a hospital should have a close follow up appointment; if they gave you one in more than 2 weeks its probably too much and i would call to arrange for a sooner visit. In case that they did not schedule a follow up appointment, she needs one

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