Dexamethasone

[sbp111]

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In my area there is a severe shortage of kenalog and depo medrol. Any remaining stock is at least twice as expensive as before. I currently use dexamethasone for TFESI and kenalog for interlaminar and joints. Any experience using dex for interlaminar and joints? I’ve always been taught It does not work as well or last as long, but I have seen studies that supported use. Just curious about your real world experience.

 

[hyperalgesia]

Oh god here we go lol

 

[au bon pain]

Traumeel

\end thread

 

[Ducttape]

yup. end of thread as we have gone off the deep end again.

fwiw, do not use traumeel in a medicare patient.

 

[sbp111]

What about Celestone soluspan? That is available but I’ve never used it

 

[MitchLevi]

Dex shouldn’t be billable for a joint imo, worthless.


Celestone in a joint is better

 

[mille125]

Dex shouldn’t be billable for a joint imo, worthless.


Celestone in a joint is better

Agree....celestone is better than dex by a mile

 

[powermd]

 

[au bon pain]

Traumeel

\end thread

yup. end of thread as we have gone off the deep end again.

fwiw, do not use traumeel in a medicare patient.


View attachment 425753

I just realized I didn’t put traumeel in the appropriate color. Will fix now

To be clear to any fellows that may be reading this: don’t use traumeel. Ever.

 

[clubdeac]

I just realized I didn’t put traumeel in the appropriate color. Will fix now

To be clear to any fellows that may be reading this: don’t use traumeel. Ever.

I forget, what again is traumeel exactly

 

[MitchLevi]

I’ve never heard of that

 

[mille125]

I’ve never heard of that

Me neither

 

[nvrsumr]

Plenty of success with dex for joints. Anecdotes cancel. make your own decision.

 

[mille125]

Plenty of success with dex for joints. Anecdotes cancel. make your own decision.

Glad to hear that. Definitely not my experience. I used it for awhile when I ran out of depo and kenalog was not available. Lots of patients had little to no pain relief compared to previous for knee joints and hip bursitis.

 

[MitchLevi]

Plenty of success with dex for joints. Anecdotes cancel. make your own decision.

I believe you, unfortunately in my little corner of the world it does virtually nothing

 

[Dr. Ice]

Mine too..dex is trash all the way around

 

[clubdeac]

Dex sucks…I have plenty of patients who acted as their own controls. Received depo TFESI yr or two ago with months and months relief. Repeated this yr with dexa and 2-4 weeks max. I’ve seen this over and over

 

[MitchLevi]

Dex sucks…I have plenty of patients who acted as their own controls. Received depo TFESI yr or two ago with months and months relief. Repeated this yr with dexa and 2-4 weeks max. I’ve seen this over and over

Constantly with me. One of my spine surgeon partners does a right L4-5 TFESI and the pt gets 9M, I repeat with Dex and I’m lucky if I get 8W, usually 4-6W. I fail to understand why this is recommended, but it’s what I do bc my career is not worth it.

 

[mille125]

Constantly with me. One of my spine surgeon partners does a right L4-5 TFESI and the pt gets 9M, I repeat with Dex and I’m lucky if I get 8W, usually 4-6W. I fail to understand why this is recommended, but it’s what I do bc my career is not worth it.

agreed