Steroidne injekcije

    I started losing my sense of smell again in February, and by April I was anosmic again. I did get it back, partially and intermittently, for about ten days after I used a Nasacort inhaler from my stash (they no longer sell them), and then I became anosmic again. On the 16 th of June, 2004, I got another Kenalog injection, on the left side, in preparation for my trip to Austin, Texas, to visit my daughter Lotus. The Kenalog effected a restoration of my sense of smell more rapidly than usual this time. The very next day the grocery store was a scent carnival -- every few steps brought a new, intense odor (most pleasant, some not). Walking through my garden I brushed against the dill plants and the scent was delightfully intense. As I weeded my flower beds the next day I could smell the marigolds and several of the weeds I pulled. The Datura was stinky and the rosemary delightful. Getting one's sense of smell back after a period of anosmia is a real trip! My Seventh Kenalog Injection, June, 2005     Having been congested for a good while, I went in to see my doc on the 27 th of June, 2005.  He scoped my nose, found no polyps there, and ordered a Kenalog injection for me so I should be able to enjoy my July vacation.  He advised me that we can also try, once the Kenalog has worn off, Astelin , an antihistamine nasal spray which is prescribed for vasomotor rhinitis (including nasal congestion). June, 2007     My sense of smell is still good, two years after my last Kenalog injection.  I have been stuffy, but not anosmic.  I am using Astelin now during the pollen season.  It seems to help a bit, but I am still more congested than I'd like to be. The Down Side of Steroid Use     Although I have observed no undesirable side effects of my Kenalog injections, it is well known that there is a long list of such possible side effects, contraindications, and complications. One correspondent reported to me that he had suffered tissue loss at the site of the injection. Apparently he had successive injections in the same site. My nurse rotates the site of injection to reduce that possibility. Some physicians are reluctant to use steroid therapy, others not. Another of my correspondents, who is a practicing physician, wrote to me " The role of steroids in treatment of all types of respiratory inflammatory problems has really changed over the past 5-10 years with much earlier initiation and better/quicker resolution. There does not seem to be much long term down side to the use of a short course of systemic steroids."

By using a high frequency ultrasound probe the wrist is imaged by placing the probe transverse across dorsiflexed wrist. The median nerve and ulnar artery is identified. At the level of the distal wrist crease, the needle is passed into the skin superficial to the ulnar artery, penetrating the flexor retinaculum. The needle is advanced toward the median nerve. The steroid solution is injected just under the flexor retinaculum then retracted and redirected deeper to the ulnar side of the median nerve. This allows the median nerve to be completely surrounded with the steroid solution. [ 3 ]

Although soft tissue (fat) atrophy and local depigmentation are possible with any steroid preparation injected into soft tissue, the risk can be modulated by using a corticosteroid agent with appropriate solubility. A less soluble agent such as triamcinolone acetonide or hexacetonide is preferred for intra-articular injections of deep structures, such as the knee, elbow, or shoulder. A more soluble agent, such as betamethasone sodium phosphate and acetate or dexamethasone sodium phosphate, is preferred for soft tissue injections of bursae, tendon sheaths, metacarpophalangeal joints, proximal phalangeal joints, and the carpal tunnel.

Steroidne injekcije

steroidne injekcije

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