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PeaceGirl32

Prednisone and Valtrex for first OB??

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After so much reading on this site, I am very confused by the treatment I received from my doctor.

Here are the facts:

Symptoms =

-sores in genital area (3, he said)

-extreme sciatic pain that began prior to the sores and remained

Treatment =

-Prednisone 50mg 1x/day for 5 days

-Valtrex 1000mg 2x/day for 7 days

Results =

-Sciatic pain decreased completely while on Prednisone, but came back.

-Sores healed

My fear is that the Prednisone could have rendered the Valtrex ineffective, hence the continued sciatic pain possibly indicating continued infection?

My doctor did mention Shingles as something to rule out, which could explain the Prednisone. I'm still waiting for the swab results to find out my exact diagnosis.

Has anyone else been given Prednisone to assist with other symptoms during OBs?

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After so much reading on this site, I am very confused by the treatment I received from my doctor.

Here are the facts:

Symptoms =

-sores in genital area (3, he said)

-extreme sciatic pain that began prior to the sores and remained

Treatment =

-Prednisone 50mg 1x/day for 5 days

-Valtrex 1000mg 2x/day for 7 days

Results =

-Sciatic pain decreased completely while on Prednisone, but came back.

-Sores healed

My fear is that the Prednisone could have rendered the Valtrex ineffective, hence the continued sciatic pain possibly indicating continued infection?

My doctor did mention Shingles as something to rule out, which could explain the Prednisone. I'm still waiting for the swab results to find out my exact diagnosis.

Has anyone else been given Prednisone to assist with other symptoms during OBs?

Prednisone and other steroids are actually contraindicated in the treatment of Herpes simplex. They can make things worse. I would not necessarily say the Prednisone "rendered the Valtrex ineffective." I would just say that the steroid would either have no effect or, possibly, made your Herpes outbreak worse.

Steroids do not cure anything. They only suppress and mask symptoms. That is likely why your sciatic pain was not noticed while you took the Pred.

I'm not sure what you mean about "sciatic pain possibly indicating continued infection."

Regardless of what meds the docs give you, if you do have herpes, you have herpes for life. You will always have the infection once you get it, unless medical science comes up with a cure in the future.

What tests did that doc perform to check for Herpes simplex?

:wavey:

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Something positive: OB did not get worse while on Prednisone.

As for my concern about making the valtrex ineffective, I guess my question is how an anti-viral medication is supposed to work when steroids can suppress the immune system. A question to ask my doctor next week.

My comment about the sciatic pain indicating continued infection is due to the fact that, while this is my first outbreak of sores, I have had sciatic pain in the past with skin irritation. From my research, I have learned that sciatic pain can be caused by infection. Due to the continued pain, I am concerned about another possible OB now that I am done with the valtrex. I am most definitely aware that, if this is in fact herpes, it is with me for life.

My doctor did a swab of the sores to test and I should find out the results this week.

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Something positive: OB did not get worse while on Prednisone.

As for my concern about making the valtrex ineffective, I guess my question is how an anti-viral medication is supposed to work when steroids can suppress the immune system. A question to ask my doctor next week.

Ahhhh...now I understand what you were getting at. I would be very interested in your doctor's answer to that question, as you make an excellent point about steroids potentially interfering with the immune response.

My comment about the sciatic pain indicating continued infection is due to the fact that, while this is my first outbreak of sores, I have had sciatic pain in the past with skin irritation. From my research, I have learned that sciatic pain can be caused by infection. Due to the continued pain, I am concerned about another possible OB now that I am done with the valtrex.

Oh, okay, got it!

Your situation is probably going to be a bit unclear. How can you tell whether sciatic discomfort is related to prodrome or whether it is just your normal sciatic nerve issues? I know of no way.

Since you (may be) new to HSV, you could potentially have another outbreak soon after your primary. Those who do experience recurrences, seem to have greater frequency in the first year or so. Unfortunately, you'll just have to wait and see how that goes for you. There is no way to predict it. Worrying definitely doesn't help, since unmitigated stress is a known trigger for outbreaks.

I am most definitely aware that, if this is in fact herpes, it is with me for life.

Okay, good. Your wording in the previous post made it unclear to me.

My doctor did a swab of the sores to test and I should find out the results this week.

Did the doctor order the lab to "type" your sample? If you are not sure, you might want to call and request he add that, if it was not already done.

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My doctor did mention Shingles as something to rule out, which could explain the Prednisone. I'm still waiting for the swab results to find out my exact diagnosis.

You know, it is interesting that some of the literature mentions using corticosteroids in combo with antiviral meds when treating neuralgia associated with herpes zoster (shingles). What I've read says it can give "modest" pain relief.

Odd, since the same articles often state something to this effect: "Chronic corticosteroid use, chemotherapy and radiation therapy may increase the risk of developing herpes zoster."

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Quick update: results are back and it is definitely HSV2.

Prednisone was an effort to help with the sciatic pain and the off chance that it was shingles, but it is not part of my new prescription of Valtrex to be filled the moment I suspect an OB.

So, now it's time to continue putting my plans into action of how to change my lifestyle, get more exercise, take supplements, etc. etc. (pretty sure I would be continuing regardless - good wake-up call!)

Life goes on and, I can't say it enough, this site and those of you responding have been such a great help!!!

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