I have a Rheumatology card where you can actually ring in if you're having trouble with your RA and there's an injection clinic, where you just can turn up on a Friday, you know they can just book you in there, there's no waiting for it, so you know what I mean, if you have joints which are regularly troublesome you can pop in and they can put a cortisone in or whatever. So they're pretty good.
So do you feel quite involved in the management of your RA?
I do feel yeah now definitely. Yeah, especially with finishing work it's made it a lot better, mana, sort of managing it really. I feel a lot more comfortable with it, before that I couldn't come to terms with it at all really.
Do you like I was going to say, the fact that you can just ring up and sort of take a bit of control yourself?
Yeah it does help you really, especially if you're having trouble with a joint like, as I said me two shoulders, me shoulders were bad and I was having a lot of problems even just cleaning me teeth, brushing me hair, just trying to move me hands round the back there, you had to try and shift them, it was, it's weird like trying to explain to people like right, it's just sort of day to day stuff and you just, the pain is incredible, so to pick a phone up and to just explain to them down the phone and they say 'Right not a problem like right, come in on Friday such a time like right and we'll put some cortisone in them'. Put some cortisone in and two days later you feel super human again like basically. Yes, it's pretty good.
Researchers also looked at how much patients were bothered by a combination of MS symptoms and AEs before, during, and after treatment. What they found was that the combined effect of symptoms and side effects was not substantially different between baseline and one week after treatment. This suggests that one week after treatment, the benefit gained from a decrease in MS symptoms was neutralized somewhat by the increased burden of adverse events related to treatment. Interestingly, the combined burden was the lowest on Day Two of IVMP treatment.
As a glucocorticoid , the lipophilic structure of prednisolone allows for easy passage through the cell membrane where it then binds to its respective glucocorticoid receptor (GCR) located in the cytoplasm. Upon binding, formation of the GC/GCR complex causes dissociation of chaperone proteins from the glucocorticoid receptor enabling the GC/GCR complex to translocate inside the nucleus. This process occurs within 20 minutes of binding. Once inside the nucleus, the homodimer GC/GCR complex binds to specific DNA binding-sites known as glucocorticoid response elements (GREs) resulting in gene expression or inhibition. Complex binding to positive GREs leads to synthesis of anti-inflammatory proteins while binding to negative GREs block the transcription of inflammatory genes.