Columnists

Concerning Corticosteroids And Meningitis

Issue 43.12

If you have access to the internet or a television, chances are good that you’ve heard about the meningitis outbreak caused by tainted batches of corticosteroid injections.  I want to assure the patients of Desert Pain Specialists and inform our community that we do not, nor have we ever used Methylprednisolone (the long acting corticosteroid implicated in the meningitis cases) in our epidural injections.  Secondly, we do not order our medications through compounding pharmacies – facilities which mix drugs in mass production to decrease the cost.  Our medications are produced in FDA approved pharmacies.   As pain management physicians, this is something we take very seriously.  Even though there have not been any documented cases of fungal meningitis in the state of Utah,  I wanted to take this opportunity to write about the risks vs benefit that accompany virtually all of medicine. 

We have answered many calls from concerned patients, and rightly so.  We do not dismiss these phone calls simply telling them ‘not to worry’, or ‘we have not been affected.’   Even though our patients have not been exposed to these tainted medications, there is always a very small risk of infection when we perform an injection of any kind.  This is just one of the risks that are outweighed by the benefit of pain relief that generally comes from such an injection.  On the reverse, if a patient is currently battling an active infection, we generally postpone injections until a full recovery is achieved because the risk of infection and its complications outweighs the benefits temporarily.  We do all we can to reduce the risk of infection such as using sterile instruments, antiseptic skin cleanser, and sterile technique.

Don’t think this principle only applies to injections.  It is involved when deciding whether surgery is right for you.  For example, what are the chances that a certain surgery will cure or take away the pain (benefit) and will you survive the surgery and general anesthesia (risk).  General practitioners face this as well with the medicines they prescribe.  There is a small but real risk of allergic reactions, drug interactions, and side effects to all medications (risk) but the benefit which the doctor and patient are seeking will hopefully outweigh those risks.

As J R R Tolkien stated in his Lord of the Rings, “It’s a dangerous business, Frodo, going out your door. You step onto the road, and if you don’t keep your feet, there’s no knowing where you might be swept off to.” True, we take simple risks every day just by getting out of bed, but that is life.  Similarly, we accept small risks to help treat patients’ pain, but not at the expense of patients’ health and safety.

Please don’t hesitate to call if you have questions or concerns or would like to schedule an appointment, 435-216-7000.

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