Now you understand what you need to do and how you need to do it, but you still don’t have the proper doses or full time frame for your post cycle therapy treatment and that’s the final point of our discussion. While Nolvadex and Clomid can work equally as well, they will only work equally as well if they are dosed properly. This is where many fail when they use Clomid as Nolvadex is much stronger on a per milligram basis. For example, with 40mg of Nolvadex, for Clomid to match it you need 150mg. As for hCG dosing, 500iu to 1,000iu per day every day for 10 straight days is your plan and implemented precisely as discussed above. Once the hCG therapy is complete, you will start your Nolvadex therapy at 40mg per day or Clomid at 150mg per day; whichever you choose, you will continue it for two weeks. Once the two weeks is complete, you will complete two more weeks this time with a Nolvadex dosing at 20mg per day or a Clomid dosing at 100mg per day. No, you’re not done yet, you will complete one more week at 10mg per day for Nolvadex or 50mg per day with Clomid and add in an additional week at the same dose if you feel it is necessary.
Epidural steroid injections are most commonly used in situations of radicular pain, which is a radiating pain that is transmitted away from the spine by an irritated spinal nerve. Irritation of a spinal nerve in the low back ( lumbar radiculopathy ), such as from lumbar spinal stenosis , cervical spinal stenosis, herniated disc , and foraminal encroachment, causes back pain that goes down the leg. Epidural injection is also used as a minimally invasive procedure to treat nerve compression in the neck (cervical spine), referred to as cervical radiculopathy , which causes pain.
Pain after a corticosteroid injection is not the norm, but it’s not abnormal either. I can’t speak to your situation, but I can say that occasionally patients will have what’s called “post injection flare” where the pain is worse for 2-3 days after the injection. I would tell patients to put ice on the area and as long as it’s not red, swollen or with discharge at the injection site, sit on it for a couple days to see if it resolves. If it’s not any better after 2-3 days, then come into the office. And just so you know, it does NOT mean the injection did or did not work correctly, and it does not matter which technique was used to get the steroid into the knee joint.