Anabolic Steroids: Friend or Foe?
Steroids: Friend or foe?
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Once again, I find myself on the old "downalator." Reducing my dose of prednisone is not my favorite thing to do. I've done it many times in the last 20 years, and it never gets any easier. It's really a good thing. It just doesn't feel like it. As usual I will share with you what I and my family have experienced because that's the view from here. It helps a little that I'm a nurse, gave birth to a nurse and married to a nurse. All of that helps with the jargon and offers a basic understanding of this whole business. Living with autoimmune disease is a very complicated business. As many of you have found, you need all the help you can get.
My oldest sister suffered terribly from psoriatic arthritis. Many years ago, when she was first diagnosed, she was placed on prednisone. At that time, shortly after it first became common usage, it was considered a miracle. Then the doctors began to see the horrendous long term effects this drug can have. My sister thought it was great. Now that she is no longer living, I don't think she would mind if I share with you what some of her experiences were. She would like to help others in any way she could because that's the kind of person she was. She thought if one dose was good, then two would make her feel better. She always took more than the doctor prescribed. If the doctor questioned her about needing an early refill she would lie and tell them she spilled them down the drain or left them somewhere. She was a woman in great pain and thought she had found the answer to receive the relief she desperately needed. It took several years but this practice began to "catch up" with her, and she began to have a dissolving of the bone; as many of you have also experienced, known as osteonecrosis.
Osteonecrosis is a non-reversible form of destruction of the bone mass. For my sister it was all over her body. She lost a toe bone, leaving only the skin behind. She lost her cervical spine and the last few years of her life her head was held up by nuts and bolts...truly. She had hip surgeries which would not heal. She had knee surgeries which would not heal and became so severely infected her prosthetic knee had to be removed and led to further infection in the femur. There isn't room in this blog to share with you all of the immense problems she suffered. She also had GI bleeds and soft tissue problems.
My beloved Dad had Giant Cell arteritis and was placed on huge doses of prednisone in order to think clearly and to protect his eyesight which was affected. He also had Polymyalgia Rheumatica which as many of you know is very painful, everywhere in his body. The last four years of his life his cervical spine began to fracture, one right after the other. He had fractured ribs just from leaning on a counter. He suffered a great deal. All of this bone destruction from large doses of prednisone. Thankfully, they now have more effective drugs for all of these problems.
There are many side effects of prednisone, too many to list here. It is a helpful drug for inflammation, certainly, but don't lose sight of the fact it is also a destructive one. I have many problems, most recently with my mucosal lining when I had abdominal surgery. Years of even low dose prednisone has thinned the linings all over my body. I know the importance of keeping the dose low but it isn't easy when you go through times when they have to crank it up a bit. You should always follow your physician's advice on how to come down on the dose and find the lowest dose which you can live with. If you have a doctor who doesn't seem to understand the dangers of this particular drug, then I would suggest that you get a new one.
In the early years of my disease, I drove three hours to see a wonderful rheumatologist in Beverly Hills who also practiced at Cedars Hospital and UCLA. He was British and very dedicated to the dangers of prednisone. He used to help me come down to a lower dose by having me call him every two weeks and asking how I was doing then telling me to cut it down by 1 mg. That's dedication for such a busy doctor. He was also the doctor who taught me the importance of physical therapy as he had an excellent young female PT right there in his office to work on his patients and to teach them.
There are dangers out there. I know many of you who read this blog on a regular basis have had your own experiences with this particular drug. Your stories would be helpful if you have a moment to share.
Video: Steroids: Friend or Foe?
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