Tag Archive for steroids

Is that a combine in the field?

I spent last week in the hospital. It’s Fall, the weather is changing, mold counts are rising, ragweed season was rough, and farmers are out in the fields harvesting their crops. It’s always the perfect storm of things to induce inflammation in my airways.

It started off with an asthma attack. I was in the garage riding my spin bike one night when I hit a wall after 15 minutes. I backed off, slowed down, and figured things would soon get back to “normal.” Things did not get back to normal. I started myself on some standby prednisone and talked to my lung doctor when things didn’t completely improve. I restarted the prednisone, but it wasn’t enough. One the way to an urgent clinic I got a flat tire. Urgent clinic told me I had to go to the hospital, and the doctor in the ER admitted me after 125mg of solumedrol and some duoneb seemingly had no effect.

This is the first time I have been admitted not in the middle of an active attack where I felt like I was in distress. The ER doctor was going to admit me as soon as I got there, but I wanted to try some standard treatment first. After that it was three days of 240 mg solumedrol before tapering down to 60 mg of prednisone and getting out of there.

Right now I feel like I’m struggling. Doing everything for yourself is harder than it looks, and I’ve come down with bronchitis as well. Here’s hoping the medicine works and I can fully recover without relapsing.

Prednisone Burst

My lung doc finally gave in and subscribed me some prednisone today. I’ve been feeling bad for about a week. The weather is changing, allergies are bad, one of my kids is kind of sick, and they’ve started harvesting corn. It could be just one, several, or all of those reasons why I’m having trouble breathing. Monday my blood-oxygen saturation kept dipping below 90%, and every day this week my PeakFlow numbers have been steadily dropping. While I really dislike systemic steroids and their side-effects, Liz reminded me it could be worse.

The last time I was admitted to the hospital I had been on 80mg of predisone daily. They gave me two, 120mg IV injections of solumedrol, and then admitted me into a room where they showed up every 6 hours for another 120mg of solumedrol. Some of the side-effects include:

  • It made me a little crazy
  • I became temporarily diabetic and required insulin
  • I retained water and gained weight
  • I developed cataracts
  • I lost muscle tone
  • I couldn’t sleep
  • My hands cramped up
  • My cognitive abilities were diminished
  • I got cranky and moody
  • My vision became blurry at times (probably due to the increased blood sugar levels)
  • My face became round and puffy
  • I lost my appetite

I had been on prednisone for most of the previous 2 years leading up to this hospitalization. When you’ve been on prednisone that long, you can’t just quit. You must be tapered off because your body is somewhat dependent on it. I’m not sure exactly when I developed hypothyroidism, but it was sometime after this long period of time on the medicine. If you want to see a long list of known effects, check them out here.

One of my lung doctors has told me multiple times the prednisone would kill me before the asthma if I couldn’t find a better way to treat my asthma. I’m happy to say this is only the second time in the past 6 months I’ve had to resort to this treatment. I’m hoping the short burst will get me back on my feet.

New treatment options

Since I last saw my pulmonologist I’ve been in the Emergency Room four times and admitted once.  First thing out of his mouth was, “Wow, you’ve had a rough two months!”  We talked about what’s been going on, symptoms, how the meds are working, prednisone, etc.  Dr M said it was obvious every time my taper gets down to a certain level everything flares up again.  He said I basically have three options.

  1. Go to an asthma clinic and get a full work-up.
  2. Look into bronchial thermoplasty
  3. Become steroid dependent

I first heard about bronchial thermoplasty three years ago.  They’ve been doing it in Europe for a while and FDA has approved it for use in the US.  The quick explanation is they scope a wire down into your airways using radio frequencies to heat up and burn away extra tissue.  This assists with the extreme swelling and inflammation many of us asthmatics deal with on a regular basis.

Steroid dependency is needing a small dose of prednisone or another steroid on a regular basis.  This is different from using inhaled corticosteroids as an inhaled maintenance medication.  I’ve been on prednisone 80 some days already this summer so continuing would be an easy step.  Dr M would rather not have to resort to that right now at my age, but we’ll see.

Dr M was really intent on option #1.  He talked about some of the different centers in the area and how beneficial it would be.  He welcomes second opinions and would like to consult to make sure he, Dr K and Dr J are all on the same page with treating me.  He was all ready to call up the Cleveland Clinic and get something scheduled when I finally had the chance to inform him I’m heading to Pittsburgh in 10 days to participate in SARP and see Dr W.  Dr M likes that I try to stay on top of things.

So for now we’re going to see how Pittsburgh goes and what they find.  I’d rather not stay on prednisone forever, but it’s better than visiting my friends at the ER every week and much less drastic than the bronchial thermoplasty.