Prednisone is a small pill, a corticosteroid used mainly to bring an inflammation in the body under control. I was first introduced to corticosteroids when I was hospitalized sixteen years ago for a COPD exacerbation – what I call an extremely severe asthma attack. Depending on the severity, the corticosteroid is administered intravenously under the label of Solu Medrol. Because it travels through the veins more quickly than a pill, it can bring the inflammation under control better than a pill, thus making the patient breathe more comfortably in less time. The normal procedure for me is to have three days of IV steroids before switching to prednisone. Regardless of which type of steroid is administered, I cannot sleep more than one hour per day for the first three days. Even when I doze off, I think I’ve slept for a few hours when it has only been ten minutes. I don’t complain because at least I am able to breathe without struggling.
Increased appetite is another side effect of Solu Medrol and prednisone. In my case, I actually get food cravings as if I were pregnant and place special requests with my family to bring food to my hospital room. Bloating follows, which becomes uncomfortable at times. By the time I was released from my first hospitalization of seven days, I had gained thirty-five pounds.
For some folks, like me, the combination of steroids and antibiotics create a secondary infection in the mouth called Thrush. That, in itself, can make it very painful to eat. The thrush has to be treated with special medication called Nystatin before it travels throughout your body. Solu Medrol and prednisone lower your body’s natural defenses, thus making you more susceptible to other germs.
Prednisone replaces the IV steroids several days before releasing the patient from the hospital. The patient cannot just stop taking the steroid because there are serious side effects that could damage the adrenal glands and other organs. Depending on how severe the exacerbation is, the patient starts on 60 mg prednisone, which is eventually tapered down to 10 mg. per day. Prednisone comes in a 10 or 20 mg pill. It really doesn’t matter what dosage you have to take, because prednisone has one of the worst aftertastes I’ve ever encountered.
Over the years, I have learned that prednisone causes hair loss, which eventually will grow back. For some people, it causes an increase in facial hair (not so good for women). It robs the body of potassium and therefore increases the chances of getting leg cramps. It makes the body retain fluid, which, in turn, increases blood pressure readings, and it raises blood sugar levels to a point where the patient may have to take insulin temporarily. Usually the blood pressure and blood sugar levels will return to normal once the prednisone is out of your system. The combination of taking prednisone and being bed-ridden causes swelling in the feet and lower legs, plus loss of muscle tone in the legs.
Although there are unpleasant side effects when taking prednisone, I can live with them because of the benefits I receive when using this “miracle pill”.