Talking with your Doctor about Prednisone

There is no way to sugar coat it - Prednisone is a rough drug. It can help a TON but it can also have you dealing with some pretty harsh side effects along the way. The very best way to not only fight your disease properly but also to endure the side effects of Prednisone is to have a great - not just good - but great relationship with the doctor that is prescribing it to you!

Like every great relationship, communication and honesty is the key. That goes both ways! I've talked with many, many people who have been on or are on Prednisone that feel unsure or uncomfortable talking with their doctor about the side effects and even about their tapering plan. With Prednisone, it is vital to be on the same page as your doctor about your treatment plan. 

So Here are some things to consider;

 - Often times Prednisone is not an easy drug to come off of so it's very important to have an idea about a tapering plan or ideal time frame before going on Prednisone. This is something that you will really need to discuss with your doctor thoroughly. Often times people are put on Prednisone very quickly and many times at large dosages because their immune system is going nuts, while this might be the case, it's still important to ask a lot of questions. Sometimes, your doctor may not know how quickly your immune system quiet down on Prednisone so it might be hard for them to tell you exactly how long you'll be on Prednisone. I've certainly had this happen to me. In those cases I usually ask my doctor for the worst case scenario that way if plans change it's usually for the better:) 

 - You will most likely be dealing with some sort of side effects, especially if you are going on large dosages. Talking with your doctor about what to expect on Prednisone with your specific dosage is a really good way to get a handle on your side effects before you even began having them. I can't tell you how many people have told me they wished they would have been better prepared on what to expect with the side effects, myself included. It really does make a big difference. 

 - If you are going on long term Prednisone treatment it's also a good idea to ask your doctor about recommendations for follow up care with different doctors. Unfortunately, Prednisone has the ability to effect many areas of your body so you may need to be treated with multiple doctors. For example Prednisone can do a number on your teeth, bones, eyes, and even your emotional state so it's very important to have follow up care to catch any problems early on and even to prevent them entirely with the appropriate providers.  

 - Consider asking your doctor about different methods to deal with the side effects of Prednisone. For example weight gain and water retention is a side effect that common with many people on Prednisone. Your doctor may be able to advise you in ways to change your diet and even exercises you can do (even while ill) that can help keep some of the weight off. 

 There are also some red flags to watch for. If you are having a rough time with Prednisone you need to be able to discuss them openly with your doctor. If your doctor isn't willing to talk to you or work with you for a possible change in treatment or dosage then it might be worth looking into another doctor. Prednisone is such a serious drug with the possibility of intense side effects so if your doctor isn't allowing you to express your frustrations and your worries and taking your complaints that is a big problem! 

I hope you have been able to talk with your doctor openly! I have always believed the more knowledge you have the better so if you are facing a treatment with Prednisone I urge you to seek out as much information as possible so that you can feel confident about your treatment plan The best place to start is with your doctor!:)

Understanding Addison's Disease/Crisis with Prednisone

If you are taking any type of long term corticosteroid use your doctor should have talked to you about a tapering process. You doctor should also explain why you have to taper off of the Prednisone instead of jumping off of it like you do a lot of other medications. Even though it can be tough, it is extremely important to follow the tapering regiment your doctor has planned for you. If you don't you could become seriously ill with something called Addison's Disease and Addison's Crisis.

In order to understand what Addison's disease/Crisis is or why it happens we first need to understand a bit about the physiology of our body and how it works with Prednisone. Your adrenal glands actually make a hormone very similar to Prednisone called Cortisol. Most of you probably know that when you are stressed your body produces more cortisol and so you end up gaining weight (sounds familiar lol) While too much Cortisol can cause problems, Cortisol is actually vital for life. Cortisol helps the body to carry out processes and helps keep the body in a state of homeostasis or, rather, in a state of balance - super important.

The body makes about 7.5 mg per day equating to about 7.5 mg of Prednisone.

When Prednisone is introduced in the body at larger doses then 7.5 mg and for a few weeks and beyond your body realizes that there is too much Cortisol and so the adrenal glands quit making it as a way to compensate. The problem happens when you suddenly come off of Prednisone before the body starts making it again and that is what Addison's Disease is. In order for your body to acclimate to producing Cortisol again, the body has to understand that it's not getting enough and therefore slowly starts to produce it. Unfortunately it does take some time for your body to get back that process which can make getting off of Prednisone slow.

So what happens if you jump off Prednisone before your body starts making Cortisol? The symptoms can range immensely, from aches (addison's disease) to the more serious Addison's Crisis which can cause comas and even death. While tapering off of Prednisone it's extremely important to understand Addison's symptoms so that you can tell your doctor if you are experience any of them. Everyone's body is different so the tapering process might be different from one person to the next. Your doctor will be able to help if you are having any of these symptoms;

• Muscle weakness and fatigue
• Weight loss and decreased appetite
• Darkening of your skin (hyperpigmentation)
• Low blood pressure, even fainting
• Salt craving
• Low blood sugar (hypoglycemia)
• Nausea, diarrhea or vomiting
• Muscle or joint pains
• Irritability
• Depression
• Body hair loss or sexual dysfunction in women

There are more serious symptoms that indicate Addison's Crisis. If you have these symptoms you need to talk to your doctor immediately. They include; 

• Pain in your lower back, abdomen or legs
• Severe vomiting and diarrhea, leading to dehydration
• Low blood pressure
• Loss of consciousness
• High potassium (hyperkalemia)

The more you understand about Prednsione and your body the better your treatment plan will be. It's so important to talk with your doctor often so that you both are comfortable with your tapering plan. With good communicate between you and your doctor you should be able to avoid most (if not all) of the symptoms of Addison's Disease and certainly all of the symptoms of Addison's Crisis:)