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Using and weaning from steroids

Posted by Chris M. on 11/5/2009, 12:06 am
72.251.74.148

One should truly follow the advice of their Doctors for medical care, and this has the same disclosure.
However, when I first came on line computers it was my Pharmacist who sent me chasing after information on why the big bottle of Prednisone my local Doctor had ordered might not be in my best interest.

If we care about others as my Pharmacist did, we can offer the same- clear information, unvarnished so you can consider all sides for yourself. The article is obviously not geared to COPD. It's statements about steroids is pretty clear, and I've adhered and avoided use of them for many years. I don't believe in taking away my bodies defenses during flu seasons or even when I'm treating a suspected infection if I can breath well enough to survive without the Prednisone. Each persons tolerances are different, each infection a different moment.
Steroids can be essential to keep a patient alive, or a demon who destroys lives.

Link: http://www.sarcinfo.com/weaning.htm

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Re: Using and weaning from steroids

Posted by garyTX on 11/5/2009, 8:44 pm, in reply to "Using and weaning from steroids"
69.46.49.175

Ten Things You Should Know about Prednisone are spelled out in the link below...garyTX

Link: http://arthritis.about.com/od/prednisone/a/prednisonefacts.htm

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Re: Using and weaning from steroids

Posted by Chris M. on 11/5/2009, 9:32 pm, in reply to "Re: Using and weaning from steroids"
72.251.78.232

If you put this stuff in a black box and described it's effects to most sane folks, they'd avoid it like it was poison...it shows how badly we manage breathing . In our earlier years we had colds and flu's, and much worse infections, but once they introduce this puppy- we can't do without it for a sniffle. Docs get fewer emergency calls if they prescribe it!

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Re: Using and weaning from steroids

Posted by Martha on 11/6/2009, 12:10 am, in reply to "Re: Using and weaning from steroids"
68.12.160.104

In my earlier years, I did have bad colds and flu and didn't do anything but OTC. The difference now is that I have so little lung function that the least problem has a huge impact. The allergies that were just a nuisance, now have a very debilitating effect on me. Treatment is different now.

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Re: Using and weaning from steroids

Posted by Chris M. on 11/6/2009, 12:35 am, in reply to "Re: Using and weaning from steroids"
72.251.78.232

I picked up a bunch of cheap but hand sized saline wash/sprayer bottles...Come to find it helps quite a bit. Somewhere in my wanderings I read that reducing the colony or concentration of bacteria, virus or allergens can seriously help control the problems. It does seem to help. It's a gross subject, but some good rinsing actually does seem to help.

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Re: Using and weaning from steroids

Posted by CarolCA on 11/6/2009, 2:08 pm, in reply to "Re: Using and weaning from steroids"
98.248.53.53

One of the things they told us at our meeting was to make sure that it had alcohol in it and when you are using it or the wipes (with alcohol, many don't) is to make sure that you clean between the fingers and around the nails, especially the thumb and forefinger as that is the place they found the most bacteria, doorknobs, handles of carts, etc. She also said that many of the antibacterial soaps that we use at home are pretty useless unless they have alcohol in them.

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Re: Using and weaning from steroids

Posted by Martha on 11/6/2009, 9:12 am, in reply to "Re: Using and weaning from steroids"
68.12.160.104

It sure does help. I use my NeilMed saline nasal wash twice a day when the allergies get really bad.

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Re: Using and weaning from steroids

Posted by CarolCA on 11/6/2009, 12:16 am, in reply to "Re: Using and weaning from steroids"
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When I got the worst was when I used OTC meds like combination drugs with decongestants, antihistmines, etc. They seemed to help me feel better but it hung on forever.

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Re: Using and weaning from steroids

Posted by Martha on 11/6/2009, 9:16 am, in reply to "Re: Using and weaning from steroids"
68.12.160.104

I can't use the combination drugs. The decongestant in the combos is pseudoephedrine. I get so hopped up on it I can't sleep, my skin crawls, and my mind is very fuzzy.

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Re: Using and weaning from steroids

Posted by PennyPA on 11/6/2009, 9:26 am, in reply to "Re: Using and weaning from steroids"
70.210.87.120

And it's highly suggested that people with HBP not use any med with pseudoephedrine.

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Re: Using and weaning from steroids

Posted by CarolCA on 11/5/2009, 10:59 pm, in reply to "Re: Using and weaning from steroids"
98.248.53.53

But, also, Chris, there is less chance that it will become life threatening when you have bronchitis if you take Pred. Once it used to go into my lungs from a cold I was sick for weeks. Really sick, broken ribs from coughing, etc. With Pred I can get my lungs open and be up and running very fast.

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Re: Using and weaning from steroids

Posted by Cathy-WI on 11/5/2009, 2:27 pm, in reply to "Using and weaning from steroids"
68.112.179.214

It's so good to see you posting again, Chris. We sure missed you and are very happy you're feeling better.

Prednisone is no stranger to me, either. For a period of time I seemed to be a frequent flyer in the ER for exacerbations. Each time I was given an IV steroid for several days, followed by a regimen of prednisone. I didn't take it any longer than necessary, but when I needed it, it was the only thing that worked. I do think you can develop a resistence to it - another reason to be cautious about its use. However, for me it's a great drug when needed.

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Re: Using and weaning from steroids

Posted by c.j. on 11/5/2009, 12:59 pm, in reply to "Using and weaning from steroids"
12.74.125.196

Chris -

Glad your recovery is going well. We've all missed you greatly.

I was put on 10 mgm Prednison daily by my pulmo on Sept 1. After several attempts at reducing it to 5 mgm daily which resulted in extreme SOB, I was told to continue 10 mgm daily OR try 10 mgm every other day on Oct. 2. My cardiologist had suggested splitting the dose for better results just as this article has suggested. I think I am going to try that starting tomorrow. I see the cardio in a couple of weeks and the pulmo in Jan 2010. I worry about being on the Pred forever.

My FEV 1 was 16 on my last visit -- a drop from 18 three months prior. With the Pred, I am not as profoundly sob.

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Re: Using and weaning from steroids

Posted by John O. on 11/5/2009, 1:51 pm, in reply to "Re: Using and weaning from steroids"
69.129.197.8

c.j., I think I may have mentioned in an earlier post what I'm doing, deceasing 1mg a month. From 10 I'm down to 8, ready to go to 7 in a week or so. So far, so good.

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Re: Using and weaning from steroids

Posted by Joe - Tx on 11/5/2009, 8:07 pm, in reply to "Re: Using and weaning from steroids"
69.149.79.71

John, I weaned from predisone at about the same speed you are.
I did feel a few more aches and pains and loss of energy but nothing serious. I still take a corti-steroid in Advair and the doc sez I have to stay on it. My last bone scan was improved and my arms aren't covered with sores and bruises anymore.

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Re: Using and weaning from steroids

Posted by john O. on 11/5/2009, 8:55 pm, in reply to "Re: Using and weaning from steroids"
69.129.197.8

Joe, my last refill on the 1mg tabs says to decrease by that amount every two weeks rather than every month. I'm going to se how that goes. If I can be exac-free I think I can do it. Likewise I'll continue the inhaled steroid.

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Re: Using and weaning from steroids

Posted by c.j. on 11/5/2009, 4:27 pm, in reply to "Re: Using and weaning from steroids"
12.74.126.111

I called and asked about decreasing by 1 mgm etc. The message through the nurse was "no" -- will have to wait till I see her in January to talk about it. My lung function is so poor and I got so short of breath cutting back to 5 mgm it was frightening. Everything seemed to get so bad so quickly -- on 8/27 I was SOB but functioning. Sept 1st I was profoundly SOB and it was a struggle to do anything --eat, fix a meal, bathe, etc.

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Chris - so happy to see you back!!

Posted by ElaineNY on 11/5/2009, 11:56 am, in reply to "Using and weaning from steroids"
205.188.117.20

.

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Re: Chris - great to be back-- Thanks all...

Posted by Chris M. on 11/5/2009, 8:15 pm, in reply to "Chris - so happy to see you back!!"
72.251.78.232

glad not to be sidelined...Thanks for all the greetings and concern.

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Our experience here...

Posted by ElaineNY on 11/5/2009, 11:55 am, in reply to "Using and weaning from steroids"
205.188.117.20

Because both my husband and I have recently been on prednisone this article was great! A little late to make any changes but good info for next time (hope there isn't but probably will be). I was put on prednisone for ulcerative colitis (have trying about everything else). I started at 40 mg. and was on it about 5.5 months tapering slowly after down to 20 mg. I now have the withdrawal symptoms of aching and joint pain. Everything else seems ok and the prednisone did the job it was supposed to.
My husband went to the ER with SOB, little coughing and wheezing. ER doctor put him on prednisone and antibiotic. He started at 60 mg.one week, then 40, then 30 and 20 and done. Four weeks - he is off now for one week and seems ok. Just short enough time so he did not get major side effects. It also did for him what it was supposed to. He is breathing better - just very tired! ER doctor consulted with a pulmonary doctor and his oncologist as he has lung cancer. They all agreed to needed to get better QUICKLY! Prednisone will do that.
ElaineNY

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Re: Using and weaning from steroids

Posted by CarolMA on 11/5/2009, 7:51 am, in reply to "Using and weaning from steroids"
71.126.50.175

Welcome back Chris...
Seeing your name first thing this morning, made my day...
You have been missed.

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Re: Using and weaning from steroids

Posted by Chris M. on 11/5/2009, 8:19 pm, in reply to "Re: Using and weaning from steroids"
72.251.78.232

Thanks, Carol...appreciate.

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Re: Using and weaning from steroids

Posted by linda md on 11/5/2009, 12:28 am, in reply to "Using and weaning from steroids"
98.140.246.15

Hi Chris, So glad to see that you are back. Sure did miss your great posts. Hope you are doing well.

I am so glad you posted this article as I am presently on a pred taper. Started at 60 mg. after a trip to the ER and am now doing the slow taper. I saw my pulmo the day after I went to the ER and he was furious they started me on pred. He said, "don't you ever let them do that to you again". Excellent article, thanks again.

Take care of yourself and Welcome Back.
Linda

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Re: Using and weaning from steroids

Posted by Chris M. on 11/5/2009, 8:54 pm, in reply to "Re: Using and weaning from steroids"
72.251.78.232

I have a pretty feisty Pulmo who speaks his mind too.
Antibiotics actually treat the bacterial infection whereas Prednisone in its varying forms are just anti inflammmatory and bash down your defenses of white cells etc.

I sure get a wheeze with an infection, but as the antibiotic takes control and the infection becomes more controlled, I don't always need steroids.

We tend to think of infections as "all over the lung" but it's more likely an inner image might show much smaller areas closer together. Getting adequate liquids, antibiotics, and good coughing might do much to open our breathing tubes without having to destroy all the other defenses, especially when we need to battle flus, and colds. The effects of oral steroids aren't immediately gone with their remains, and it takes awhile to rebuild our defenses.

It does take some self control to not loose it when we are struggling to breathe, but nebulising helps, along with slow inhalations in moist air, drinking warm fluids, better coughing, double the dose of N-Acetlycysteine....Yeah, I know it sounds hard, but fear can intensify the issues with breathing well, so it takes good self control. There's 'tussin, 'tussin, 'tussin...
My favorite helper is a bowl of salted warm water to huddle, with a towel over my head and inhale...at least it's breathing...

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Re: Using and weaning from steroids

Posted by CarolCA on 11/5/2009, 1:18 am, in reply to "Re: Using and weaning from steroids"
98.248.53.53

And what would he suggest in place of that? If you were bad enough to go to ER and he wasn't there he should not say those things because he didn't see you, One day after you started it you would not have had to taper so long if at all. That is not required anymore unless you have been on for at least a week. True that 60mg is sort of high so a smaller dose may have worked as well. Last time I was there they wanted me at 40mg and I told them I wouldn't take more than 20mg and that was OK with them. I took it that night and then no more. I have never been on 60mg.

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CarolCA

Posted by linda md on 11/5/2009, 7:21 am, in reply to "Re: Using and weaning from steroids"
98.140.246.15

I should have said after my 2nd ER visit (week earlier they started me the on 60 mg. pred), I saw my pulmo. You are correct, I was on the pred for about a week, so I could not just stop it.

I wonder too, what he would have the ER docs do. Pulmo also told me that if I am not wheezing, I do not need pred. Well, they told me I was not wheezing, but I was not moving air well at all. So, I figured that is why they started me on the pred. My pulmo did back down and said that I was the patient and just following their advice. I feel the ER doc made a correct call as the most important thing is to keep the airways open, especially with my history of respiratory failure, ventilator and trach. I have only been on pred on two other occasions. I will ask my pulmo when I see him what he suggests I do if this happens again.
Linda

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Re: CarolCA

Posted by CarolCA on 11/5/2009, 1:49 pm, in reply to "CarolCA"
98.248.53.53

My Doctor pretty much looks for the wheeze before he uses it but that just doesn't always work for me that way. I just know when my bronchial tubes need that extra boost to open. It will be interesting to see what your doctor says.

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