Lung Cancer and Its Little Dramas

Sunday, October 24, 2021

I’ve been talking ad nauseam about steroids, I know, and this post will continue the theme, because this prednisone taper is turning out to be one helluva process. And, may I say, it is not without its drama.

Last Wednesday, as instructed– Wednesdays mark The Official Changing of The Dosage– I dropped my prednisone dosage by 10 mg., from 30 to 20. Generally, I can start feeling effects from medicines within a couple of days. Sure enough, I slept 12 hours Thursday night (which I never do– except after chemo, radiation, and now, steroids). And when Mark and I did our gentle walk– in almost slow motion– midday on Friday, my heart rate was close to a level I’d typically aim for in a cardio workout. Plus, I needed a big nap after a very short walk…. Ruh roh, I thought, as I dropped onto the bed, we’ve entered the land of prednisone withdrawal.

Prednisone is a horrible-excellent drug. Horrible because it is powerful enough to wreak havoc on the body, even at low doses.  Most excellently, it can also save your life. (As we’ve seen, it has done that for me, so I shouldn’t really be moaning about it, but since it can’t hear me right now, here ‘goes…..)

A quick review*(see below for links): what prednisone does is mimic cortisol, the hormone the adrenal gland produces, to reduce inflammation or manage your body’s immune response.  Prednisone can be prescribed for bad poison ivy, asthma, severe allergies, all kinds of arthritis, IBS (i.e., Crohn’s disease), and just about anything you can think of, such as pneumonitis (ahem).  But sometimes, for some people, the side effects may cancel out the benefits [unless you’re one of the you could die people, then who cares about side effects?].

Here’s the roundup of the usual side effects-suspects: fluid retention, causing swelling in your lower legs; high blood pressure; problems with mood swings, memory, behavior, and other psychological effects, such as confusion or delirium [oh dear]; upset stomach [I take medicine to prevent this], weight gain [there is no medicine to keep you from wanting to eat your entire house], with fat deposits in your abdomen, your face and the back of your neck [is that disgusting or what?].

When taking oral corticosteroids longer term, you may experience: elevated pressure in the eyes (glaucoma); clouding of the lens in one or both eyes (cataracts); a round face (moon face) [see me with my hand up?]; high blood sugar, which can trigger or worsen diabetes; increased risk of infections, especially with common bacterial, viral and fungal microorganisms [which is why I swill my prednisone with a really expensive antibiotic]; thinning bones (osteoporosis) and fractures [I should buy stock in calcium supplements]; suppressed adrenal gland hormone production that may result in a variety of signs and symptoms, including severe fatigue, loss of appetite, nausea and muscle weakness [dang, I never get the good side effects, like loss of appetite]; thin skin, bruising and slower wound healing; and many more.  (Mayo Clinic)

All of this badness is why, when you’ve been taking prednisone for a long time [SINCE @#$%^&* JULY, FOR EXAMPLE] you have to taper slowly or you can drop into withdrawal, which is pretty much all the same bad stuff as the side effects above, plus.

But one person’s slow taper may not be someone else’s. And by Saturday afternoon, it was clear that the plan I was following belonged to someone who was not me.

Saturday started innocuously. I woke up after many hours of sleep and wandered around, trying to organize the day in my oddly-fuzzy head. Portland is getting a lot of Afghan refugees and an aid organization has been soliciting donations. I’d bought a bedding kit and was planning to deliver it between 12 and 3. The thing is, I had to fit all the bedding into a plastic tub with a lid that could close. Two pillows, a queen-size comforter, sheets. Honey, there is no way that stuff was going to fit in the tub I had, but damned if I was going to let that stop me from trying.

It started funny. I admit, I was giggling over the absurdity of what I was trying to do. Then, all of a sudden, it was neither funny nor absurd. I found myself flinging tub and comforter across the room, yelling “FUCK!” as I stomped my really ticked-off feet.

“Can I help you?” came my mother’s sweet, calming mom-voice from down the hall.

“NO YOU CANNOT HELP ME!!! NO!” StompStompStomp

Silence from down the hall. Footsteps from above, coming down the stairs.

My husband peeked into the room. “GO AWAY! I AM HAVING A TERRIBLE DAY!” I yelled. “I see that,” he said. Then I started to cry. “I think it’s the steroids,” I wept. “It’s definitely the steroids,” he said, pulling me close.

The decision that I should immediately take 5 more mg. of prednisone came via unanimous family vote, followed by much discussion of how the tapering plan would be revised come Wednesday. I took 5 more mg. of prednisone and went down for a nap.

Today, Sunday, my pulse is back to normal and I have not once raised my voice. Boy, do I feel beat, though. Tomorrow and Tuesday will be 25 mg. days. Wednesday will bring a new number– maybe 22.5, maybe 20. There may be an argument for another week of 25, but I think I will veto that. Because, JULY, people.

In case you you’ve imagined me languishing on a tufted sofa, my forehead patted with a cool cloth by a nurse who’s murmuring comforting sounds, well, just chase that image right out of your mind. ‘Cuz I’m probably stomping deep in the middle of one of lung cancer’s little dramas– probably a drama that isn’t even directly connected to lung cancer, and loud to boot.

Here’s hoping you’re having a day without drama, or, if dramas occur, that they are very interesting, with the possibility of laughter in hindsight.

Thanks for reading.

P.S. If you live in Portland and want to put together a kit for the refugee organization, I’ll be dropping mine off in November and will happily take yours. Send me a text, an email, or a note via the contact form on the About page here.

*Some Things You Never Knew You Wanted to Know About Prednisone

Or, Some Things You Knew You Never Wanted to Know About Prednisone

• How to Reduce Prednisone Withdrawal Symptoms
• 8 Prednisone Side Effects & How to Minimize Them
• Prednisone and Other Corticosteroids: Balance the Risks and the Benefits
• What Does Prednisone Do?

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Images

• Spiral Staircase From Below:  Creative Commons Zero – CC0.
• Prednisone: me
• The Fainting Lady
• Zombie Doll Image by Pete Linforth from Pixabay
• Dancing theater person