Saturday, October 31, 2009

Prednisone Blindside Response

I have been perplexed. The past few weeks I've noticed increased appetite and disrupted sleep. Increased appetite is an understatement. I've been ravenous. My usual lay down, close eyes, and fall asleep routine has been failing, and I awaken in the early morning, hungry and unable to return to sleep. I blamed it all on the extraordinary circumstances of my packing and moving, the excitement of house sale and new house. Tonight I it all came to a head. I was upset at my hungriness and the way it prevented sleep, and beginning to despair of having any improved health from my increased activity if all it meant was more appetite. As I bit into my low-cal, high-fiber, whole grain English muffin it hit me - my steroid dose is up. This is a sneaky steroid increase. I'm not taking a higher dose of prednisone. My oral dose remains at its baseline, not enough to cause these symptoms. However, almost three weeks ago I had a joint injection - a large dose of steroid (corticosteroid) medication was inserted directly into my left knee joint to treat an acute flare. We do this kind of treatment to put the medication directly where it is needed and to minimize the systemic affect of the meds, but a goodly portion is still absorbed into the bloodstream and disseminated to the rest of the body.

I am greatly relieved to realize the source of my symptoms. I've had such an increase in activity that I'm hoping to see better overall health. I thought it was being thwarted by my need to eat more, but now I know it is temporary. Moreover, having insomnia and being on an irregular schedule has never been good for my lupus. Keeping the wolf under control is much easier with adequate rest and a predictable meal, sleep and medication schedule. I should be close to getting over the steroid symptoms. One way I've been fighting them is to feed my appetite with huge amounts of plain steamed vegetables. My Publix had a $1 sale on microwavable vegetable packs, found in the produce section. I scooped up a pile and I indulge in them liberally. I also invested in several cases of my favorite sparkling water (yes, at $4 for 12 cans, it's an investment), and I fill up on bubbles.

A disease that has affected you for 17 years isn't going to be controlled or conquered overnight. I'm happy for every little insight that helps me manage better, even if it comes at 3 a.m.


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