Meds meds meds

Ok, I thought I would make a list of the arthritis meds I'm currently on:

Daily:
20 mg prednisone
1 mg folic acid

Weekly:
15 mg methotrexate

I just got approved to take Enbrel, so I'll be back to the weekly injection thing soon hopefully. I forget if that's supposed to go every week, or every other week--I'm just waiting to hear from the pharmacy letting me know that it's ready. Hopefully this will allow me to lower my prednisone dose.

Ah, prednisone. 20 mg is a very high dose to be on. Doctors are shocked when I tell them. I have been on prednisone, on various doses, basically since I was diagnosed with rheumatoid arthritis. That's seven years.

That's bad.

The longer you use prednisone, the more likely you are to get some nasty side effects. And there are lots of them ("can range from mild annoyances to serious, irreversible damage"*):

- Retention of sodium and fluid (that is, swelling, bloating)
- Weight gain, obesity
- High blood pressure
- Loss of potassium
- Headache and muscle weakness
- Puffiness to the face
- Growth of facial hair
- Thinning (!) and easy bruising of the skin
- Glaucoma
- Cataracts
- Ulcers in the stomach and duodenum
- Worsening of diabetes
- Irregular periods
- Rounding of the upper back ("buffalo hump" [ed. their phrase, not mine])
- Retardation of growth in children
- Convulsions
- Psychiatric disturbances: depression, euphoria, insomnia, mood swings, personality changes, and even psychotic behavior
- Prednisone supresses the immune system, so you also deal with impaired wound healing, more severe and/or frequent infections, and decreases the effectiveness of vaccines and antibioitcs
- Osteoporosis and resulting fractures
- Aseptic necrosis (death and degeneration) of the hip or knee joints

Another catch is, prolonged use of this type of drug causes your adrenal glands to atrophy and stop producing their own corticosteroids. So you can't just go off the prednisone--you have to gradually lower the dose. Sudden withdrawal may induce an adrenal crisis which may include symptoms like nausea, vomiting, and shock.

Being that I am fond of my hips and knees, achy and creaky as they may be, as well as my eyes, digestive system, and bones in general, I am eager to get to a lower dose. Also, I would like my old, human, face back.

* a lot of the information here came from this article: http://www.medicinenet.com/prednisone/article.htm and from the Arthritis Foundation's online drug guide.