This is a warning to Asthma or COPD patients and Dr's who use prednisone as a crutch or a way to get the patient from stop calling or complaining that a dose or taper will make there breathimg much better very quickly, There can be serious complications because of this use. One complication that is not talked about to much is AVASCULAR NECROSIS or bone death due to the lack of blood supply,This usually affects the long bones (HIPS and SHOULDERS)sometimes the knees and wrists this disease causes the heads of these bones to collapse and requires usually a total replacement of the joint but it does not stop there because the disease is progressive and if young enough up to 55 years old you most likely will need to have the joints replaced again.
Depending on the severity of the disease it can be very debilitating to the point of having to use a wheelchair. So if you have been a user of prednisone for a period of time and have a arthritis or stiff type feelings in your joints get it checked out ASAP. From a patient who found out to late.R.Beck
I've been on prednisone 4 times since last january. 50mg taper in december and a 20mg taper last week. Unforunately we have to, I am also on 6 puffs of advair 250/25 MDI (yes above the recommended dosage), singulair 10mg, nasonex and still using ventolin and atrovent daily. So prednisone is the only other thing that we can add when the asthma flares which has been regular the last couple of months .... it refuses to settle down and we can't pin point the exact triggers.
It ***** because I also have osteoporosis in my family and only weigh 90ibs so I'm small framed which is another risk. Oh well, can't do anything about it. Plus it ***** because the prednisone doesn't work 100% so sometimes I wonder whether if it is worth it.
Wow, They really have you on a lot of meds before my illness took over I was respiratory therapist for 15yrs but I can't work because of the avascular necrosis.Why can't they at least up your Advair to 500/50 2puffs bid. Have you been checked for GERD or allergy tested.Just be careful about the amount of prednisone you are taking. I was in the same situation and thought there was no hope until I my lung collapsed and I went to a different hospital and new pulmo's. they started over with my pulmonary meds and my lungs turned around 100% until I found out what the prednisone did to my joints and the 3 replacements I now need.Hope you feel better Randy.
I'm using the advair puffer because any of the diskus give me increased mucus because of the lactose in them. The puffer gives me 750/75 per dose instead of the 500/50 per dose in the diskus.
I have been allergy tested twice, first was positive for cats and dust mites, did allergy symptoms, no help for asthma but got rid of 90% of allergy symptoms (minus red and inflamed nasal mucosal). My second allergy testing (skin and blood) showed no allergies what so ever so we stopped the shots because of the uncontrolled asthma and lack of allergies from testing.
I finally was sent to a respiralogist and see him again on monday for the results from my pulmonary function testing. I'm going to ask him about GERD because we have never tested for it (although I have no symptoms of hearburn) but I tried gaviscon and it increased my peak flows a bit for the days I used it.
My allergist is determined I am still allergic to cats and because I own two of them, it is chronic exposure. The cats aren't going anywhere and I'm so close to be accepted into vet school, I have to be able to be around them. I'm too far into my degree and plans to change the career I'm going for, without being in school until I'm 30.
I will watch the amount of prednisone I'm using, I don't want any problems following me for the rest of my life, I already have enough!
Hi Tammy, I am also a cat owner and do have allergies from them and they are not going anywhere they are the only thing that keeps me sane. I just make sure when I do handle them I wash after and vacuum a little more than normal.and if I do have to take an extra puff of a med so be it..
I totally agree, But in my experience as a health care provider in the Respiratory field I have noticed to many doctors relying on prednisone to treat so called problem asthmatic patients without regard for patients well being in the long run. I know doctors are busy but to many none pulmonary doctors are using prednisone as a quick fix for patients with asthma or other pulmonary problems.
This is a very good thread. Thanks for bringing it up.
I was on pred 6 times in 2010 and antibiotics more than that. My worst year ever! The two years before that I was only on it twice, and for the 17 years before that ocassionally, but not once a year. Eighteen years ago was another bad year for allergies and sinus infections. I was on mederol dose packs about 5 times, low dosage. After allergy testing found nothing, my husband and I decided that it was some "high tech" air filters that he had gotten. We got rid of those and I stopped having the sinus infections.
In 2008 most of my bursts were low dosage from my allergist (40 mg for 5 days). She has been ordering lots of tests to try to find what is keeping my lungs so inflamed and is very mindful of what the pred does long term. The last dose was in October from my primary care provider and was 60 mg for 7 days. Withdrawal from that was horrible pain, but it was needed for a para-flu virus that almost had me in the hospital twice. That would have meant IV steroids. So I am very thankful I avoided that.
My meds list- two puffs Advair 230/21 twice a day, two sprays/nostril Patanase twice a day, pulmacort sinus rinse once a day (I have to mix that in my sinus rinse bottle), guaifenesen-PE 4 - 6 times a day, 3 zyrtec a day, Singulair, Dexilant, ranitidine, 100,000 iu vitamin D3 a week, weekly allergy shots, and monthly Xolair shots. In addition to that, if I know I will have to be around a lot of fragrances, I take klonapin, tessalon pearl, an extra singulair, an albuterol neb, extra Patanase, atrovent, and NasalCrom. I also have RLS that is made worse by the asthma meds so I take requip for that. I feel like a walking pharmacy.
I just had an impedance study done that shows I have significant acidic and non-acidic reflux described as chronic GERD. At this point I have not discussed it with any doctors so I don't know what will be done about that.
My allergist just got back from a medical conference. I saw her in the hall at the office as I was paying for my allergy shot the other day. She stopped and talked to me and told me that my name is in her notes from the conference. She marked several things to try with me.
Some friends keep asking me if trying another allergist would help. My allergist is a professor at the med school, lectures around the world, and does her own research and development. She is a fellow in both of the US's allergy and asthma boards. She is the very best in the area.
We did try to find a pulmonologist for me last year. That was a total disaster. The first one was just plain rude and dismissive. I saw her two weeks after nearly being hospitalized. I was still coughing gunk up in her pressence. She did not listen to my lungs at all, but said I was better because my peak flow had increased 20 points since the first time I saw her (she was heading out the door of that visit when she remembered to listen to my lungs). Between the two visits my peak flows had been up 100 points. Her whole attitude was that treating asthma was beneath her. She was fired after the second visit. I really liked the second pulmo I saw, but he has since quit private practice and is the hospitalist. So, I am back to not having a pulmo.
Well, that is my story. Yeah, pred is a terrible medicine, but it is very necessary at times. Having the propper maintenance meds can make all the difference in not over using pred. Another thought to consider is that asthma is not the only disease/condition pred is used to treat. There are many other uses. I refused pred for a non-asthma use in 2009. It took longer to get over the problem, but it was a wise choice.
Tammy, a friend just told me that she was on cromlyn (sp?) neb the last time she was in the hospital and it worked very well for her. Have you tried that. It is not a good rescue med and is no longer available as an MDI, but it might help you. Also, have you been evaluated for VCD?
I don't know how bad you condition is because you speak only of the treatments. You are taking an alarming number of meds so I assume you are a serious case. To help you along you might consider taking some natural anti-inflammatories that have no side effects. I am thinking mullein, marshmallow and large doses of vitamin B5. Prednisone and inhaled steroids can cause osteoporosis, but I guess you know that. It can also cause adrenal fatigue, which it did in my case. Here's hoping you are just having a flareup that will soon subside.
Sometimes heartburn is caused by a deficiency in stomach acid. (I would have thought it was due to too much acid.) This happened to one of my daughters. She was told to take a spoon of apple cider vinegar before eating. The condition disappeared immediately.
I am also no fan of steroids and have stopped using them, having suffered serious side effects. In addition to adrenal fatigue, it gave me a serious case of chronic bronchitis, which I thought was a worsening of my illness. When I stopped taking the poison, my bronchitis abated. There is little talk of horrendous side effects, a case where the FDA is not doing its job. They did put out a warning one year ago saying that Advair should only be used when nothing else works, and even then, for only short periods. Well, that was something, anyway. But I still see Advair aggressively promoted on TV as though it were a panacea. Hah!
Don't forget using bursts can cause polar cataracts- something I am having great difficulty with. I had to use bursts about 6 times in the past 10 years.
Just a comment- I have read posts where someone has PF of 480-510, etc. Man, mine are only 350 at best! I am 5'4" female and when ill PF are only 250...
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