Prednisone vs. Hydrocortisone for Adrenal Suppression: Pros, Cons, and Tips

One of the things that always puzzled me as I read through medical journals and textbooks was one would say to use Prednisone while another would say to use Hydrocortisone for adrenal suppression. These were always one-off sentences, almost throwaways and there was never any elaboration on the why of it. Nor a comparison/contrast of one steroid over the other.

I think I know the why part of it. Maybe.

It's a half life thing.

Prednisone sits and sits and sits in your system. If memory serves, the endo calculated a half life of slightly over 24 hours.

So if you take Prednisone every morning, there is never a time where you are without and this can work against HPA axis recovery.

Hydrocortisone, on the other hand, has a half life of 12ish hours. So you have at least half a day without any steroids in your system, time in which your brain is supposed to go 'oh sh*t, we need steroids STAT' and trigger natural steroid production. The 'oh sh*t' moments help the HPA axis recover functionality.

Now, when I was very first diagnosed as being suppressed, my am cortisol was 1.3 and Prednisone was used to treat it. I am torn on whether or not this was a good thing. At a level of 1, your body needs some help--a cortisol of 1 is not really compatible with life--and it's probably not a great idea to have a short half life steroid, at least not initially.

However, I don't think we needed to use Prednisone the entire year and I wonder how that prolonged the recovery. Also, I ended up with a pretty bad case of exogenous Cushings from the treatment, which tells me the docs weren't doing the greatest job of calculating my dose.

And this was with regular ACTH challenges. So they had data. I don't know what they were thinking. If I'm in the mood for masochism, I'll find some old pictures and show how bloated my moon face was back then. I even had a hump! I might have benefited from switching to Hydrocortisone during that episode.

Of course switching from Prednisone to Hydrocortisone this time was not easy either. It took me a very long time to adjust. So long the endo even said 'Wow, that's a long time' when I told him that I didn't adjust until February.

The pain. Oh God. The pain.

It was enough to make me fantasize about narcotics. Or drinking. Or narcotics and drinking together.

I don't drink.

I hate narcotics.

But I thought about them, very fondly, from December through February.

What I ended up doing was splitting the dose even though the endo told me not to. I came clean last week and told them I did it anyway in the hopes of helping other patients down the line. It made life livable and it did not impede recovery as far as I could tell. (And the endo doesn't seem to hate me for being such a rebel, I was clear the situation was intolerable without split dosing.)

Knowing that the goal was to be without steroids in my system as much as possible, I did the split doses all before noon. To be clear, I didn't change my total dose, just split it in two.

I took the first dose in the morning when I got up (usually between 7 and 9am) and then the second dose between 10 and 11am. This made it so that the excruciating muscle pain did not hit until after I had finished my evening job and put my toddler to bed.

At night, I used Tylenol pm or Advil pm or Benadryl to help me sleep through the pain.

Gradually, over time, I took the second dose earlier and earlier until it merged with my morning dose. That was the point where things seemed to improve. The pain faded. I began to exercise. Tapers started happening faster and faster.

Hydrocortisone has not caused severe Cushings like the Prednisone did, but we've also been working with much lower doses. My memory is a little foggy, but I seem to recall starting at 20mg of Prednisone last time and camping there for months, which is a lot.

Prednisone seems to be less painful, but also less effective than Hydrocortisone. Which is not ideal when you have the lazy stubborn azzhole HPA axis I do.

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I Love Prednisone & I ain't foolin'

I love prednisone in the summer, I love prednisone in the fall, I love prednisone in the winter, and I got my hands on some today because I am very very lucky and this doesn't have to rhyme.

I've had two itis-es since Saturday: laryng- and bronch-, and finally went to the doctor today. I was already on the mend. That's how it always works. She told me to use my inhaler every four hours but the albuterol wasn't doin' nothin. So she gave me 10 20-mg tablets of prednisone--co-pay only $2.40. What can beat that?

I love prednisone because it's the one thing that always cures my very bad asthma or bronchitis. I try to avoid it because it's not good for you--I treat it as the last resort. In fact, I wrote a long poem about it as last resort many many years ago, when I was at a resort of sorts, an artists colony in the middle of allergens. The poem was almost accepted in a feminist magazine's special issue on invisible disabilities, but the editor objected to a line about breaking the back of something, maybe capitalism. It was ableist to be seeing a broken back as negative, that was the argument, though the back that was being broken was sheerly metaphorical. Maybe that made it worse. Anyway, it's probably one of the better poems in English about prednisone.

Stanley Elkin wrote a wonderful essay, Out of One's Tree: My Bout With Temporary Insanity, about craziness caused by high doses of prednisone he was taking to treat breathing problems caused by his MS. He might also have been taking it for the MS itself. I sent a copy of the Elkin essay to my cousin D, after our family dinner was briefly interrupted by a call from one of his patients. D is a psychiatrist, a psychoanalyst yet, and I think he had to admit his patient to a hospital because she was suffering from prednisone side effects. But I never take it long enough to be so affected. I don't think.

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Rising Above

It may be premature yet to say this, but I feel like the taper to 20mg of Hydrocortisone (which is the equivalent of 4 mg of prednisone) is a success.

Here's what I did today; grocery store, pharmacy, craft store, made cookies, did a Valentine's craft and will be making dinner.

I've also maintained some semblance of an exercise routine throughout the taper, which is huge (although a good bit of that was me saying F*ck You to the fatigue, adrenal and muscle pain and exercising anyway).

Nor have I been sleeping much as the toddler has been up at night having problems breathing.

Those of you who have been reading a while can understand how good this is. To do all this and not crash is monumental. I am pleased.

On top of that, as of today I am condensing the pills, no more split dosing. We'll see how that goes over.

The eerie thing is that this taper has gone well just like the taper from 5mg to 4mg of prednisone. Odd that this would be consistent. 4 to 3mg of prednisone marked the beginning of the end last time, will it be the same this time around???

I won't find out for a couple of months. The plan is to just park at 20mg of HC until March. Of course I say that now, knowing full well I will start to get impatient sooner as opposed to later. But the smart thing would be to wait, here's hoping I'm as smart as I think I am.

With the HC's shorter half life and the fact that I'm now at a sub-physiologic dose, between the two, this will hopefully give my HPA axis ample time to recover fully.

On the toddler reading front, if anyone cares, I'm just reading the Usborne Phonics Books and asking her to read the words she knows/introducing her to new ones. This approach seems to be working well and the books also have whimsical plots that hold her interest.

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This Is Your Brain on Steroids

I am tapering down to 4 pills which is roughly 4mg equivalent of Prednisone or 20 mg of Hydrocortisone.

This is a sub-physiologic dose!!!

I am taking it slow. Trying alternate day between the new lower dose and the old higher dose. Hoping that is effective at gently easing my brain into the new dose.

Which I need because, yesterday? My brain did not work. At all.

Went to the mall with a friend and my brain decided that Floor 3 meant we had to go down to the basement level instead of up to the actual third floor.

I took me about 2 minutes to realize my mistake.

Why yes, I do drive a vehicle with that cognition. Defensive driving, it's not just because of the drunks people. Also, those people driving slow in one lane? Might just be trying not to kill anyone so stop honking.

Further, I hope to go back to work with this brain. I'm sure my work performance will be stellar! Right? RIGHT?

Embarrassed, I explained to my friend that I was tapering steroids and therefore was not in full possession of all my synapses. Fortunately, they have known me for a looong time and it was no big deal.

But gah.

My brain is a moron.

On the klutz front, I have lost all the skin on my toe (and I mean ALL of it) from the blister which is minor, but majorly annoying. As I had plans to like, you know, use my leg in the near future. The ankle, is ostensibly the worst injury but it's just bruising, not sprain or strain so it's functional. Nor does it rub like the toe, which aggravates the whole thing.

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Prednisone Hydrocortisone Flip Flop Flim Flam

The endo called and is perplexed that the HC is causing problems.

All I can say is I had one AI patient warn me that HC threw them into a crisis and landed them in the hospital.

They take prednisone now.

Adrenal stuff is the weird shiznit.

Or maybe it was just the BP meds. Maybe my high blood pressure has just gone back to normal. Which is also weirdness of the yo-yo variety.

Regardless of the weirdness, we agreed for the weekend I'm doing prednisone and then I'll go back to Hydrocortisone on Monday. If it doesn't go well, I call back.

Just so we don't have to worry about me totally crashing over the weekend.

Which is a blessing as I am volunteering at the preschool's allegedly 'free' breakfast with Santa Claus (since when did free mean I have to provide $20 worth of food?) and going directly out-of-town for the extended family Christmas/ Grandpa's 80th birthday party on Saturday. It is a go go go day.

Not a good time to be struggling and not the kind of thing I can survive without some steroid support.

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A List & Day One

1. The hydrocortisone dose is 20mg.

2.I am no longer taking Singulair. There never seemed to be a good time to mention that, it never fit the narrative I had going at the time. It's now back to being an 'as needed' medication.

Only took 9 months!

3.Slowly realizing I have more problems with muscle cramps/pain than I have allowed myself to feel. To where I almost denied having them to then endo. Almost.

There are things I just ignore. I have almost daily neck pain. My gut is still painful from the cranberry acid. These are not things I dwell on, except maybe here on the blog. I am used to ignoring muscle spasms/cramps unless they are really bad because I've had them for years.

Luckily the toddler used me as a jungle gym the other day and the pressure of her hands on my legs was enough to make me yelp. I actually didn't realize I was in so much pain, it was kind of latent. Because of the toddler, I fessed up to the endo.

It doesn't help that I always like to blame the muscle stuff on steroid withdrawal. As in, now that I've gone back to 5mg, I feel good, but my muscles are all up in arms and very pissed off about it.

4.I am now taking Liosinopril daily. I don't get it and am confused. When did I switch from having high blood pressure that didn't respond to medication, to not needing medication at all, to suddenly using one medication for high blood pressure that seems to be working?????

Or has my body now decided to do it by the book and ramp up the BP with the prednisone?????

And how will the hydrocortisone affect that? It has more mineralcorticoid activity than prednisone meaning, from what I understand, it will influence blood pressure quite a bit more, but I don't know which way things will swing.

5.Bumping up to 10mg on Friday was fantastic. It worked really well and seems to have help flip the switch so that 5mg now is feeling pretty good. I think I underdosed whatever that episode was prior to Thanksgiving which is why I was dragging for so long. A one time booster dose worked wonders.

So today is day 1 of Hydrocortisone (HC), I hope it goes well. We also have a blizzard warning and I will be so bummed if pre-school closes. Parent-teacher conferences are today and I have been waiting since August to hear what's really been going on at p-school all these months.

I would call off my tutoring tonight, between the storm and the HC, but the last time I tried to call the family, I couldn't get through to anyone.

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Down and Out

1. The cranberries are still having their way with me and they fight dirty. GERD pain is the worst and it's still hurting three days later.

2. BP tanked to 100/70 from a high of 150/100 (highest ever at home and my heart rate was an impossible 57) but I started BP meds anyway. Felt like my head was going to explode yesterday.

The drop in pressure didn't bother me like it has in the past, mostly I felt blessed relief. Still spent lots of my free time on the couch though, applying direct pressure to my brain in an attempt to squash the never-ending headache I seem to have of late. Watched the Rudolph the Red Nosed Reindeer special with the toddler sitting on me.

No back pain this time either.

3. I am irked that my body had a trend going and now this latest turn of the medical merry-go-round is doing something different. I guess consistency is too much to hope for.

4.Why am I still so so sooooo tired? I just feel wiped. I never got to 100% this time around although I was able to do things like grocery shop and feel optimistic. It reminds me of August when I never felt good, but was never bad enough to justify taking prednisone. Except I'm on prednisone so...?

Mostly I am just feeling deflated and like things are never going to improve.

I thought I would be exercising by now. Be back to my usual self. Instead, I feel like a sloth with mono.

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Cranberry Revenge

It seems that eating copious amounts of cranberries is not such a good idea if you have GERD.

Ow. Ow. Ow. OWWWWW!

That hurt.

My blood pressure is also being very bizarre.

I am going to try some BP meds to see if that helps bring it down as it is getting scary high.

I have lost weight. Then lost more weight. I was exercising until all the fatigue ate up my life. I cut out salt. Quit caffeine and all I have to show for it? Peak and valley blood pressure.

I did all the right things and I have this zig zagging blood pressure that, right now, is making me very nervous. Usually it spikes and then tanks. Usually it doesn't spike at all if I'm on prednisone so this is very much going against trend.

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Back to Normal

Normalcy is the theme right now.

Done with the excesses of the holiday.

Back to low carbing.

Done with the excesses of prednisone.

Down to 5mg.

Waiting for 5mg to feel good so I can get back to exercise.

Done with the shortcomings of aberrant adrenals.

For the moment anyway.

Changing topics...

Got a call from a mom friend whose little one has asthma and is not getting relief with the current treatment plan.

Clarification, I've been getting phone calls from this mom friend for a while now.

Because it's not been going well for her little one for longer than it should.

So now they are on the merry chase for the right doctor, the right medication, the right tests.

Call me crazy, but I think medical 'Chinese fire drills' are really the biggest problem in health care. Both in terms of costs and quality of care. When a child with asthma has to see more than 4 doctors to get proper care which, in turn, also forces them to use Urgent Care or the ER as the stop gap, it's costing everyone a lot of money.

No one wins.

But that's just normal for our medical system.

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Vegging

I love the holidays and am thrilled that I feel good right now so I can enjoy the kickoff for Christmas.

The tree should be going up today.

We made another pumpkin pie because the hubby loves it. The toddler helped me make it saying, "Mommy, I'm making Christmas," as she stirred.

Everyone's still in their pajamas, the house smells like cinnamon, the Christmas music is jamming and the sun is shining.

It's gonna be a great day.

But not perfect.

I've had some resurgence of the back pain as I've tapered, but I'm trying not to give it too much attention. I did find some patient accounts of having pain that persisted past treatment so the idea that prednisone must fix everything 100% perfect or else it is not adrenal is not borne out.

I have had back pain with tapering before. Based on past experience, so long as the BP is okay, it should resolve as my body adjusts to the new dose.

However, just because I want to be sure to I'm okay today, I tapered to 6mg instead of 5mg, which I'll do tomorrow. The last thing I want is to be zonked from tapering.

And now I have to go. The family is demanding lunch.

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Truth

I am holding steady at 3mg the same way a rock climber hangs by one hand after their ropes have split and the edge of the cliff looms large.

We'll see if I can pull this one off or not.

And for future reference, when your toddler tells you they are eating your soup, don't get too excited.

They are not eating your soup.

They are feeding it to the dog.

Along with a stick of butter.

So doing the happy dance in the other room because she's eating soup packed with vegetables is kind of irresponsible parenting.

Three year olds are a danger to themselves and others. They know just enough to get the lid off the probiotics supplement container, but not enough to realize eating them all may result in unpleasantly sh*tting their brains out later.

Your husband will not know what to do and when he calls you at work to ask, you will tell him it's probably fine, but call Poison Control just to be sure. And he will ignore you because why no one will ever know, however, your banshee shrieking upon uncovering this oversight will certainly ensure he doesn't do that again. Or so you hope.

True story.

Parenting: The only job you'll ever love with all your heart and never be good enough for. The performance reviews are bruuuutal.

True story.

Okay. Moving on. Let's answer some questions from yesterday's post.

Ezekiel asked: "If, hypothetically, your cortisol production doesn't wake up again is there an alternative to pred?"

Yes, but I don't know what the doctors would actually end up prescribing. But yes there are other steroid meds, some are considered better than prednisone. More detail on this when I answer the next few questions.

Anonymous wrote: "I think you're trying to taper too fast. I know most docs say to drop every two weeks, but for some of us it appears we are much, much more sensitive to the drops and the side effects of tapering make it soooooo hard to get through the days. I really think you need to stay at each dose longer and also go down by smaller amounts than 1 mg. Also, I've read that if you use your rescue inhaler more than twice a week, your asthma is not well controlled. "

You know, all the pulmonologists and endos I've seen all subscribe to the 5 day taper paradigm. I have heard of longer tapers, which is what inspired me to stick at 3mg for two weeks, but no actual medical professional has ever advised this.

As for the asthma, eh. It's annoying and unpleasant, but not impressive. I've seen worse. I'm not too worried about it. Once I get my adrenal glands going again, I will be willing to add in more asthma meds like Pulmicort, but I really don't want to muddy the waters with more steroids. They say the inhaled steroids don't have the side effects of the oral ones and true, it's not as bad, but I still react to them.

Yes, I am a special snow flake.

You may all applause. Delicately though, I am sensitive.

Edited to clarify: The asthma is the same no matter what I do. The amount of breakthrough symptoms and use of rescue inhaler has been steady so what's the point of more meds? I've done it both ways, there's no difference.

Tracy wrote: "Mayo's endos in Minnesota do adrenals just fine in person - we've seen them for secondary adrenal suppression among other things. In fact, Mayo has one of (if not the) top experts in the world in adrenal tumors.Why aren't they using hydrocortisone instead of prednisone? "

Either I am mis-remembering the info on Mayo or was actually on some other medical system website or didn't see the info you found. Or you got lucky (pass some of that luck over would ya?). The fatigue does kind of eat my memory similar to new parent sleep deprivation.

From what I have read, the steroid used for Secondary Adrenal Suppression varies. It can be either HC or prednisone. Several pieces of medical literature I've read prefer prednisone over HC for SAI but no one ever says why, which is kind of odd since HC is supposedly superior.

Badturns wrote:I'm certainly not pushing the Mayo Clinic because I have no experience there, but I went to their endocrine site and looked at the doctor's profiles http://www.mayoclinic.org/endocrinology-rst/doctors.html There are some with adrenal function/dysfunction listed under "interests" and in their list of publications. E.g., this guy: http://www.mayoclinic.org/bio/10024956.html

Yeah, my memory of what I saw or didn't see where may be flawed or I may have missed something.

However, I will say I'm wary of 'pituitary centers' which is where some of the endos who do adrenals end up. Cushings patients often report cold abuse and lack of care when they seek help from those specialty centers--these are people who actually do have tumors on the pituitary and the pituitary centers are refusing to test! They get their diagnosis from a 'not pituitary center.' It's that f*cked up. Not saying it would happen to me, but, given my record thus far, I am really good at finding doctors who could give a sh*t.

Honestly, I feel awful for endocrine patients. The stories I read online are heartbreaking. People are ignored, belittled and mistreated...by the uber specialists, the doctors who are supposed to be the endgame of medical perfection. It's horrific. Believe it or not, I am nowhere near as bad off as some people. There are people out there who have proven tumors on their pituitary and the doctors still don't care. Isn't that crazy? Shame on those doctors.

Run2WinthePrize posted a comment on the Methacholine Challenge test and I just want to respond here too so she is sure to see my response.

1. MCT negatives have about a 10% error rate from what I remember so with all your symptoms I would definitely go to that other lab for another MCT to rule out operator error or equipment failure. A negative MCT is not 100% accurate and someone has to be that 10%, you know?

2.I hope you find an answer soon especially since you are so symptomatic.

And that's it. Did I miss anything?

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The View from 2mg

I tapered down to 2mg yesterday. It seems to be going better than 3mg. Yesterday was a bit rough, but I violated my rule of staying home and doing nothing. Instead I packed boxes with gifts for children overseas for a church charity thing.

Not my church, a friend's church. My father was a minister, retired now, and none of us do organized religion in any way shape or form, we are beyond burned out. Although I plan on torturing the toddler mightily with Sunday School at some point.

So anyway, I spent about 5 hours there mostly because the toddler was having such fun playing with all the other kids, not because there was that much work to do.

It kind of wiped me out a bit though. I had some transient flank pain and the blood pressure sank a bit more than usual. So I downed my favorite adrenal cocktail: pickles and brine and chased it with some sugary stuff. And it was fine.

I am hopeful that I will be off steroids by Christmas. Then we see what happens next. Will exercise tank me again? Will any medical professional give a sh*t if it does? How many prednisone refills will my endo give me before either deciding I'm an addict or thinking gee, maybe we should like, you know, collect some empirical objective data on this because maybe there's something more serious going on?

Today I have stayed home, although I called to make a doctor's appointment for a nagging issue that has not resolved since March. I am not at all worried and am just doing my due diligence, but it's one of those things that until they know for sure it's okay, it's like DEF CON 5 to a doctor.

So I may have to traipse out to see the doctor today.

I purposely waited until noon to call so I could make an actual appointment and not get rush treatment.

Listen, I REFUSE to have any more problems. There IS NOT GOING TO BE ANYTHING WRONG.

Got it?

Also, while we're at it...a quick shout out to my stupid gallbladder. STOP SPASMING you wimp. You don't have stones*. There's no need to have a seizure in there. WHY are you bothering me??????? Sit down and shut the hell up. I don't want to hear a peep from you unless there's a stone so big I can palpate it myself. Until then I am IGNORING you, you jacka$$.

Oh. Hahahaha. They just called. I must've been convincing, they gave me an appt for next week.



*My gallbladder periodically behaves badly. So badly I can't sleep on my side for months at a time, too painful. There are never ever any stones. It's never anything except painful. I have had this off and on for about 6 years now. Someday I will get to a GI doc and probably find there are GERD related gut motility/functional issues like my Dad has.

PS: I responded to comment on the last post IN the comments. Just FYI.

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My Big Secret

First a housekeeping note: This blog now allows anonymous comments. I learned the inability to do a url/name comment was causing some people problems. So I think I have fixed that. Unless I get a bunch of nasty trolls, anonymous is fine. Just type in some kind of name so we know which Anon is who.

Ezekiel asked...

"My next question, why taper so quickly? You seem to be struggling with the current taper schedule. When I was coming down from 5mg, I went to 4mg for six weeks, then 3mg for six weeks etc. I actually got down to 1mg, but my symptoms came back and I had to go back to 10mg for a week then back down bi-weekly until I got back to 2mg where I've stayed. Some of my fellow patients have tapered started at 5mg then every other day take 4mg for two weeks then stay on 4mg for two weeks, then every other day with 3mg etc.

Hope I haven't overstepped. I just know how miserable it is to come off too quickly and I want to help if I can.

Thanks again for responding. "

Okay, here's the big secret.

Are you ready?

Can you handle the truth?

I'm going to SHOUT so brace yourself.

I HAVE NO EFFING CLUE WHAT I AM DOING!

NONE.

I AM MAKING THIS UP AS I GO.

BECAUSE MY ENDOCRINOLOGIST ISN'T DOING ANYTHING OTHER THAN PRESCRIBING PREDNISONE.

THAT IS THE SUM TOTAL OF MY MEDICAL CARE FOR SECONDARY ADRENAL INSUFFICIENCY.

I'm not shouting at you by the way, just into the wind. So it can throw the spit back into my face, that's the only way I'm sure I'm actually making any noise. I can't tell from the complete absence of medical care if I'm really getting the words out or not. Maybe I'm secretly a mute and didn't know it. Or maybe the doctors are all deaf and they don't know it.

"Here's some prednisone, now go away." That is all I get.

Okay, yeah, I got a suggested taper, but, if the science says that anything over 5 days over 5mg is going to make the hypothalamas-pituitary-adrenal axis suppression worse, would you follow a dose that told you to take 15mg for 15 days and then just stop cold turkey? Especially when dropping from 10mg to 5mg just about brought you to your knees?

I didn't think so. (And I have disclosed to the endo what I'm actually doing for the most part. They know what I think of their taper and literally gave no response at all to my concern, just a shrug.)

Sad, isn't it? Especially considering the risk. Can you imagine if I knew NOTHING and was trying to sort this all out on my own? I could easily kill myself.

Hey, would you like to meet my real doctor?

Say hello to....ME.

Yep, I'm practicing medicine without a license.

As for your comment, your suggestion is a good one. I do think I'm going to have to camp at lower doses for longer periods of time before continuing the taper. At 3mg I am mostly functional but it is not easy, I have to push myself. Exercise is only happening because not exercising is starting to hurt. My body needs me to move, so I'm moving.

I am going to try 2mg later this week and if that goes okay, I'm going to sit on that dose for a while. Maybe the rest of the month. We'll see.

For the record this is the slowest taper and lowest dose I've ever done.

As hard as this is, I am taking the following as a BIG positive signs:

1.No adrenal flank or back pain
2.Haven't been forced to bump up the dose through 2 colds now which, I think, is HUGE.

If I don't have to stress dose, I must be making cortisol. Just a question of whether or not that will hold up.

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Diving into the Tear Pool

Well the toddler did not nap yesterday and I am the kind of mommy who was a light sleeper going into motherhood, and now, with the mommy radar? I can not sleep unless the toddler is sleeping. Every song, every whisper, holler, and bam of books as they hit the sides of the crib keep me on the edge.

Then the hubby came home, he who has the gift of death sleep. He crashed into bed and began snoring like a dragon with sleep apnea.

So between a rock and a hard place...

I began smacking the hubby on the shoulder and hissing for him to roll over. The toddler started screeching the ABC song like an opera singer with laryngitis and a love of Chinese music scales.

At which point, I actually cried because I was so tired and I knew there was going to be no nap for me.

The hubby was resentful because I made him get up with the toddler. He had no clue I was in the middle of a taper not going well. He doesn't pay attention, he doesn't ask and I don't bother him with it for the most part. When I do tell him, he forgets.

So...the result? Mutual resentment, every marriage's third wheel. Public displays of which are also fun at parties.

This is a problem and I don't know the solution.

Anyway, I took some Nyquil last night and got abut 8.5 hours uninterrupted sleep with another 2 trying to ignore the wailing of the toddler. Note to hubby, you have to feed the littles, they are unpleasant inmates otherwise. Adults can skip breakfast, children can't unless you actually want them to behave like unmedicated lunatics.

So yesterday imploded pretty spectacularly. Today is hurting, the sleep was not nearly enough, I could have slept all day if not for the way my house conducts the shrieks of the toddler straight into my throbbing head. The 3mg taper officially sucks ass.

I overdid it yesterday, I know. I had the toddler out on the town from 9 until 2. Too much for me. But I needed a hair cut desperately, I've now lost too much hair to do long hair. My mother's group sent out a call for help, I showed up. That was dumb.

As usual I was fine right up until I hit the windshield of the universe going 80 million miles per hour. SPLAT.

Now I am trying to figure out how to survive this adult Halloween party the hubby is all hepped up about going to tonight as well as how I'm going to manage the groceries. I was supposed to go last night and couldn't. Thought about trying this morning and can't. Tomorrow will probably be out by virtue of the party.

Can't send the hubby on his own either as I've switched stores and shopping strategies, it would be a financial disaster for him to go by himself right now.

Hopefully I will get lucky and my body will adjust to this taper sooner as opposed to later so I can once again handle the simple things most everyone else does without a second thought.

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Waiting

The 3mg taper is not as easy as the 4mg drop last week.

Man am I pooped.

Once the toddler is finally down for the nap count, I am going to crash into my bed.

I can not wait.

So tired. How is it possible to sustain life and be this tired?

We'll see how I feel over the next few days, but if today is any indication, I may camp at 3mg for another week before dropping down to 2mg.

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From Good to Better with Hope of Pumpkin Festivals

Last night?

ZERO asthma.

NADA.

Yay!

Did the toddler sleep through the night?

Nope.

Boo hiss!

I could really use some good, restorative sleep.

I did exercise though. I hate not exercising, it has been hard to just sit around and not do much other than feel like my fat was getting fatter. So my thought was to exercise until I taper, then do nothing for about 48 hours until I'm sure my body has adjusted. Then exercise, lightly, until the next taper. Rinse and repeat.

Sounds like a plan to me.

In other good news, this Saturday is looking super gorgeous and the pumpkin patch is still going strong. Since the hubby and toddler got rained out the last time and I was too sick to go, it looks like we are getting a second chance at my favorite Fall activity.

This week is looking very happy. I could get used to this.

I am wracking my brain trying to find a way to do the mummy thing I mentioned yesterday too. There has to be a way. We'll see how I feel with the taper down to 4mg.

OH! And I finally bought a scale and I have lost another 5lbs. How I don't know because there's been zero exercise and I've been eating more--I have prednisone appetite and there was a lot of cake over the weekend. Total carb binge so I know I'm retaining a buttload of water.

On the one hand, I've felt really negative about my weight especially with the lack of exercise. On the other, I noticed my bracelet was just hanging on my wrist and my ring had become capable of just slipping off. So the scale helped me sort all that out and shut down some of the self-abuse.

I'm now back to low carbing and hopefully I'll drop another 20 lbs asap. At that point, I'll be in the home stretch to the current goal weight.

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JINX!!!!

Shhhhh.

Be vewy vewy quiet.

I think I turned the corner.

I only had to use the inhaler once last night instead of the 3-4 times it's been used the last several nights.

Only once.

That is GOOD.

I have less gunk.

That is really GOOD.

That'll teach me to whine dire health predicitons on the internet.

But shhhhhh. Don't tell the universe. That bitch hates me.

Also, it's not like the toddler slept.

The truth about parenting?

For realz?

Kids only sleep when you don't want them to. They never sleep when you need them to. Never.

You've been warned.

So the lack of sleep on top of the lack of sleep sucked zombie azz.

Two days of bday parties (hers and the neighbor boy) with no nap and copious amounts of cake turns out to negatively impact sleep in the under 5 set.

Who knew?

You know what I want to do now that I feel so much better? I want to have a mummy musical parade for the neighborhood kids. I have a not scary mummy story I can read for the littles who don't quite know what a mummy is yet. Excess toilet paper to make mummy wrappings. Everyone would bring their own musical instrument and we would make a racket. I think it would be fun. The toddler would love it.

But I need to taper down to 4mg on Thursday. Which means I have to sit on my hands because I will (most likely) have the energy of a comatose sloth.

I am grateful for prednisone, but I also hate it.

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Stockholm Syndrome

Everyone is sick with a capital S.

The toddler is taking her inhaler because she's barking like a seal at night. The boogie drainage is out of control.

Hubby is getting better at least, but still congested and napping a lot.

We've managed to infect a relative RN who is staying with us to help care for our elderly relative with lung cancer (she had a large portion of her lung removed this week along with a tumor). Can you say bad timing?

Everyone is sniffing, sneezing, talking like they smoke too much and popping Dayquil and Nyquil.

And I am over here thinking, how am I not sick? HOW?????

Usually if the hubby is sick, I am done for because he only gets sick with new super germs (i.e. he is NEVER sick so if he is sick, it's some serious viral death.) The last time he got sick, I kissed him and ended up puking my guts out which bought me a diagnosis of adrenal suppression.

Sometimes, I am the last to get sick. Sometimes I fight it for weeks before it finally overwhelms my immune system.

I hope that is not the case, but man, am I nervous. Even though I had to take more prednisone than planned, I did just finished completely weaning off the Pulmicort. I will be SO irritated if I have to go back on that shit, you have no idea how pissed I will be about that. Kicking puppies and screaming MotherF*cker pissed (I'll wait until the toddler is asleep/out of the house, don't worry. Actually, I would never kick a puppy, but I might slam some cupboard doors and swear extensively).

Why is it always two steps forward and three hundred miles backwards? Why?

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