I've heard prednisone called "the worst miracle drug ever."
When I started taking it in May, the majority of the improvement came overnight; within a couple of days, I felt almost normal.
But I also felt hungry (like a baby who needed feeding every two to three hours), and euphoric, and I couldn't sleep, or I woke up, more than once a night, in a cold sweat.
So while getting a firm diagnosis of Rheumatoid Arthritis upset me, at least it meant there would be meds other than prednisone in the picture, meds intended to treat my disease and not my symptoms.
We had a plan to decrease the prednisone gradually, and I went fairly smoothly from 10 mg a day to 7.5, from 7.5 to 5. Getting to 5 eliminated the nighttime side effects almost entirely, which was a relief.
The day I left for Atlanta was the day to go to 2.5 mg, to break the little 5 mg tablets in half and take a slim crescent, the last step toward eliminating prednisone altogether.
But I sat in the airport on that day of flight delays and watched my fingers start to swell and felt the odd sensations that I get when my toe joints are inflamed, and I called the doctor's office and received the instruction to wait another month before trying to reduce the dose.
So, yesterday I did it. I took one of the broken tablets, and I waited. I'm going to say I noticed my joints more than I have for a while, everything that tends to bother me did a little bit more than the day before. I'm trying to remember if it didn't feel like this going from 7.5 to 5. I think maybe it did, and then things normalized. One of the side effects of steroid withdrawal, ironically, IS joint pain, so what can you expect?
It's too bad a person can't keep taking prednisone, since it works so well for symptoms, but I've also gained weight and had dental side effects (Hello! Please feel free to have seven cavities!!), and I am very, very hopeful about being able to stop taking it altogether before too much longer. The idea is to give it two weeks at this new level and then stop taking it.
I guess this is also a test of the methotrexate, to see if it works well enough by itself. There are many other medications available for Rheumatoid Arthritis, but you have to prove methotrexate doesn't work by itself before insurance companies will pay for the others, which are, not surprisingly, more expensive.
It's funny that insurance will pay for the drug that works for a lot of RA patients, though no one knows why for certain, but resists paying for drugs developed to inhibit specific disesase processes that are part of RA. Not surprisingly, the reason is money. A year's worth of methotrexate costs under $600 in the generic tablet form, and I pay $136 of that. The newer drugs cost more than $16,000 a year. I have a prescription plan, so I wouldn't have to pay a giant proportion of the cost, whatever drug the doctor prescribes, probably in the neighborhood of $300 annually. I'm lucky in that.
But I also worry about the delay in figuring out whether it's methotrexate or prednisone that has been making life livable, or some combination of the two. I've been on methotrexate for almost 12 weeks, so if I feel miserable without the prednisone, that should be an indicator that other or additional meds are in order.
All this means I don't know what the next few weeks will be like. If I feel okay, that is a sign that methotrexate by itself is enough. If not, there will be another discovery phase to find something that works better.
Sometimes people pray for particular things, perhaps as particular as which drug might work, but I'm simply praying for *something* to work and, whether or not it does, to have the courage to take on whatever comes next. So if you are the praying type and want to join in, I would appreciate it.