I Wish Prednisone Didn't Have Positive Effects on My RA
Along with rheumatoid arthritis, I live with another autoimmune condition called Crohn's disease. Luckily, the same systemic biologic I was prescribed for Crohn's also manages my arthritis.
In general, I'm lucky to say that my conditions have mostly been in remission for the last few years. With a combination of Remicade via IV every 5 weeks and Azathioprine orally every night, things have been a lot better than they once were. This isn't to say that I've been symptom or flare-free, but in general, I can't complain about how I've felt.
Managing 2 conditions during a hospital visit
I was hospitalized for a major Crohn's disease flare at the beginning of this year. While my RA was still somewhat controlled, I knew that an increase in inflammation in my body would begin causing swelling and pain in my joints. I shared this concern with the treating physicians while I was in the hospital, asking that they consider both my Crohn's and RA when deciding on treatment options. As most autoimmune flares go, I was not surprised when I was prescribed IV steroids and discharged on 40mg prednisone a day.
My Crohn's treatment helped my RA!
I met with my rheumatologist shortly after I got home from that hospital visit, and we discussed the symptoms I was experiencing and how the steroids could affect my disease status and my body as a whole. I am no stranger to prednisone, but it's been several years since I was on a dose this high. Although it was prescribed for my Crohn's disease, I knew I'd likely see positive effects on my RA.
Sure enough, my joints began to hurt less, I noticed less swelling, especially in my knees, and I could think more clearly. This was no coincidence, as steroids work to reduce systemic inflammation in the body. However, being on steroids is not all sunshine and rainbows. The prednisone made me feel both manic and depressive. It caused my insomnia to rage, and it increased my anxiety while fueling my need to be productive, leaving me exhausted and unfulfilled at the end of the day.
It was time to taper off
These challenges felt like a small price to pay for relief from the pain and agony of an RA flare, but they are also only sustainable for short periods of time. Anyone who has been on steroids for an autoimmune disease knows that higher doses of prednisone are meant to be short-term and that the taper plan is critical.
My doctor instructed me to reduce my dose by 10mg every two weeks and then to end with two weeks at 5mg before stopping completely. The hope was, and always is, that the slow decline of the dosage allows a gradual establishment of a new baseline. It's much more tolerable than the flare itself, but without the side effects of the steroid medication.
I wish prednisone didn't have positive effects on my RA
I wish I never welcomed the benefits of steroids with open arms, but that wasn't the case. I wish I didn't know pain so bad that I desperately reached for steroids with prayers that I would find some relief. Living with an autoimmune disease, I intimately understand the risk/harm/benefit/challenge cycle of steroids. And unfortunately, I know that my use of them will not be limited to this flare or this year.
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