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Prednisone angry

I'm a 35 y.o. male, otherwise healthy. Asthma and aeroallergies since childhood. Resolved a bit in college years, back with a vengence.

I've had six flare ups requiring prednisone from Sept 07 until January 08. Now in April I caught a cold, and I am having another bad flare up. Peak flows droped to less than 40% of my normal, spiro is off too. Back on prednisone 60 mg 4 days, 40 mg for 3 days, 20 mg 3 days, and 10 mg for 3 days. Almost went to the ER, but was able to hold out at home on back to back nebs and took pred at home per my action plan.

Meds: xopenex mdi, pulmicort 0.5/3ml BID, xopenex 1.25 BID, Advair 500/50, singulair 10 mg.

1. Does prednisone at this frequent of intervals since Jan have any lasting side effects? 2. Prednisone makes me very irritable and easily frustrated and hungry? Is this normal.

Doc says that we may consider Xolair if I don't improve. Taking a wait and see approach for the next flare.

3. Am I permanently damaging my lungs by waiting to see what happens, especially heading into the pollen/alergy season?

2. Prednisone definitely makes me irritable, moody, and hungry -- and causes me to have insomnia (which is really the pits when trying to recuperate). I've heard other asthma patients complain about these side effects, too, so I think they're pretty common.

Hope that you can feel better soon. Take care. Judy

A bunch of us refer to pred as the evil candy for a reason. It's totally normal. And no, you shouldn't have any long-term side effects from the repeated bursts.

I highly doubt you'll do any permanent damage to your lungs by waiting. The issue is with your airways, and they just get swollen, which is why you have trouble breathing. Once you treat it, they won't be so inflamed, and your symptoms will reverse. Incidentally, it's difficult to get Xolair approved by your insurance because it's so expensive, so that's probably why your doctor is waiting. He'll want to get as much proof you need it as possible.

Becca

I'm sorry to hear that your asthma has been out of control, frequently in the red zone since September, requiring bursts of prednisone every 4-6 weeks. You have been taking maximal doses of the two most effective asthma controllers: inhaled corticosteroids and a long-acting bronchodilator (ICS+LABA), plus Singulair (which may or may not add to the inhalers). Your doctor is "following the book" (current asthma guidelines). Indeed, adding Xolair (anti IgE shots) is the next step.

Have you identified your aeroallergen triggers and minimized your exposures to them in your home, especially your bedroom? Have you successfully avoided all exposures to smoke and chemical fumes?

Sadly, it's very common for prednisone to cause mood changes (both when taking prednisone and when stopping it). Intermittent bursts of prednisone don't hurt your lungs, but there is a risk of long-term side-effects if you continue to need high daily ICS doses, plus frequent prednisone.

Read the paperback asthma book by Jon Berkowitz, MD, for many good ideas. Keep asking lots of questions. Please let us know about your recovery back into the yellow and green zones.

My mother has been diagnosed with aspergillosis and bronchiectasis over the past 10 or so years, and has a history of asthma and allergies for most of her life. She's been doing the prednisone thing on and off for several years, and while it's great at clearing up her lung problems, she's experiencing the problems associated with prednisone's effect of lowering her immunities in general. Within the last month she ended up with oral thrush (yes, she's on Advair, but does rinse religiously), a sinus infection, coughing that spurs a gagging/vomiting reflex, a GERD/Barrett's esophagus diagnosis, strange sensation to light touch on the left side of her face, neck and head, decreased sensation of her tongue & roof of mouth...(left side only), increased intraocular pressure of the left eye due to inflammation, left ear pain, a strange feeling that something's in her throat that needs to be removed... severe loss of appetite and weight loss of 15 pounds. Our general practitioner explained that these symptoms are not related and that they've all occurred at the same time just by coincidence. He suspects a virus....She was scoped by an ENT who said everything looked good... all thrush is gone, no further sign of infection. The Gastroenterologist scoped everything up to and including duodenum and besides minor gastritis and the Barrett's, everything else looked good. Opthalmologist is getting the eye pressure under control with drops (go figure... a form of prednisone!) Our next step is a neurologist to see if we can get help on the things going on with the left side of her head/face/neck.

Her IgE reading was over 3000... her allergist and pulmonary spec. tell us normal is around 120 or so. They're suggesting Xolair but as we already know, it's expensive and insurance companies do not like it for that reason.

She's experienced all the typical prednisone side effects.... moon face, insomnia, bruising, etc... but our biggest concern is how it takes down her body's immunities. I think the GERD and the increased eye pressure may be other side effects too. This past month has required her to be on antibiotics, an antifungal, narcotic cough med's, Nexium, eye drops and now they want to increase the prednisone again... due to the IgE as I understand it.

It's like a vicious circle... she needs the prednisone to control bronchial inflammation, but it can cause her immunities to lower their defenses so she's more susceptible to illness.

Can Xolair be the saving grace for her? If so, I'm in hopes that her history and IgE blood level would justify insurance payment.

Thanks for letting me vent.... it's been a frustrating month. My mom is usually a very active person and her life is just the pits right now!

Kris