I’m sitting here in my recliner, feet elevated, back straight, laptop on the arm of the chair, as my daily (morning) dose, which is 25mg now, of prednisone surges through my system. That strange, antsy, weak, shaky, buzzy feeling that is repeated each and every day for a few hours. It isn’t as strong now as when I was on a higher dose, but it is still there, every morning, predictably starting within a half hour or so after my dose. My teeth and jaw sometime feel like they want to chatter, my fingers often feel like they have a small tremor. Within a few hours, the surge wanes, and I feel what has become “normal” for my “prednisone self” – a little “off,” a little weak, a little shaky, but not as bad as the morning rush.
This last week has been both bad and good. The bad – 23 plus hours of atrial fibrillation, starting Thursday afternoon, and finally ending on Friday afternoon. I never feel very good when I’m in afib, but afib on prednisone is something else entirely. A heart racing along at 120bpm (give or take a few) is a heart that is working pretty hard, yet not doing a very good job. I always feel a little shaky and weak, and pee a lot, when I’m in afib (which hasn’t very often – before this darned prednisone I’ve been very well controlled, with episodes few and far between and pretty short in duration). Add that afib weakness to the shaky-weak-off feeling of prednisone, and you feel pretty awful. 23 hours is a LONG time to feel pretty awful. Did I say I also can’t sleep when in afib? I can’t lay flat, need to stay at least 45 degrees elevated and on my back – I’m a side sleeper, so goodbye sleep when in afib. I listened to an audio book the whole night, drifting off for a few minutes here and there, rewinding to get back to where I last remembered the story, over and over the whole night. So add sleep deprivation to the whole mess…. I injected my first dose of Lovenox (anticoagulant) at 12 hours of afib. I stopped warfarin (an EVIL drug in my mind) when I moved down here 2 ½ years ago, and had an “emergency” supply of injectable, fast acting, anticoagulant for the “what if” of a long run of afib, e.g., over 12 hours. I never had to use it before – last Friday morning I used it. Better to be anticoagulated for a short period of time than risk a stroke. Anyway….we had a brief crisis with our solar power at 7am, which added stress to the picture – it was resolved within a half hour, but it set my “relax and spontaneously convert to normal rhythm” mode into total chaos. By 18 hours, I just knew that I would probably need to be cardioverted by being shocked, that I wasn’t going to get out of this spontaneously. I told my husband that I wanted to go to the emergency room in the afternoon, and we finally headed there a little before 4pm, at hour 23 of afib. I couldn’t even find the strength to walk the few feet into the tiny local ER – I was wheeled in! The nurse put the pulse oximeter on my finger, heart still chugging along at 115bpm, I told her that the head of the gurney needed to be elevated, I stood up from the wheel chair, turned, and sat on the gurney, and I spontaneously converted to normal sinus rhythm! Hallelujah!!! I felt so much better within minutes, although still exhausted and sleep deprived. They drew blood, did a chest xray and an EKG, watched me for a few hours to make sure I didn’t go back into afib, and then sent me on my way. I walked out of the ER under my own power - tired, happy, relieved, and “unshocked.” But, also disgusted and humbled by what havoc this darned prednisone is causing in my life. It is hard to remember sometimes how good I actually have it – have many are so much worse off than me. I need to remind myself, and a few days later I did.
The good part of the “both bad and good” came several days later. I felt connected and stable enough on Monday that we drove to the nearest Walmart to stock up on some needed OTC medications, and get a battery for my car. It is 70 miles away – and I drove both ways. I felt pretty weak after walking around the store for 45 minutes, but after a short rest for lunch, I had enough energy to drive back. Yea!! That is a milestone, a good one.
I am still tapering down to 20mg. My doctor says I’m doing fine (this was before the afib event though). My inflammation markers (sed rate and c-reactive protein) in my blood work have returned to normal. I’m on 25mg, and it is working. I hope to get to 20mg within the week. He said that I will stay on the 20mg for 4-6 weeks, and then slowly, very slowly, taper to 10mg, basing it on symptoms and my blood tests. I wonder if I will get the “surge” on 10mg? Then we will just have to see how long I will need to be on that much lower dose.
Meanwhile, I’m hanging in there, still.
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