Long Time Steroids?

[Scarlett]

I have constantly high ESA and CRP- high inflammation prob caused by asthma/arthritis/ulcerative colitis. Every blood test I have shows that it is high. I'm in pain all the time, and feel like I am turning to stone. A few days ago I was given a short course of prednisolone - 30mg a day for 5 days as I have a bad chest infection. I also have steroid facet joint injections for my back every 6 months.When I have the steroids, I start to feel like a normal person. I can do chores without needing to lie down every 4 minutes. I have energy and am in less pain. But then I stop them and I feel terrible again. My question is this: are people ever prescribed permanent low-dose steroids for problems such as mine? I know the side effects (weight gain, appetite madness, bone probs etc) but I'm beginning to wonder if I wouldn't just have a nicer life if I did have them?!

[Scarlett]

ESA= ESR

[bookend]

The following links will provide you with a good overview of the situation:

http://www.nhs.uk/Conditions/Corticosteroid-(drugs)/Pages/Introduction.aspx

http://www.nhs.uk/Conditions/Corticosteroid-(drugs)/Pages/Sideeffects.aspx

I'm a reluctant long-term user of corticosteroids in the sense that I was not initially keen on taking them as I had some knowledge of their side-effects. However, I trust my doctor implicitly and right now I take 30mg a day of prednisolone for three days and usually manage to leave them off for a week or fortnight at a stretch. They don't appear to be doing me much harm using this regime.

Women need to be aware of the osteoporosis risk at high dosage. Years ago the so called "moon face" was distinctive in high dose users of steroids but it's unusual nowadays. Ultimately though, it's best to remember that steroids only serve to mask the condition on a temporary basis. In no sense can they be regarded as a cure.

If they work for you and enable you to get around more easily, judicious use will lead to no harm.

[Sqad]

// I'm in pain all the time, //

One cannot contemplate a more miserable existence than "being in pain all the time" and surely it is the prime function of a medical practitioner to relive pain in any way which is balanced against the negative aspects.
Does the end, justify the means? A question that only the patient can answer after knowing the full facts of the treatment.

\\\\My question is this: are people ever prescribed permanent low-dose steroids for problems such as mine?\\\

The answer to your question is YES, they are, BUT although disease severity is an important confounding factor, low dose long-term prednisone use equal to or greater than 5 mg/d is correlated with the development of specific adverse events in a dose-dependent fashion.

A good post by bookend above.

Talk it over with your Rheumatologist.

[Cloverjo]

My gran was on steroids permanently. There are side effects, as Sqad says. With her it was thin skin. Terribly thin: she had some horrible injuries after innocuous looking incidents.
I don't want to put you off if they give you relief, so carry on and see how it goes.

[bednobs]

i waas a long-twerm low dose (7.5mg pd) user of steroids and took them for about 10 years along with various steroid infusions and injections at times.
i did have the moonface, unlike bookender, and osteoporosis and terribly thin skin but no appetite and sleep disturbances. I did become rather dependent on them and it took me a very long time (nearly three years) to wean off of them at a very very slow rate. I remember when i was first diagnosed my sister said to me "don't take them- think of the side effects" however, the primary side effect for me was that i could actually live my life!
I did want to come off them though for many reasons.

[Scarlett]

Interesting, thank you. Sqad- I wish I could talk it over with a rheumatologist but I have been turned away by every single one round here as my blood tests don't show the all-vital rheumatoid thing, just raised ESR and CRP. The sort of entropathic arthritis I have doesn't seem to show up in blood tests so unfortunately I don't get taken very seriously. I often wish cannabinoid medicine or even cannabis was properly regulated as I think that would probably help a lot with chronic pain!