Prednisone burst is causing problems… sugar… advice?
Question:
– Hide quoted text — Show quoted text -> I’m sorry I don’t remember your exact case, but why aren’t you using steroid > inhalers instead of pred bursts? I don’t need my Pulmicort very often, but > when I feel twitchy or start coughing I take a couple puffs and it immediately > starts calming the flare. It has been discussed here quite a bit of late as > the ultimate in asthma control. I would never go with pred again, unless it > was absolutely necessary and after all other avenues had been tried. >> Three prednisone bursts in four months? >> Hmm When a pred burst doesn’t work for me my doctor would suggest >I >> take a course of Zithromax or Levaquin. >Zithromax for the first (post flu), Biaxan XL for the second >(bronchitis) and Augmenten for the third (appears to be a sinus >infection). I’m severely allergic to Levaquin. Also the bursts all >seemed to work, but the first two had to be restarted at a higher >dose and a longer taper. The third was at the higher dose but a >relatively short duration. >I don’t know if it’s actually an unresolved infection or exactly >what they diagnosed. >What I don’t need is another chronic illness to deal with (I.E. >Steroid Induced Diabetes). I suspect I have one to deal with >anyway… >Dan Rhea >"Loyalty is for family, friends and country, not operating systems, >compilers and computers" > - Dan Rhea, 1986 >"Quoting yourself is the first sign of insanity" > – Anon > Sue M.
Hi Sue, I normally take Advair 250 twice a day and augment that with Pulmocort if I start having problems. I only go on a pred burst if my peak flow warrants it (and even then I double check with my pulmonologist). I also take Singulair, Alegra-D, Nasarel and monthly allergy shots. Unfortunately an infection can wreak havoc with your asthma control. To add to the challenge, I’m overweight (330 pounds), and have sleep apnea (controlled with a CPAP machine). With the possibility of steroid induced diabetes to deal with as well, I was feeling a bit overwhelmed. I’m starting to calm down now… dealing with diabetes (if I do indeed have it), will probably be about the same as dealing with my weight… I will just have a lot more compelling reason stick with a good diet. Dan Rhea "Loyalty is for family, friends and country, not operating systems, compilers and computers" – Dan Rhea, 1986 "Quoting yourself is the first sign of insanity" - Anon
Response:
<snipped but read in detail> > I’m rambling…anyway…it’s actually easier to deal with than asthma in > my opinion…it’ll be a breeze in comparison 
> — > eric > www.ericjarvis.co.uk > "I am a man of many parts, unfortunately most of > them are no longer in stock"
Hi Eric, The rambling is appreciated, and it’s helpful since I’m starting to calm down and look at this realistically. Since I weigh 330 pounds (don’t know what that is in stones, but a suspect it’s way too many). The point is clear that I need to get my weight down. If it actually does turn out that I have steroid induced diabetes then it really just adds a much better reason for me to get my weight down to something reasonable. The exercise shouldn’t be a problem either… I live in south Florida and have a heated pool I can use year round (and do). Hope they get your immune system issues sorted out… that "reboot" procedure sounds daunting. Dan Rhea "Loyalty is for family, friends and country, not operating systems, compilers and computers" – Dan Rhea, 1986 "Quoting yourself is the first sign of insanity" - Anon
Response:
I’m thinking I remember someone here recently writing about sugar problems with Advair. You can check the insert, (www.rxlist.com usually has them online). How about the ng archives too, to find the articles. Well, since it’s the new year it’s a perfect time to make resolutions, most people do about their diets, weight, etc. I hear food journals are v.helpful. Good luck with that project. – Hide quoted text — Show quoted text – >Hi Sue, >I normally take Advair 250 twice a day and augment that with >Pulmocort if I start having problems. I only go on a pred burst if >my peak flow warrants it (and even then I double check with my >pulmonologist). I also take Singulair, Alegra-D, Nasarel and monthly >allergy shots. Unfortunately an infection can wreak havoc with your >asthma control. To add to the challenge, I’m overweight (330 >pounds), and have sleep apnea (controlled with a CPAP machine). With >the possibility of steroid induced diabetes to deal with as well, I >was feeling a bit overwhelmed. >I’m starting to calm down now… dealing with diabetes (if I do >indeed have it), will probably be about the same as dealing with my >weight… I will just have a lot more compelling reason stick with a >good diet. >Dan Rhea >"Loyalty is for family, friends and country, not operating systems, >compilers and computers" > - Dan Rhea, 1986 >"Quoting yourself is the first sign of insanity" > – Anon
Sue M.
Response:
Dan: Eric is right on; the diabetes is actually easier for me to control than the asthma. Not saying you can ignore it -no. With reasonable diet and meds you will avoid or at least delay any complications that follows diabetes. Like you, I’m steroid dependant with frequent bursts needed to get back to some level of control, but like the others said, it’s a manageable straw and the load won’t get much heavier. Best to you in the new year. — Dirk de Vries, a sojourner and a pilgrim
– Hide quoted text — Show quoted text -> Anyway… any suggestions on good sites about steroid induced > diabetes? I’m freaking out a bit about this and I know that what > works best for me when something like this happens is to read as > much about it as possible so I know what to ask, what to expect, and > what to watch out for. > don’t freak out…diabetes isn’t any tougher to handle than asthma…you > can cope with one you can handle both…loads of us do > I’d start with the diabetes support newsgroups…there are several they > are all slightly different in tone but excellent in terms of advice…if > you’ve caught it early then there’s likely to be no long term damage > (other than to the pancreas) and it’ll just be a matter of a few > (generally good) lifestyle changes and possibly another type of medication > to add to the list > — > eric > www.ericjarvis.co.uk > "I am a man of many parts, unfortunately most of > them are no longer in stock"
Response:
I’m sorry I don’t remember your exact case, but why aren’t you using steroid inhalers instead of pred bursts? I don’t need my Pulmicort very often, but when I feel twitchy or start coughing I take a couple puffs and it immediately starts calming the flare. It has been discussed here quite a bit of late as the ultimate in asthma control. I would never go with pred again, unless it was absolutely necessary and after all other avenues had been tried. – Hide quoted text — Show quoted text -> Three prednisone bursts in four months? > Hmm When a pred burst doesn’t work for me my doctor would suggest >I > take a course of Zithromax or Levaquin. >Zithromax for the first (post flu), Biaxan XL for the second >(bronchitis) and Augmenten for the third (appears to be a sinus >infection). I’m severely allergic to Levaquin. Also the bursts all >seemed to work, but the first two had to be restarted at a higher >dose and a longer taper. The third was at the higher dose but a >relatively short duration. >I don’t know if it’s actually an unresolved infection or exactly >what they diagnosed. >What I don’t need is another chronic illness to deal with (I.E. >Steroid Induced Diabetes). I suspect I have one to deal with >anyway… >Dan Rhea >"Loyalty is for family, friends and country, not operating systems, >compilers and computers" > - Dan Rhea, 1986 >"Quoting yourself is the first sign of insanity" > – Anon
Sue M.
Response:
> in the new year it looks like I’ll go on immune suppressants to > effectively close down and reboot my immune system…in the mean time I’m > having to cope with yet another pred burst and the resulting need to > tighten my diabetes control…it isn’t great…but there are worse things > in life
Like using SIMT (specific inspiratory muscle training) to reduce medication consumption and combat asthma symptoms? (Sorry, just couldn’t help it!) Anyway, all the best wishes for the New Year and for a speedy return to good health in your beloved Cornwall (England). Regards from your well-wisher, Richard Friedel If a nation expects to be ignorant and free, it expects what never was and never will be. Thomas Jefferson
Response:
- Hide quoted text — Show quoted text -> > Anyway… any suggestions on good sites about steroid induced > > diabetes? I’m freaking out a bit about this and I know that what > > works best for me when something like this happens is to read as > > much about it as possible so I know what to ask, what to expect, > > and what to watch out for. > don’t freak out…diabetes isn’t any tougher to handle than > asthma…you can cope with one you can handle both…loads of us do > I sure hope so Eric… The last few months has been pretty rough on > the asthma front. > My current worry is that if they rapidly pull the prednisone taper > I’m on, I will probably have another flare and not be able to take > anything for it because of the sugar problem. Something I obviously > need to learn a lot more about in the next few days. With this > current flare, I went from a peak flow of 675 down to 400. The taper > is a 60, 50, 40 etc. with three days at each dose level. I’m > currently on the second day at 40mg.
I was diagnosed type 2 diabetic last year…I’d probably been so for around a year or so…in my case it’s genetic…though something else is going on with my immune system…I’ve spent the last three months getting one infection after another whilst my asthma and eczema have been getting worse, and in the last few weeks I’ve started getting symptoms that may well be arthritis in the new year it looks like I’ll go on immune suppressants to effectively close down and reboot my immune system…in the mean time I’m having to cope with yet another pred burst and the resulting need to tighten my diabetes control…it isn’t great…but there are worse things in life > I have subscribed to alt.support.diabetes, but it will take some > time to sort it all out. Like here, it seems best to lurk a bit and > learn who the "players" are before jumping in with questions.
absolutely…the FAQ pages are good…start with those > I also have not been "Officially" diagnosed at this point, but I’m > the one that noticed the symptoms and asked my doctor to test my > urine for sugar (thirst, headache, frequent urination). The good > news is that this only seems to have been going on for a bit over a > week so maybe I’m overreacting a bit. On the other hand, I’ve read > that type 2 diabetes can exist without symptoms for quite a while. > I’ll have to see what the blood tests tomorrow show.
if it’s type 2 and you can control it with diet and exercise, if there is nothing else associated with it then you may be about to begin the best years of your life I wasn’t overweight to start with as such…though I was, at 12 stone, the heaviest I’ve ever been…I’m now, nearly a year later, at 10 stone…the weight I was when I was 21 and playing football (soccer) twice a week at college (and once taking a set of a Davis Cup tennis player – he played once for Denmark, it’s not that impressive)…up till the recent batch of problems I’d hit a stage where I really had never felt better in my entire life…not bad for 45 diet wise it’s easy…but DON’T listen to the advice from dietitians, and be wary with dietary advice from the medics…they will try to sell you a simple one size fits all diet…and diabetes doesn’t work that way any more than asthma does the key is to test test test…once you get your blood glucose test kit you need to learn what foods do what to your body…if you’ve got the slightest bit of scientific curiousity this is actually enormous fun right now you can start by doing the basics that can’t hurt…cut out sugar…and honey…and fruit sugars…a little bit of fruit is fine…small amounts spread through the day are great…a lot in one go is bad news…cut down to the amount of carbohydrates you actually need…less will be a problem…every carbohydrate more than you need is going to be turned into sugar…this takes practise to get right…but the chances are you need to cut down anyway start exercising…an hour of reasonably brisk walking per day could end up being all you need…I get by on a twenty minute walk to the station that burns off my breakfast…a half hour stroll round the park that burns off my lunch…and then a walk home from the station before supper…you may not need much more than that get your head right…don’t think about this as a limitation on your diet…there isn’t one…you can eat absolutely anything…just not very much of some stuff…and I’ve found that as I get used to what works, it’s actually the really tasty stuff that has stayed in my diet and the quick and nasty rubbish that was the problem find yourself a couple of treats that don’t hurt your blood sugar levels and it’s easy to reward yourself for each blood sugar target you reach..initially I set myself the goal of getting below 10 (180 IIRC with the US system)…then of getting down to 8 which the doctors recommended…then never going above 10…now I’m trying to stay within normal limits, and most of the time succeeding…if I’ve had a good day I allow myself a cup of cashew nuts, or pistachio…or a few pieces of high quality 80%+ cocoa solids chocolate I’m rambling…anyway…it’s actually easier to deal with than asthma in my opinion…it’ll be a breeze in comparison — eric www.ericjarvis.co.uk "I am a man of many parts, unfortunately most of them are no longer in stock"
Response:
– Hide quoted text — Show quoted text -> Anyway… any suggestions on good sites about steroid induced > diabetes? I’m freaking out a bit about this and I know that what > works best for me when something like this happens is to read as > much about it as possible so I know what to ask, what to expect, and > what to watch out for. > don’t freak out…diabetes isn’t any tougher to handle than asthma…you > can cope with one you can handle both…loads of us do > I’d start with the diabetes support newsgroups…there are several they > are all slightly different in tone but excellent in terms of advice…if > you’ve caught it early then there’s likely to be no long term damage > (other than to the pancreas) and it’ll just be a matter of a few > (generally good) lifestyle changes and possibly another type of medication > to add to the list > — > eric > www.ericjarvis.co.uk > "I am a man of many parts, unfortunately most of > them are no longer in stock"
I sure hope so Eric… The last few months has been pretty rough on the asthma front. My current worry is that if they rapidly pull the prednisone taper I’m on, I will probably have another flare and not be able to take anything for it because of the sugar problem. Something I obviously need to learn a lot more about in the next few days. With this current flare, I went from a peak flow of 675 down to 400. The taper is a 60, 50, 40 etc. with three days at each dose level. I’m currently on the second day at 40mg. I have subscribed to alt.support.diabetes, but it will take some time to sort it all out. Like here, it seems best to lurk a bit and learn who the "players" are before jumping in with questions. I also have not been "Officially" diagnosed at this point, but I’m the one that noticed the symptoms and asked my doctor to test my urine for sugar (thirst, headache, frequent urination). The good news is that this only seems to have been going on for a bit over a week so maybe I’m overreacting a bit. On the other hand, I’ve read that type 2 diabetes can exist without symptoms for quite a while. I’ll have to see what the blood tests tomorrow show. Dan Rhea "Loyalty is for family, friends and country, not operating systems, compilers and computers" – Dan Rhea, 1986 "Quoting yourself is the first sign of insanity" - Anon
Response:
> Anyway… any suggestions on good sites about steroid induced > diabetes? I’m freaking out a bit about this and I know that what > works best for me when something like this happens is to read as > much about it as possible so I know what to ask, what to expect, and > what to watch out for.
don’t freak out…diabetes isn’t any tougher to handle than asthma…you can cope with one you can handle both…loads of us do I’d start with the diabetes support newsgroups…there are several they are all slightly different in tone but excellent in terms of advice…if you’ve caught it early then there’s likely to be no long term damage (other than to the pancreas) and it’ll just be a matter of a few (generally good) lifestyle changes and possibly another type of medication to add to the list — eric www.ericjarvis.co.uk "I am a man of many parts, unfortunately most of them are no longer in stock"
Response:
Three prednisone bursts in four months? Hmm When a pred burst doesn’t work for me my doctor would suggest I take a course of Zithromax or Levaquin.
Response:
> Three prednisone bursts in four months? > Hmm When a pred burst doesn’t work for me my doctor would suggest I > take a course of Zithromax or Levaquin.
Zithromax for the first (post flu), Biaxan XL for the second (bronchitis) and Augmenten for the third (appears to be a sinus infection). I’m severely allergic to Levaquin. Also the bursts all seemed to work, but the first two had to be restarted at a higher dose and a longer taper. The third was at the higher dose but a relatively short duration. I don’t know if it’s actually an unresolved infection or exactly what they diagnosed. What I don’t need is another chronic illness to deal with (I.E. Steroid Induced Diabetes). I suspect I have one to deal with anyway… Dan Rhea "Loyalty is for family, friends and country, not operating systems, compilers and computers" – Dan Rhea, 1986 "Quoting yourself is the first sign of insanity" - Anon
Response:
Hi folks, Well, my third prednisone burst in four months appears to have bounced me into one of the bad side effects… I had my doctor check my urine for sugar today (I noticed I was urinating a lot, and the smell of my urine was very odd) and sugar was indeed present. My doctor already has me modifying my diet and wants me to consult with my pulmonologist tomorrow about speeding up my taper to get me off of the prednisone as soon as possible (I just hope it doesn’t trigger an even nastier flare). I’m going for a bunch of blood tests tomorrow to properly quantify the problem. I’m also overweight, so the prednisone may not be the only factor involved. Anyway… any suggestions on good sites about steroid induced diabetes? I’m freaking out a bit about this and I know that what works best for me when something like this happens is to read as much about it as possible so I know what to ask, what to expect, and what to watch out for. Thanks… Dan Rhea "Loyalty is for family, friends and country, not operating systems, compilers and computers" – Dan Rhea, 1986 "Quoting yourself is the first sign of insanity" - Anon
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