I have been on steroids for over a year and rarely get below 25mg, did get to 17.5mg but only for a few days then things went wrong, anyway after a recent admission to the brompton thay have said i need to go on in for 2-3 weeks for steroid reduction. Just wondering if anyone has done this and what are the pros to doing it in hospital? it seems a long time to be so far away from home and i am thinking abour trying to reduce very slowly at home as in the past have allways reduced by 5mg every 5 days, but it was suggested to reduce by 1mg a week or 2.5mg a fortnight.
if any one can offer advice would be very gratefull
There are probably two reasons to doing a steroid reduction in hospital.
1 - to monitor your asthma closely to ensure any deterioration is sorted there and then.
2 - to ensure that the reduction of steroids doesn't cause any other associated problems associated with long term steroids and consequent reduction. e.g. the usual steroid withdrawal symptoms and adrenal problems.
I don't know of anyone who has done this in hospital though I have vaguely heard of it.
I, myself have been on steroids permanently for over 10 years (I think it may be longer!) as I get deterioration in my asthma and also withdrawal symptoms associated with adrenal supression which can happen over a long time on steroids (This is for oral steroids, taken all the time over months and years - does not aply to inhaled steroids!) I can't get lower than 10mg now.
Long term oral steroids can cause the adrenal gland to become supressed and the body stops producing enough of its own steroid - this can be temporary and the adrenal glands may come out of hibernation so to speak. Very rarely, it can be permanent and people then need to be on a maintenance dose, often less than 10mg a day of pred or equivalent.
I have tried reducing by 1mg a month when I get lower than 20mg or 15. It is a long stretched out process. You could suggest a lower rate of reduction such as 1mg a month to your speciallist.
Please don't alter your doses yourself without guidance from Doctors!!!
Did they explain why they want to do it in hospital? It may be worth a go if you can get down to a lower dose in hospital in 2-3 weeks. I would love to reduce further and get off steroids completely but we think that is very unlikely now.
Good luck and please let us know how you get on.
Kate
PS this is not advice but personal experience and suggestions to be taken back to the consultant.
I had my steroids reduced in hospital about a year ago. I'd been on oral pred high dose for a while with several admissions and came off a bit too quickly (following medical guidance, just my body is fairly steroid resistant so doesn't react in the normal way) and showed signs of an adrenal crisis. Thank goodness my GP was really on the ball and recognised the symptoms, was on the phone to an endo-something or other consultant at the hospital and I was whisked over there pretty sharpish, filled up with steroids again (D'Oh) and then a very slow reduction plan put in place once I was stable and this was monitored carefully. Once it seemed OK, I was released (sorry ... discharged) and the very slow reduction (I think it was in 1mg increments) continued and monitored by my consultant and GP till I actually got off the Pred.
Back on a high daily dose again now...
Sarah 07,
Sorry if I sounded a little harsh with my reply earlier,you have nothing to apologise for.
Hopefully you will get replies on how people went on with their reduction,
and support from your GP or hospital which ever way you decide to reduce your medication.
sorry again, love Glynis xxx
Sarah, I have never done pred reduction here at the RBH but I have been in with many people who have. basically they monitor you carefully to make sure that you don't blip too badly and if you do they can get on to it quickly and maybe get you through a blip without the need to put your pred back up. It is boring I guess and so long as you are well people often go out during the day or at weekends with family etc. Bring loads of book, DVD's etc to keep you occupied and just go with the flow. I have seen people get down from huge doses of pred sucessfully and stay down so it is a worth while exercise. Sometimes they do it in a couple of bursts, 2-3 weeks then give you a little break from hospital and bring you back to reduce further.
Good luck with it, it does work or they would not do it but obviously be prepared for it to be a bit boring but then for most of us an admission without ""excitement"" makes a change and it gives you a good chance to catch up on things, writing Christmas Cards or thank you letters etc.
Bex
Hi
I have been in hospital too whilst on a reduction and I barely got below 15mg, then re-admitted. However, I have no totally come off pred and haven't felt this good for ages!! What works for some people doesn't work for others unfortunately, but keep at the reduction and your body will obviosuly be able to start producing its own steriods effectively again. good luck
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