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About The Siuslaw news. (Florence, Lane County, Or.) 1960-current | View Entire Issue (Oct. 24, 2015)
4 B SIUSLAW NEWS ❚ SATURDAY, OCTOBER 24, 2015 TO YOUR GOOD HEALTH Do prednisone benefits outweight its risks? DEAR DR. ROACH: I am an 80- year-old woman who always had excel- lent health until about four years ago, when I was diagnosed as having bronchiectasis. Since then, I have had to use an albuterol solution, plus an Airway Vest, in periodic daily treatments in order to continue breathing. A few weeks ago, my doctor pre- scribed 10 mg of prednisone daily in addition, and the results have been amazing. Instead of five to six inhaler treatments each 24 hours, I need only two or three, and (the best result) I can sleep through the night! Previously, I woke every three to four hours nightly for a treatment with the inhaler and vest, and I often slept poorly afterward. My prednisone dosage has been reduced to 5 mg daily, and although I know it is a (possibly dangerous) corti- costeroid, I dread the prospect of going back to the days of arranging my life SALOME’S STARS ARIES (March 21 to April 19) Deciding to work out that pesky prob- lem (even though you might have been bored, bored, bored with it) should be paying off right about now. Expect to hear some very welcome news very soon. TAURUS (April 20 to May 20) Unexpected news might cause you to rethink a previous conclusion. Don’t be bullheaded and try to bluff it out. Make the needed change, and then take a bow for your objectivity. GEMINI (May 21 to June 20) Money matters should be considered as you continue to work out your hol- iday plans. This is a good time to scout out discounts before demand for them outstrips their availability. CANCER (June 21 to July 22) A calm period early in the week helps around the use of the albuterol inhalers, as well as feeling so much less able to enjoy what life I have left. What would be the result of continuing a minimal dosage of prednisone (5 mg or less per day)? What alternatives do I have? — C.B. ANSWER: This is a good question, not just for bronchiectasis (a scarring condition of the airways, so they can’t clear mucus properly), but for the many, many diseases treated with prednisone. Long-term use of high-dose prednisone (and similar steroids, such as cortisone and methylprednisolone, or Medrol) can cause diabetes in susceptible individu- als, and it raises blood pressure, weak- ens bones, increases hunger and causes weight gain in most, causes thinning and other skin problems and, in high doses, causes confusion or psychosis. It is indeed a dangerous drug. However, as bad as it is, it sometimes is so effective at improving the disease it’s treating that the benefit is worth the risk of all these side effects. There are some conditions where the prednisone has to be permanent, although we are finding more and more alternatives to reduce or replace the prednisone. The body makes its own steroid, cor- tisone, at the daily equivalent of roughly 5 mg of prednisone. At that dose or less, the risks of prednisone are much less than at the high dose of 40 mg, 60 mg or greater used for inflammatory and autoimmune diseases. If you have to stay on this dose, it sounds like the ben- efit outweighs the risk. One alternative you haven’t men- tioned is steroid inhalers. For asthma and sometimes for bronchiectasis, steroid inhalers, which use far more potent steroids than prednisone, can have as good a benefit. They are poorly absorbed, and as such have little or no systemic side effects, like raising blood sugar and blood pressure. If you are doing well on a 5 mg dose of pred- nisone, you would likely do well on a steroid inhaler. DR. ROACH WRITES: I wrote recently about loss of eyebrow hair. One reader wrote in to tell me that in her case, a magnesium supplement solved her problem entirely. I did find that mag- nesium deficiency can cause hair loss, so it may be worth a try. Dr. Roach regrets that he is unable to answer individual letters, but will incor- porate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu. To view and order health pamphlets, visit www.rbmamall.com, or write to Good Health, 628 Virginia Drive Orlando, FL 32803. you complete most, if not all, of your unfinished tasks. A new project appears by midweek, and this one could carry some big career potential. LEO (July 23 to August 22) Positive results from recent ventures continue to pump up those self- esteem levels, making you Fabulous Felines feel you can tackle any chal- lenge anyone wants to throw at you. VIRGO (August 23 to September 22) Family and friends might feel neglected because of your almost total focus on a project. Try to rework your schedule so you can have time for both your loved ones and your work. LIBRA (September 23 to October 22) Don’t be surprised if you sudden- ly hear from someone from your past who wants to contact you about the possibility of renewing a long-dor- mant (if not dead) relationship. SCORPIO (October 23 to November 21) This is a good time to check over what went right and what went wrong with recent efforts. This can provide valuable lessons for proj- ects that will be coming up soon. SAGITTARIUS (November 22 to December 21) Dealing with people who feel they’re always right about everything might be a problem for some. But the savvy Archer should be able to deflate their oversize egos. CAPRICORN (December 22 to January 19) This week favors a bal- ance between the demands of your work and your need for fun timeouts. Taking breaks helps restore and keep your energy levels high. AQUARIUS (January 20 to February 18) There could be an occa- sional setback in what you’re working on. But look at them as lessons on how to do better as you move along. More supporters turn up to cheer you on. PISCES (February 19 to March 20) Although a more positive aspect influences this week’s course, you still need to be sure that those who will work with you have no reason to work against you. Good luck. Siuslaw N ews ! AD IT DAY E R TO www. the siuslawnews.com E -E DITION • S PORTS • T OP S TORIES • O BITUARIES • W EATHER • F ORUMS • B LOGS