I am not alone in having a VERY BAD reaction to prednisone. There’s even a book called Coping With Prednisone (*and Other Cortisone-Related Medicines) written by Eugenia Zuckerman and Julie R. Ingelfinger, M.D. On the cover it says: “It may work miracles, but how do you handle the side effects?” Of course, there are also people who don’t experience side effects, but I shouldn’t beat myself up because I’m one of the people who does. The package insert clearly states, in bold capital letters, that I must inform my doctor ASAP if I experience sudden depression and self-destructive thoughts. I had yet another appointment on Monday, April 15, and conscientious patient that I am, I informed my doctor. I now wonder if that was the smartest move.
Good doctor that she is, she told me that she would write my GP a letter, so that I could get a referral to a shrink. She also called me back into the examining room when I was getting ready to leave, just to make sure that I was not in immediate danger of offing myself. (I wasn’t.) I explained that those thoughts snuck into my brain and were very uncomfortable to have. They feel like mosquitoes in my mind. I reassured her that I have enough insight to recognize those thoughts for what they are, and that I am all about self-preservation. Everything I do is geared toward self-preservation, so this is very out of character. She consulted with a rheumatologist and a psychiatrist, and we agreed to lower the dose of prednisone to 6.25 mg. This should reduce the psychiatric side effects while still keeping the inflammation at bay.
I am so pissed off that I got psychiatric side effects. I became a prednisone psycho. It is hard to tell whether I am feeling and thinking a certain way, or whether it’s the prednisone speaking. My perception is unreliable. I do not want to express myself because I am uncertain about what will come out. I start thinking that nobody wants to hear/read what I have to say anyway. Then I feel that I have nothing to say. I get stuck in a swamp of silence, and I can only see a thick, sticky fog. The fog turns to rain, and I realize I am crying again.
Telling my doctor about this got me a one-way ticket to a psychiatrist. She told me that they had conferred on my case and considered my request for a mastectomy, and that the answer was no. They think I am too emotionally fragile to handle it, and they want me to see a shrink. I feel angry and powerless again. I feel insulted. I worry that they think that this is all in my head, even though they have ample physical evidence of the disease process. I am afraid that all they can see is my depression, and that this will interfere with my treatment. When I see my GP a week later, he tells me that he also thinks it is time for me to see a shrink. Three days later, I get my referral letter showing I have an appointment in two weeks. This is serious. It usually takes months to be able to see a shrink. I handle my depression with 300 mg of Wellbutrin. I. Do. Not. Want. More. Meds. I do not want to switch meds. I dream of the day when I can stop the meds.
My rational mind understands the doctors’ thought process and decisions, so I agree to see the shrink. I have two caveats: I will not switch meds, and I will not take new meds. This particular brand of depression should subside when the prednisone dose is lowered. As for being too emotionally fragile to handle a mastectomy… Of course I’m emotionally fragile! I’ve been sick for four months. I have not gotten better. There is no protocol for dealing with Granulomatous Mastitis. Chronic pain has taken its toll. I have been unable to perform my usual activities of daily living. I have been unable to exercise. My kids have told me that they wish they had a healthy mommy. That completely broke my heart because as bad as it is for me, I cannot underestimate the effect this has on my children. More than anything, I want to be a good mom and give my kids a good childhood. If I have to take a high dose of prednisone again, if I absolutely can’t avoid it, I have to learn to cope with the emotional fallout. I know what book I’ll be ordering from Amazon next (even though I would much rather order commercial vampire lit or Gloria Naylor’s Mama Day).