In praise of prednisone

September 27, 2011

If pressed to name my favorite synthetic corticosteroid, I would have to choose prednisone. “Why?” you may ask in this perfectly natural conversation we’re having. It’s so versatile—a pharmaceutical Meryl Streep. My grandmother took it on and off over the years for a host of ailments, including TB-ravaged lungs, arthritis, and headaches. I’ve been prescribed it for acute cases of “mom back” when I could not simply cease tending small children for days on end to nurse my lumbar region.

That’s its action: quelling inflammation. It can take the heat out of strained muscles and dampen down an immune system in attack mode, so that you may hold on to costly donor organs or keep your lupus or multiple sclerosis in check. If your adrenal gland is slacking off or your tumor is secreting hormones, prednisone is also your friend.

If you’ve been on it awhile, you have to wean off it; abrupt stoppage can put you in the ER. But in small doses for short stints, it’s relatively safe. I’ve only ever taken it in five-day bursts, so I’ve dodged its more alarmingly named side effects, such as “moon face” and “buffalo hump.”

By the time my younger son was given prednisone to keep his reflux-inflamed airway from swelling shut, I was already fondly inclined toward it. Eight or nine years ago I’d experienced a few days of mysterious swelling and pain in my hands. One morning I woke crying because they hurt beneath the weight of the quilt but I could not quite scrabble them free of it; my fingers were stiff and puffed tightly as sausage casings, and it took concerted effort to drag the heavy meat of them out to air. To the doctor I flew. I recall some talk of rheumatoid arthritis, but blood tests showed nothing awry. A few days of prednisone and my hands were back to typing up masterpieces and fending off suitors with their usual facility. But what was it? I asked the doctor. She shrugged. Whatever it was had retreated, and we’d worry about naming it only if it came back.