New Direction

My new RA doctor heeded my request and has switched my medications around so that I am taking far less prednisone and much more Imuran. We will see how the liver likes that and how the RA stands it over the next three months and adjust again, as needed.

This pleases me as I am the heaviest I've ever been after a year of predominantly using prednisone to help with the RA flares I was having almost constantly. Unfortunately, one of prednisone's biggest negatives is that it stimulates appetite. I was finding myself eating way more than I wanted or needed and would litterally catch myself at the refridgerator with the door open and not remember how I got there-- my hunger cravings having caused me to ease there and start looking for something to munch.

Each time I've been on prednisone for an extended time I have gained around 15-25 lbs. Back when I was grossly underweight at 115-120 lbs, this was a good thing. Getting me to the 155-165 lbs my doctors wanted me at made sense too. However, I was averaging 166-168 a year ago before I moved to SJ and my RA doctor and I decided to go with prednisone while I moved, found a new RA doctor, and got up to speed with the medical services/system here. A year of prednisone later and I'm happy when the scale reads less than 190. Ecstatic when it reaches as low as 185, which it has twice since moving here-- both times after being violent ill, but still. My face has gotten very heavy and round-looking, to the point of what both M and her mom refer to as "prednisone face" (having seen it in M's brother when he was on prednisone).

Over the course of the year, I have averaged about 20 mg a day, with bad flares causing me to go up as high as 50 mg before tapering back down. During that same time, I was taking 50 mg of Imuran. My new doctor has me up to 100 mg of Imuran and I have been able to lower my prednisone intake to 5-10 mg a day, usually closer to 5. Already I am seeing a decrease in my appetite after only a couple of weeks.

A month ago I was eating a 12" sandwich, a bowl of soup, a cookie and/or chips, and drinking a 24-32 oz soda for lunch. Today I had an 8" sandwich and a 12 oz soda and felt pleasantly full. I was not even tempted by the last bit of pound cake on the counter, and I love pound cake.

Hopefully, this trend will continue and I'll go back to eating sensible amounts and not feeling like grazing or binging between meals. If it does, some weight will come off as my caloric intake decreases. If I can up the activity level, even a small amount, at the same time, I feel like going back to 175 or less is achievable.

Here's hoping!