Friday morning started with a 20 minute drive on the freeway to visit my rheumatologist, and ended with a stop for burgers, soda and fries. In between, there were conversations with medical staff, a nice long visit with my doctor, and the administration of a hefty Kenalog and Celestone steroid injection. A lupus flare had built up strength all week, while my energy waned.
After my Benlysta infusion on Friday last week, early this week Monday morning began with a burning sensation in my chest from another new case of bronchitis. Asthma flared, large and small airways narrowed, and mandatory phone calls to my family doctor and rheumatologist were placed. By the time of the rheumatologist visit, additional lupus flare symptoms piled up on top of the bronchitis: new discoid rashes on hands, forearm, forehead and hairline, a huge new infected mouth ulcer, bilaterally inflamed hand joints, growing malaise, and increased mental clouding and confusion (so much so that everyone around me was talking about it and starting to worry.)
Along with the physical lupus symptoms, the house was soon evidencing a few of its own… a pile of unopened mail on the desk, a white tile kitchen floor that really needed mopping, overflowing laundry baskets, an emptying fridge, and record dust fall measurements on the piano, hutch and coffee tables.
Outside, there was plenty of evidence of the flare, too. Wednesday night ended by driving my vehicle right into the stucco wall bordering the driveway at the property line, grossly misjudging the distance and depth while turning into the driveway. The first clue that I’d hit the wall was the sensation of the car vibrating and the sound of crunching stucco grinding into the vehicle rear quarter panel. Then, my Grand Caravan was unable to move any farther forward because the corner of the stucco wall was wedged deeply into the side of the vehicle. The damaged car was backed out into the street again to get it free from the wall.
Steroids have their place in the treatment of lupus. A couple of days later, my doctor and I decided that I would not continue to drop my daily prednisone dose any farther, so I would stay at 5 mg. per day for the time being. A steroid injection quickly began to make me feel better, so much so that everyone was soon talking about how the “E.B. effect” had set in, and teased me lovingly throughout the next day. I became the object of much amusement to my family who describe the prednisone induced phenomenon as the “Energizer Bunny Effect”. They have observed it many times before, after a surge of steroids was employed to shut down one of my previous lupus flares. They love me, but think the way steroids affect me is funny!
The behavioral impacts of feeling gleefully better and perky after steroids is a shock and often starkly noticeable, especially to the people nearest. For them and for me, it was truly amazing to see and feel the difference! Up before the sun rose, I was out and about buying food for a big Saturday breakfast, making coffee, scrambled eggs, cinnamon rolls and bacon before the rest of the household was even thinking about getting up. The bacon aroma wafted back through the house to the bedrooms, and drew the sleepy occupants out to the kitchen.
They wiped slumber from their eyes and stood staring in disbelief, as they watched their suddenly transformed breakfast cook. Just the night before, she was hurting, fatigued, very confused and struggling. That next morning, their breakfast cook was unbearably gabby, perky, fast-moving and smiling while she juggled skillets, knives, wire whips and a spatula! They all concluded and decreed by consensus that the “E.B. Effect” was officially in full swing.
As the hours passed, the E.B. Effect demonstrated its downside and aftermath. 18 hours of pep and vigor were followed by sheer exhaustion. The perky little cook of the morning flopped down in a chair at day’s end, and collapsed. Then, she awoke the following morning in full CNS lupus flare symptoms, and spent all of Sunday home from church in bed, sleeping, resting and recuperating from sheer exhaustion, bronchitis, underlying lupus flare, and ill-advised over activity in the face of the previous day’s false prednisone induced “energy.”
She had forgotten the age-old biblical adage, especially wise and proper after steroid injections, “moderation in all things!”