On the road again -
Just can’t wait to get on the road again.
The life I love is making music with my friends

And I can’t wait to get on the road again.
On the road again

Goin’ places that I’ve never been.
Seein’ things that I may never see again

I like all sorts of music and I’d be hard pressed to say what I like more. At times I believe Country & Western serves as the background music to my life and Willie Nelson’s “On The Road Again” has come up for me many times in my life and today is no exception.

I had to take a few days off last week to gather myself for what I knew would be a few days of hard living. Last Wednesday I asked my doctor about decreasing my prednisone and he agreed to drop it from 20mgs to 10mgs. For those who are unfamiliar with prednisone, the drop is equivalent to someone going 100 miles per hour down a highway and midstream they find themselves only able to go 50 miles per hour. To really drive the point home, imagine yourself driving fast and furious, passing everyone you encounter on the road and then, all of a sudden, you can’t even keep up with the speed limit. The cars you once passed are now passing you and the drivers are flipping you the bird, blowing their horns, some are laughing, etc.

Unfortunately, using the above scenario, human nature will cause you to do foolish things like floor the gas peddle or push the engine and neither will do you any good. In fact, performing such foolish acts might serve up a healthy dose of bad.

When I’ve had my prednisone reduced in the past, I found myself a prime candidate for SOS (Stuck On Stupid). Fear has a way of raising its ugly head and fear will serve you up a healthy dose of bad in all sorts of ways. Fear is what makes you gun the engine, floor the gas peddle, blow sweat, get mad, etc. Basically, I pushed myself, in spite of myself, to do what I was able to do with half the stuff I came in with. Did that sentence make your head swim?

Now you won’t notice the drop the first day but you will the next. The first noticeable sign is the decrease in speed. With the same amount of pressured applied to my personal gas peddle I’m only doing half the speed.

The second noticeable sign is pain. For the first few days I start feeling as if the prednisone was covering my joints. Now that the drug has been reduced I can feel the pain roaming through my body and settling in my joints. My thumb is usually the first indicator of the drop as it begins to feel a little swollen, hard to move and painful. Afterward, the pain moves to one or both elbows, hips, and knees. Sometimes I may feel pain and stiffness around my shoulders and neck.

Finally – and the reason why I needed some days off – I begin doing what I’ve done all of my life, play mental gymnastics with myself. I needed to pay attention and pull the plug when the mental games began. Again, to use an analogy, this means at the first sign or indication of car problems I must pull the car into the slow lane or off the highway altogether. There are no points and no rewards for being SOS by ignoring warning signs.

Typically, I will experience flares as a result of stress. In the past, when prednisone was cut back, I would continue working, pretending the side effects of the cutback won’t bother me because mentally I want to be a hard-ass by proving – to myself mostly – that it will not affect me. Proof by experience has taught me being SOS will invariably cause me to hit a wall, have a flare, inflammation sets in and back on the ugly stuff I go. Instead, I chose to take time off, wait and watch for the triggers that cause my brain to floor the gas and gun the engine. I don’t want the car to fail this time and end up in the shop for another expensive repair.

Prednisone is a wonderful drug with some powerful side-effects. It can hype you up big time and the hyping causes me to lose sleep. If I’m lucky, I might get four hours of sleep a night. Typically I’m not that lucky as it is more common for me to sleep two hours on, 30-minutes up, and two hours on again and then I’m wide awake. There’s nothing recuperative about sleeping like that. When I drop prednisone, particularly at 10mgs and below, I tend to sleep between 8 and 10 hours. Sleeping is easy at 10mgs or less.

As an aside, I read Michael Jackson’s autopsy report and saw he was still on prednisone. Apparently, his dermatologist prescribed prednisone – 10mg tablets – to start at 60mgs which was to be reduced the next day by 20mgs to 40mgs. The report does not say how far down the reduction was to go before – if at all – stopping. From experience, 60mgs will have you awake much of the night with night sweats and you will be hyper as all get out. Not only will it affect your sleep, you will also want to eat a whole cow in one sitting. I have been as high as 80mgs per day.

Since Michael Jackson was preparing for a big 50-show concert in London and being a perfectionist Virgo, I can see him doing drugs (downers) to combat the hyper feelings one gets from prednisone and the associated inability to sleep, thus propofol, a dangerous drug indeed but in his mind he must have rationalized his actions as acceptable. You do what you gotta do in order to do what you gotta do thinking. To use my car analogy, this is the equivalent of driving your speedy car to the edge of a cliff and applying the brakes just before going off the cliff. You might win the gamble many times but you only have one time to lose.

Unfortunately, Michael’s doctor took a gamble too, probably due to fear because he knew that he knew, but instead of being proactive he was reactionary and that’s a bad place to be. I’ll talk more on that later.

Moving on, now that I have discovered the mental triggers that cause me to do stupid stuff like gun my engines, I was more relaxed during this reduction and it helped me. Instead of going in to work one day doing 100 miles per hour and appearing the next day doing only 50 miles per hour, I was able to cut down on the stresses this would have caused me. Instead of hitting the fear button by gunning my engines and pushing myself, I was able to smoothly change lanes, get myself – mentally – into the slow lane and finally, exit the highway to take surface streets. Now, with no pressures in the way to push myself, I can settle into “I’ll get there when I get there.” No pressures to push myself, no gunning my engines which will invariably cause fears, giving rise to stress, which will invariably cause pain and inflammation, my internal organs will become shock absorbers for stress and bang, a flair, my kids will go into unhappy land, and back up on the prednisone I will go.

The hardest lesson for me to learn is I am no longer a spring chicken. At my age, I really do need to slow it down. When I was younger I easily bounced back from many things. Today, however, not so easy because there is age, menopause and my body has to deal with some of the stuff I did in my youth. Yep it does catch up with you at some point.

With that, I’m on the road again. I realize I am substantially slower than I was prior to the drop but I avoided the “OMG what’s wrong with you” criticisms that are often the mental triggers I use to push myself to get back up to speed. That hard ass drill sergeant was put to bed this weekend and I, thankfully, avoided a good deal of stress.

Now, let’s see, I can’t wait to see my cheeks again and that predi-tummy, well, time to work on that one too.