from Wikipedia.org:
Dexamethasone (DEX, brand name Decadron) is a potent synthetic member of the glucocorticoid class of steroid hormones. It acts as an anti-inflammatory and immunosuppressant. Its potency is about 20-30 times that of hydrocortisone and 4-5 times of prednisone.
This was one of the first drugs that I was put on after entering Lee County Memorial Hospital in Fort Myers. Mostly, I was put on it to relieve brain swelling, edema, and the symptoms that generates prior, during and after the de-bulking surgery that I had. Dr. Javedan put me on 6 mg/3 times a day (TID), which is a fairly hefty dose. I know that I needed it but the side effects began almost immediately. They included: hungry and thirsty all the time, restlessness, inability to sleep, constipation, dizziness, and stomach upset (that's why I'm taking a lot of Pepcid). Basically, it speeds up your metabolism completely. It's hard to relax when you are on this drug.
It's a brutal drug to be on because of this. A more subtle yet obvious effect is on mood and emotion. I consider myself and fairly “non-emotional” type of person. But while taking DEX, I find that I cry easily. I even watched a “chick-flick” and teared my way through it. You know, it's the new, “emotional” Phil Marder. After extended use, which I'm also experiencing, it can cause lack of wound healing (those blood sticks for the lab test cause leak and leave bruising on my arm), excessive hair growth (heavy beard) and puffiness in my face, development of a “pot belly” and leg/hand/foot cramps.
It didn't take very long after meeting the doctors in Chicago before they lowered my Dex dose down from 6mg x 3 times/daily (TID) to 4 mg 3 times/daily (TID). Eventually, they reduced it to 2 mg/twice daily (BID) or a total of 4 mg/day. This reduction has helped me a great deal to this point. The radio-oncologist, Dr. DeMassi , has told me that's as low as it will go because of potential brain swelling from the focused beam irradiation treatments.
So, when Dr. Nicholas' team lowered my dose to 2 mg BID, I thought that I would immediately feel much better. But, this was not the case. The rapid decline in dose caused me to “hit the wall” with severe exhaustion and worse yet, a complete shut-down of my GI digestive system. On Saturday, Jan 3rd, I was a total mess being tired and nauseous. My breakfast and lunch just sat in my stomach and never moved. Knowing that my irradiation and oral chemo was to begin on Monday, January 5, I was quite concerned. But, fortunately, on Sunday I felt much better and by Monday, January 5, I was fine and ready to start the new regime.
Hi Phil,
ReplyDeleteYour blog came up on my google alert today. My husband has had GBM for 5 years. He has been off and on dex. When you get those side effects from the reduction ask them for a script for hydrocortisone. It keeps your adrenal gland going. It made all the difference in the world for my DH. He had symptoms like you describe. He was able to wean off the dex with the help of hydrocortizone.