Wednesday, June 17, 2009

Dexamethasone for myeloma, side effects

Dexamethasone is a synthetic adrenocortial steroid. Adrenocortial steroids are also known as glucocorticosteroids or corticosteroids. Big words you don’t want to pronounce while eating breakfast cereal. If you want to know more do a Google search.
When used in the treatment of myeloma dexamethasone can trigger the destruction of myeloma cells. More information from IMF here: Source
I was given Dexamethasone for VAD cycles one and three on days 2 to 5, 9 to 12, and 17 to 20, taken by tablet (40mg).
Dexamethasone has many side effects. Side effects that I suffered were sleep disturbance, verbal aggression, mood swings and some minor effects.
Sleep disturbance: I would go to sleep in the evening for about 30 minutes then wake up wide awake ready to take on the world. From trial and error there wasn’t much point in going back to bed for at least 4 to 5 hours. If I was lucky and did go to sleep longer, sleep would only last 4 hours when I would wake early morning wide awake really buzzing, no more sleep.
As advised by my doctor I was taking the dexamethasone at breakfast, it didn’t seem to help the sleep disturbance.
To take advantage of my extra time awake I would get out of bed so as not to disturb Myra, get warm and comfortable to read, watch TV, listen to music or the radio or get on the computer. When my bone pain reduced I found walking the floor helped by making me feel tired.
The use of a sleeping pill did help.
Verbal aggression: This was interesting. Normally I am laid back, an introvert, keep calm, not prone to verbal outbursts. Myra pointed out to me that I was becoming very opinionated, loud and talking aggressively. For example, when driving any other driver was fair game. So many *#@$** wankers who got their *#@$** license from K-mart. My driving wasn’t aggressive, my comments were. Any politician on TV copped a gob full, right or wrong.
Once I realised what was happening I tried to tone it down but still had to get stress release so I still made comments while driving. My main verbal stress release was watching sport on TV, my favourite pastime. I let it all hang out, I loved it. Any one walking by must have thought we were having a domestic.
I called my verbal aggression “the other Sid”.
An important challenge for me was to acknowledge it, not let it impact on others or use it as an excuse for personal abuse. That’s why the stress release was important.
Mood swings: Not too bad, just feeling good then within 10 minutes feeling down. The sudden changes surprised me. This fluctuated during day and night. Sometimes I would mood down and stay down all day. It was never anything too deep, constant down or depression like others have told me, just up and down, up and down
Tearfulness was there, tears flowed spontaneously for reason or no reason even when feeling normal.
I kept the medical team informed but decided not to use any helpful medication that was offered unless it became worse, it didn’t.
Minor effects: During the week I was taking dexamethasone I suffered bouts of hiccups, some times for 2 hours.
During the third VAD cycle (second dexamethasone treatment) I experienced an outbreak of acne type blemishes on the face and neck which was thought to be dexamethasone related and treated with a prescription ointment and eventually cleared.

1 comment:

Lori Puente said...

HI Sid! Thanks for leaving a comment on my retrospective blog. Very cool to see someone else doing the same thing, "retrospectively". For some reason now, Dave has very little emotional swing or attitude problems on the Dex. Weirdest thing really. Maybe because he only takes it once a week now. But it could be brutal, and like you, short lived.

Good luck with your MM and I'm glad to know you are out there! Lori