The Convalescence Notebook, Part II, March 26, 2005

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This afternoon I went to see my doctor for the first time since I was discharged from the hospital a week ago. He asked me why I didn’t show up for my two previous appointments. I didn’t know I had any. I knew that before I left the hospital we had a meeting where they gave me a business card with a doctor’s name on it (which I promptly threw away) and told me they’d be seeing me in the office the next day and then the next day as well for some injections in my neck, but I was quite hazy on the details and when I called the office that afternoon, they gave me an appointment for the following week.

”You were supposed to come in for steroid injections. What have you been doing for pain?”

“Well, like I told you when you discharged me, I don’t respond well to percoset and so I discontinued that almost immediately. But I had some dexamethasone and Tylenol and they seemed to help before so I tried them and they worked great. I’ve cut the dosage down to two a day instead of five, and I take one when I get up and when I go to bed. I missed the one before bed two nights ago and suffered for it in the morning. But I took two yesterday, felt fine when I woke up, and it’s 2 p.m. and I haven’t had one yet and I still feel pretty good.”

Okay, let’s back up a bit, because this is important: the way a steroid like dexamethasone works is that it shuts down your adrenal gland. There’s a lot of side-effects (you never get the message that you’ve eaten enough, for one thing, so you’re constantly grazing, and I also suddenly understood the aggressiveness in modern sports), but it also soothes neural-related pain like mine.

So my doctor says, “Well, come back when those pills are gone and we’ll set you up with a shot.” And I said, “Why?” And he says, “Because you’ll be out of pills.” And I said, “But I haven’t had one today. I don’t think I’ll be out of these for quite a while–I only take one when I feel I need it.” “But,” he says, “we have to taper you off of steroids–the shot is designed to do that.” “But,” I say, “if I’m down to two pills a day, and I haven’t had one yet today, why would I want a shot in another week that would shut down my adrenal gland for a month, especially if I’m not experiencing any pain?” “Because,” he says, “it’s easier.”