Prednisone and Illness Question

This hemo insists on boosting dose (15mg-20mg) when I get sick (or teeth procedure, or stress, or LIFE). Is this normal protocol? I feel like I am always tapering.
Also, do you have to take antibiotics when you first get a cold?

Yes, it is normal procedure to boost Prednisone before a procedure. Your doctor is doing it right. When a person on steroids has a trauma to the body (such as surgery), the adrenals need the extra cortisol boost during that time. I'm not so sure that you'd need it just to deal with life though...can't stop that from happening.

Antibiotics will not help a cold. A cold is a virus.

I seem to recall that you have an overly cautious doctor and this sounds a bit like much of the same to me. What dose of steroids are you on before boosting it up? I wouldn't take any extra just for a dental thing or stress. I once had a chest infection and my GP said to take steroids becasue I'd recently come off them and I just ignored him. No way I was going to do that.

I'm guessing with the antibiotics for a cold thing that he's thinking of avoiding a concomitant bacterial infection taking off. A bit more overreaction I'd have thought.

How long have you been on the steroids now?

I have been taking 10mg for the past month, before that 12.5 for a month, 15mg for a month and 20mg for a month because of a drop from a dental thing. On friday my count was 80k from 200 the week before (she thinks from underlying virus? and wants to stop the free fall) and wants me to boost to 20mg. I am always tapering. She is very off hands and just says "boost and check in a week". This is almost 5 years of pred at varying doses. Thanks for your help ladies. I tried to negotiate a 12.5 for a for a few days or 15mg she said no and walked away.

If I didnt have so many side effects- high blood pressure, my hair falling out, my skin is thin, two cataracts, bone density loss, palpitations, mood disorder, arthritis, etc. I wouldn't object.

You have to do what you want. If you don't want to take a higher dose then just don't take it. To be on steroids for 5 years for ITP is just wrong. You should maybe consider changing doctors.

Oh my - I agree! I thought these were isolated situations. May be time to get a new doctor. It sounds like she is keeping you on steroids to prevent a drop; not such a good idea. Do you really go once a week?

Thanks for helping me. I go at least weekly since this started. I have been twice since Friday already. She told me there really isnt a "better" option or that will allow for bi weekly draws...like nplate or promacta or something.

Honestly, I don't know of anyone here that goes that often. Maybe at the beginning of the diagnosis, but not after 5 years. I was once in the 20's for months and still only went bi-weekly. A lot of the time I only went when I had symptoms....if not, I assumed the count was livable. If I had counts of 200 like you did last week, I wouldn't have gone back the following week for sure.

At what count do you get symptoms?

I'm on Nplate and have a blood test every 8 weeks. Many on Promacta go much longer after a while when they know they are stable. You really have to sort something better out for yourself.