Please Stand Up

My treatment for Sarcoidosis has been progressing, for the most part it has been positive but the side affects of the tablets I have been taking have been a bit much at times.  As far as the corticosteroids are concerned, I don't think they themselves have caused any of these, and I don't believe I have had any complications in regards to the immune suppression.  The other tablets that are meant to mitigate the effects however, I think have been causing quite a bit.

The most pressing side affect was being caused by Lansoprazole.  Taking Prednisolone by itself can cause stomach ulcers, so you need to take an ulcer suppressing drug alongside it to prevent that.  Lansoprazole and its related '-prazole' tablets are intended to do this.  Unfortunately one of the side affects is that it can cause diarrhoea and I was one of the people that reacted in that way.  It wasn't an everyday occurance, instead happening every 3 to 4 days.  I'm switching to an alternative called Pantoprazole to see if that is more tolerable.  Apparently there is little difference in effectiveness between the -prazole tablets, just that some people tolerate one more than the others.  If Pantoprazole doesn't make a difference I think the next one on the list is Omeprazole.

Due to the way corticosteroids work, I have also been told I need to take Bisphosphonate tablets, which prevent osteoporosis - thinning of the bones.  I was reluctant to do this because you have to see a dentist before they can be prescribed and I really hate dentists, I had very bad experiences with them as a child and ever since then I have been reluctant to visit them.  It had been over 10 years since I last saw one.  In that time, never had a toothache, never had teeth sensitive to temperature, and never had a filling.  Nevertheless with much despondence I give in and went for a checkup.  Thankfully there's nothing pressing as expected, and there's no dentalwork that needs to be done any time soon so I can start the Bisphosphonate tablets.

The Bisphosphonate tablets I have been prescribed are called Alendronic Acid and they are perhaps the most peculiar medication I've ever been given.  There are quite a few grim warnings with them on possible side affects, the most pressing being that it disrupts the recovery of bone tissue so any dental problems can be greatly worsened by the tablets if you need dental work done - hence the checkup needed beforehand - and a warning about a condition called Osteonecrosis, which basically means your bone dies and starts rotting inside your body which I googled - I really shouldn't have done that, the pictures that came up were stomach turning.

The most peculiar aspects however are the way you have to take the tablets.  For a start you have to take them once a week, on the same day, at the same time, first thing in the morning, with a glass of water, standing up.  Yea, that last one raised an eyebrow for me.  You have to be standing up when you take the tablets, and you have to remain upright for 30 minutes after, during which time you can't eat or drink or do much at all actually.  It does seem a bit like something out of a slapstick comedy routine, half expecting them to say "stand on one leg, hold your nose, count to 10 and swallow"

My Doctor did stress the directions may sound odd but I do have to follow them, so I will do as I am told.  First dose of those I will take tomorrow morning.