“Sleeping on the job”

Wayne’s adrenal gland seems to be sleeping on the job.  At the time Wayne started having issues with his gallbladder, he also started having more fatigue. Oh, I hear you out there, “Really!  He did just have gallbladder troubles and a BMT, most people would be tired!!”  And of course, you would be right, but this is more fatigue than you would expect even under his current circumstances.  So what’s up?                                                                 As you may recall, Wayne had engraftment syndrome (ES) treated with high doses of steroids.  The ES resolved and he started to taper (wean) off the steroids.  Coincidently, the steroid taper ended the same time he started having issues with the gallbladder.  So, why do they taper the steroid dose?  Steroids are really hard on the system, so why not just take him off as soon as you can?  One of the reasons you taper is to give the adrenal glands a chance to start to work.  All the time Wayne has been on synthetic steroids, the adrenal glands have been snoozing, taking a break. We have to convince them to come back to work. The reason a person is weaned off steroids slowly is to give the adrenal glands a chance to “get fired up” so it can build up,  to work full-time, on it’s own power.  In Wayne’s case, his adrenal glands just do not want to get to work, so we will have to put him back on steroids. I am pretty sure no one ever thought of  Wayne as a “Speedy Gonzales.”

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