Today’s the day: I’m moving to Taper Town.

Did you ever see a two-year-old go limp when his mom or dad tries to lead him by the hand? Neat trick. That’s what your adrenal glands, those lovely lumps of lymph tissue above your kidneys, do when you take presnisone. And just like you can’t really blame the limp two-year-old for his behavior (he’s TWO), we can’t really blame adrenal glands for sleeping while prednisone does their job for them.

One of the adrenal glands’ jobs is to make corticosteroid hormones that keep inflammatory responses from spiraling out of control. The amount they make is variable because they increase production in response to stress (illness, injury, emotional upheaval), but their normal daily output is very close to the equivalent of 5mg of prednisone daily, which is the dose at which I’ve been hovering for about a year.

It’s time to ditch the artificial stuff and all its side effects and let my adrenal glands wake up. Unfortunately, just as kids move from one phase to the next, my adrenal glands are going from limp toddlers to tired, cranky teenagers who don’t wake easily. As I lower my dose of prednisone, they’re going to be reluctant to switch from rest mode to response mode and make up the difference with natural cortisol.

This means I’m going to be cortisol deficient. It means my lupus will be stronger than my endocrine system again. It means that I can count on inflammation and the havoc it wreaks on my body. It means pain.

And that’s okay, I’ve decided. Some people are lucky in love; I’m lucky in lupus. I don’t have the life-threatening complications of many lupies. I can tolerate other immunosuppressant therapy. I have time to care for myself. My support system is superb (thank you, thank you, thank you). So, I’m moving to Taper Town.

There are no welcome mats here. It’s a tough neighborhood, resistant to gentrification. But I’m staying until my adrenal glands wake up and grow into productive members of society.

It’s Day One, and I’m taking 4mg every third day.

4-5-5, baby.

Comments always welcome!

Looking for more on this subject? The tags in the “cloud” to the right of this column will take you where you want to go.