Steroids can cure, maim!

Steroids produced naturally by the body are called hormones. They help your organs, tissues, and cells do their jobs. Your body must have a healthy balance of natural steroids to grow, stay healthy and meet the daily, stressful challenges of living and even to make babies!  But “Steroids” also refer to man-made medicines which work like the natural hormones.

There are two main types – corticosteroids and anabolic-androgenic steroids. Corticosteroids work like the natural hormone called cortisol (produced by the adrenal glands) to quickly fight inflammations in your body. Inflammation is a protective reaction of the tissue to irritation, injury, or infection. It is characterised by pain, redness, swelling, and sometimes loss of function. The greatness of corticosteroids is their ability to prevent this response often leading to a dramatic reduction in the pain, itching, redness and swelling.

On the other hand, slowing down or preventing an inflammatory response in a bacterial infection, for instance, may result in an unrestrained access of the invading bacteria resulting in more severe damage to the tissues. The absence of the usual inflammatory response may also prevent some antibiotics from working effectively. Thus, misuse of corticosteroids, by interfering with the natural defence mechanism of the body may cause more problems.

Mrs Tade was placed on high corticosteroids because of severe uveal inflammation. She had been on it for about two weeks. Unfortunately, she had to travel and forgot to take her medicines along. Three days after stopping the corticosteroids, she started experiencing feelings of weakness, fatigue decrease appetite and cramps. Fortunately for her, she had the presence of mind to go to nearest hospital. The doctor immediately recognised that she had what is called steroids withdrawal symptoms and immediately restored her medication. Within a few hours of taking the first dose, the symptoms disappeared.

Mr Paddy was not so lucky. He had been on a small dose of steroids for about fifteen years on account of a chronic auto-immune disease. He had to undergo an emergency surgery at a local hospital far away from where he normally lived. The surgery went on fine but recovery was eventful. Slowly and steadily, he started going downhill. His pulse and blood pressure(BP) were getting slower and thinner. Soon, he was in coma. Despite everything that was done, he was dead in no time. It was after his death that the doctor got to know that he had been on steroids.

He neither volunteered the information because of the poor nature of his health nor did his friends know about it. He died because of the sudden withdrawal. Using large doses of steroids for a few days, or smaller doses for more than two weeks can lead to a prolonged decrease in the natural cortisol produced by the body resulting in serious challenges and even death as seen by the two stories.

Patients should always carry a list of all their medications in their wallet to alert medical personnel in case of emergency. Remember, emergencies don’t often give any warnings!

Eight-year-old Robert was placed on some steroid-containing eye drops on account of severe allergic conjunctivitis. He was supposed to use it for just two weeks and continue with the less effective, more expensive but safer eye drops.

After two weeks, he changed to the more expensive but safer eye drops as directed by his doctor. He found this not as effective as the previous eye drops. Why should he pay more for a medicine that was more expensive but more expensive? So, his mother decided to go back to the cheaper steroid preparation.

Both mother and son were happy that he was his eyes were comfortable and did not bother to visit their eye doctor. About two years after, Robert was experiencing difficulty seeing the whiteboard in class. They had no choice but to visit his eye doctor. Sadly, he had developed severe thinning of the cornea and scleral and the contents of the eyes were only restrained by a thin remnant of the scleral coat. It was too late!

Despite all that was done to save his eyes he not only became blind, one of the eyes ruptured and had to be removed. What a price to pay for disobedience!

The examples are real life stories. Aren’t they scary? I have left out the more scary ones. We doctors see them every now and then! Steroids are great! They can cure or maim and certainly can kill. They are simply put dangerous! Even as a doctor, I prescribe them with some trepidation and never fail to give full explanations and adequate warning to my patients.

Notwithstanding, some would still go ahead and do as they please. Ideally, steroids should not be prescribed without the prescription of a registered medical doctor. And the doctor’s name and signature must be easily verifiable in the official register of the Medical and Dental Council of Nigeria.