Table 3.

Theme 2, “Prednisone: A Necessary Evil”

Theme 2: Prednisone: A Necessary Evil
Subthemes	Exemplars
Stuck on prednisone	“I think I might have tried once [to reduce prednisone] and the symptoms I had started to reappear. I’m just not prepared - because I know what it’s like when I was in that cycle of massive doses of Prednisone, weaning yourself off massive doses and wean yourself off …” Ian, male, 63. “When I was taking the high dose of Prednisone you had a little period of time where you think you can do everything and anything and then when you start reducing it, because you have to because you feel so blah, and then I couldn’t do it. I’d reduce it and for a little period of time I couldn’t do anything much and then I had to take them again and for a few days.” Margaret, female, 70. “Well, yeah I know the side effects and I guess - yeah, you consider it, but once again if I wasn’t on the little bit of prednisone I’m on, I know I go backward. I really don’t have a lot of choice I guess; it’s either live for now or live for later. My biggest thing is to just try to keep it to its minimum I need. Other than that, I really can’t do much.” Michael, male, 48. “… it’s really affecting me because I’ve been on it for so long already. I don’t know what’s going to happen in the next five or 10 years because of the prednisone because it’s just really destroying my body pretty quick over the last five years mainly, hasn’t it, I’ve really gone downhill for the bones and that, haven’t I? … It’s actually overtaking the asthma problem now is the side effects from it. [prednisone]” James, male, 45.
Damaging side effects	“Because I think that was associated to the weakening of the bones. There was a stage where I leaned over to pat mum’s cat on the lounge and I pressed some ribs against a handle and I cracked a rib.” Howard, 62, male. “I hate Prednisone because number one you get the moon face. Number two I find it hard to sleep on it and I don’t know whether that just gets in your brain and you just keep on thinking I’m not going to sleep because I’ve got this drug. It just - I get aches and pains with it … I just get pains in my back with it and yeah flushed cheeks and all sorts of things. The last lot I had, I was starting to feel really agro and that’s not me. I really hate that drug.” Judy, female, 66. “I’ve broke my feet all the time. It’s not just from - it’s just from normal walking on them. I wake up in the morning and I’ll be in a lot of pain and that - my knees, my hips, my elbows. I’ve just come out - I broke my wrist from it from doing hardly anything. I was doing a barbecue, just the tongs and I managed to break my wrist. So just very annoying and it’s getting really depressing as it goes on now.” James, male, 45. “Well I mean I think the majority of the side effects of Prednisone have happened now. Don’t forget your skin, it’s like tissue or like it can bruise very easily and had a few damage results. Like my shins, it’s like that … touch and … [it rips right open]” William, male, 72 “I worry about the Prednisone, because of the side effects, there’s three big side effects … cataracts, osteoporosis and diabetes. I worry about the ongoing use of that.” Ian, male, 63. “Well I put on tons of weight … it’s starting to affect my eyes” Rebecca, female, 21. “I go a bit - sleep deprivation, overeating - well, appetite enhancement, fluid retention. I tend to go a little bit funny in the head. I nearly drove a car off the side of the hill one time because of it … I don’t think very straight when I’m on it.” Albert, male 58. “Well, bad experience, I had prednisone for quite a long time, quite a high dosage of that, and I suffered severe depression. At my lowest, never, ever, ever thought I’d feel the way I did.” Naomi, female, 34.
But it keeps me breathing	“It keeps me breathing. That’s the only thing I can say I like about it”. James, male, 45. “[The GP] tried to tell me to knock it off [the prednisone], but it was the only thing that I could get a bit of relief with”. Harold, male, 81. “I knew it was never a good thing to be on and I always wanted to get off it. My wife in particular saying, oh don’t increase your Prednisone? I keep on saying well … Well what do you want me to do? Do you want me to collapse on the floor and cough and splutter all day and whatever and not be able to do anything?” William, male, 72 “At this point in time [the benefits of prednisone outweigh the negatives]. There’s no other - there’s nothing else available”. Ian, male, 63. “ … that’s a last resort. That’s when I’m crook, when I need that one”. Diane, female, 66.