Donuts

I’m in the pub. Well, it’s not actually a pub but a hotel. It’s one of the few places in the centre of Cardiff, currently stag night capital of Britain, where you can get a quiet drink and a seat. Only tonight there’s a wedding on. Reception is full of shrieking families, running kids on sugar highs and fat bellied men in uncomfortable suits. The noise is terrific.

Don has just told me the story about buying a jam donut. Not a thing he does often but on this occasion, a pale morning walking in Penarth, he was just overtaken by desire. I know the feeling. Prednisolone brings it on me all the time. The entrance to Greggs was blocked by lounging youth, hooded, fags in hands, every other word they uttered an expletive. So I ****ing says **** you ***, **** off. Normal conversation, for them. Don objects. There are women working here, he shouts, you’re offending them. Move off. He points his arm. Amazingly they go. No attempt made to swear back. It must be something about how Don looks.

Inside the shop the staff thank him profusely. What did you want, love, asks one of them. A donut. Have this one on Greggs. A donut free, tastes even nicer. Don is delighted. How much do they cost, I ask him. £1.50 for five or 35p each. As little as that. I could do with a bag right now.

We get onto talking about illnesses, hospital visits and inevitably my life on steroids. It’s the way of the world now. I’d never heard of polymyalgia, says Don, but now everyone seems to have it. There’s at least two at the golf club. One of them has increased his collar by at least two sizes. My fear, that one. Not happened yet but I’m still waiting.

The prednisolone experience is different for everyone. Some balloon fairly quickly, it seems. The moon face arrives and stays until the dose tapers to lower levels. Depends where you start, how you are, who you are, how much you eat. The steroids move weight around is the official line. Male sufferers I’ve talked to all report a certain bagginess around the middle but not everyone ends up with a round face.

Here I am this morning checking how I look in the mirror. Like I was yesterday and that was pretty much how I was the day before that. I had two drinks in the bar last night. Managed them okay for once. Alcohol isn’t what it once was. Nothing is.

I check the cake tin. Empty. Been that was for a few months now, ever since the PMR first showed. How far is it to the nearest Greggs I wonder. Not far. Donuts. Mmm. A difficult desire to resist but I manage it. I have an apple instead.

Weight is a Burger Thing

In the past I’d imagined that weight was entirely a burger issue. Too many pies and your trousers won’t fit. All this stuff about big bones, having a clinical dispensation towards fat gain and saying that it ran in the family was just so much excuse and avoidance. Looking like a blimp was something that happened to other people. Not to you. Faces inflated by bicycle pump could be avoided. The real issue was what went in through your mouth and how often. Now I know differently. Some things are genuinely beyond our control.

Prednisolone-driven fat increase, it turns out, is one of these. Fat gain comes with the territory. But there are things, as I’ve discovered, that you can do to help.

To start with the fat thing favours women. This doesn’t mean that men are exempt but it does mean that gain is not necessarily so great or so fast. Most of those I’ve talked to have told me that that a flabbiness about the waist is pretty inevitable but that the much-feared moon face and looking like an advert for Burger king don’t always happen.

I’ve been fighting this for three or four months now. Checking my weight daily, looking at myself super critically in the mirror for signs of face inflation, feeling my back for arriving lumps of water-born fat, pressing my fingers into my stomach to see if the flab is growing. After a while I’ve found that I’ve looked so often that I can’t remember what I might have looked like a year ago nor, even, how things were yesterday. I ask others. Any sign of change? Nope, you don’t look fat to me. That’s the response I want.

In reality the waist flab is there, of course, low key, not much of it, but still more than there should be considering the draconian diet I’ve put myself on. I figured that if prednisolone was going to deliver new weight then I could counteract that by eating less. Go on a diet. Watch what I eat. Keep a record. Know what it is that I’m putting in my mouth. Those things dieticians recommend, the keeping of a food consumption diary, may have their uses after all.

There are certain obvious things to cut back on. Twenty-first century health advice is replete with detail: cut out fried foods, pastries, pies, cream, cheese, red meats, crisps, salted nuts, beer. Eat more veg, more fruit. Stop having chips with every meal.

I began the new regime. Fine when you were in control of the constituents of a meal and were eating at home. Hopeless when others got involved and even worse when you dined out. Dieting is a struggle even on your own. Out there in the wider world it’s so much harder. I’ll have a baked potato, I tell the waitress. But hold the filling. Back it comes, no filling but thick with running butter instead. Can I have a salad. Certainly. But that arrives rich with added thousand island dressing. I’d like to order fruit salad, please. That turns up with ice cream on top. To drink? I’ll have a slim line tonic please. Sorry, we don’t do those.

It’s a battle but I’m equal to it. There’s a learning curve but I can climb it. More on that next time.

Weight

On the list of side effects contained in the Package Leaflet: Information for the User in my many boxes of Prednisolone is a warning that taking the steroid can lead to weight retention. There’s reference to the developing of what the notes indemonstrably call a rounder face. There’s a note on salt and water retention. There’s another that suggests users will have increased appetite leading to weight gain. When you look into these Prednisolone characteristics they emerge as something you really don’t want to happen. Moon face, humped back, weight inflating your belly. Just how you want to be over Christmas.

I asked the GP what she thought. It doesn’t happen to everyone, she told me. I started checking the mirror daily. Could I see fat accumulating around my neck? Was my face like the moon? Not yet. I’d never been really heavy but was slightly overweight when the PMR first stuck. Slightly overweight in my terms, that is. Friends and loved ones said I looked fine. But I didn’t feel at my best. I needed to lose half a stone. I couldn’t allow the Prednisolone to get in the way. What could I do?

Further reading revealed a number of contradictory theories:

1. That the weight gain came from an increase in appetite
2. That the steroid led to salt and water retention
3. That the moon face was the result of body fat moving around from some other part of the body
4. That you could fight it and win
5. That you’d never succeed so why not just keep your head down and suffer

Internet. Hell on a bike, it’s never definitive. It’s ever changing. Looking for a complete answer is like searching for a piece of the true cross.

I visited the chat rooms and read what had happened to others. There were stories of people putting on stone after stone, of developing camel backs and faces so round they could go bowling. There were tales of people who had taken to their beds. Stories of some who’d just accepted it all and carried on. There were also tales of people who’d managed to keep their weight level by dint of healthy eating and hadn’t gained an ounce. The problem was that you never knew where the respondents had started from. Were they unfit elderly and overweight anyway? Or were they super-fit runners without any spare fat at all? Did they have the will power to avoid chocolate and cheeseburger? Or did they eat these things daily just to get through life? You couldn’t tell. You didn’t know. You had to make it all up yourself.

I decided that it was time for me to take my eating and drinking in hand. There would be things I’d need to avoid and substitutes I’d need to learn to love. I already owned a set of Wi-Fi scales (made by Withings, a brilliant invention). These would transmit my weight to a special web site where I could keep a recorded track. Stand on the glass top in the morning (recommendation: do this at the same time daily and, preferably, naked), check the resulting graph on the computer later. I’ll beat you weight. That’s three battles I’m now engaged in. PMR, Prednisolone and heaviness. Nothing like fighting the world on all fronts.