Contact lens wear can be an inflammatory influence under normal circumstances, but an alreadysensitized cornea can show rebound inflammation if proper steps aren’t taken. It is imperative to use the immunosuppressive benefits of steroids with a slow taper as contact lens wear is resumed, or the patient will suffer setbacks and require multiple office visits. We typically restart limited contact lens wear when the rehabilitating cornea can tolerate a limited steroid dosage of once to twice daily.
Continuing with the acute bronchitis case, this patient would usually be given a short term steroid “burst” of high dose prednisone. Those high daily dose is usually tapered off over the course of a few days to avoid adrenal exhaustion and withdrawal effects. You see, when you introduce prednisone (which the body recognizes as cortisol) to the body, the adrenals stop making their own supply. The theory behind tapering off of steroids like prednisone is that by slowly removing the external steroid source, the body can adapt and begin making its own again with less stress placed on the system. The practice of tapering in short term therapy, even in higher doses is debated by many clinicians. Some doctors and clinicians claim that not only is a taper not necessary in short term therapy (14 days or less) but it is better to stop this therapy earlier, the adrenals and body adjust just fine. Using a taper just introduces more of the artificial source for a longer period of time, which is best to be avoided to minimize side effects and more quickly restore natural body hormone levels.
--- Stress is often mentioned by CSS patients around the time of their diagnosis, and in a way this seems related to the adrenal glands as well. A patient in another support group reported reading in "The Stress of Life" by Dr. H. Seyle:.... "the adrenal glands are the processors of stress in our bodies. A person's stress resistance will vary with the competence of his adrenals. Continually stressing them, finally depletes them. When we become exhausted by life, on a mental or physical level, our adrenal glands often fail to keep up, and illness ensues".