In the Predni-Zone

Last summer, I travelled to the Pfizer Pfestival. The Pfizer Pfestival is a fair for pharmaceutical company representatives, and it rewards them for efforts to convince doctors to prescribe their products by supplying them with coffee mugs and highlighters shaped like really big Prozacs. It is back-breaking work, indeed. Besides carrying a briefcase that holds a sample vagus nerve stimulator implant or other advertised device, reps must also haul in platters of ham-and-cream-cheese roll-ups for hospital lunch presentations. They also have to verify that there are enough chairs for the doctors to vacate as soon as they finish their complimentary lasagna during the talk. Hence, the Pfizer Pfestival is considered just compensation for demanding work.

Everyone loves a Pfair, so you'll find many parallels between the Pfizer Pfestival and a traditional county fair. For example, on the midway, you can play that game where you have to flip a frog onto an Eli-Lilly pad. You can win a gigantic Lunesta butterfly if you pierce at least three balloons with an Epi-Pen, and for three tickets, you can take enough Xanax (side effects may include drowsiness and dizziness) that you feel like you're on your own private Tilt-A-Whirl. In the field area, you can watch a blue-ribbon ox pull a Schering-Plough, and the barn holds the very horse whose urine was used to first synthesize Premarin. There are also several events. Each year, one contest is held to see who can list the most side effects in the shortest period of time. The winner gets a contract to do the side effect list voiceover for the next cholesterol drug commercial. The most daring attendee is determined by who takes the smallest amount of Cipro before licking a sheep in the Lick-A-Sheep-With-Anthrax Contest. But the most popular event of all takes place on the second day of the Pfestival, when the Side Effect Queen is crowned.

The Side Effect Queen is an honor like no other. The woman who is Side Effect Queen is revered by pharmaceutical company reps, because when one gets a side effect from a drug, other drugs must be prescribed to reduce that side effect, and other drugs must be given to take care of the side effects from the second drug. The Side Effect Queen, then, represents an important source of revenue for the drug industry. The Side Effect Queen is chosen from among a group of women who at least 9 out of 10 doctors agree frequently experience side effects from prescription medications. Women who experience rarer side effects (such as "hairy tongue," a potential side effect of amoxicillin) are given extra credit in the pre-pageant rankings. Contestants appear on a stage and take part in three events: 1) Year-End Healthcare Costs , 2) Illness Attire, and 3) Narrative of Particularly Heinous Side Effect Occurrence. In my ratty sweatshirt and exercise pants that had spent three days on my warmed-over body, I produced a trash bag full of receipts and began rattling off the costs of my prescription and non-prescription drugs for the year, as well as devices such as knee braces. I handily passed through the first two rounds this way, but my Narrative Reconstruction is what earned me the title of Pfizer Pfestival Side Effect Queen.

I should note before I share my story that I have been chosen Side Effect Queen for several years running. A couple of years ago, I proudly jiggled around the fair grounds showing off my thirty pound medication-related weight gain and the loss of 65% of my hair. I was fat, bald, and twenty-six, and the judges overwhelmingly decided that such a collection constituted a Trifecta of Misery. They were especially excited when they discovered that accompanying the hair loss was a thickened scalp that flaked so extensively, every time I scratched my head, it appeared that I was in my own snow globe. The year before that, I won for successive episodes of a potentially fatal side effect, the details of which delighted the judges to no end: anaphylactic shock.

On every patient instruction sheet that comes with a prescription, there is generally a warning that enjoins you to CONTACT YOUR DOCTOR IMMEDIATELY if you develop itchiness, a rash, or hives. Prior to this experience, my experience with hives consisted of hitting one out of a tree with a broomstick at the age of seven. I learned the hard way one morning what a wicked homonym "hive" actually is. Furiously scratching my arms in bed a few days after starting a new medication, I suddenly remembered what the patient package insert said. I gasped, shot up in bed, and shouted, "I need to CONTACT MY DOCTOR IMMEDIATELY!!!" I flipped on the light in a panic, and discovered with horror that my entire body was covered in red welts. By the time I got to the doctor, my face was so dappled with hives that they mistook me for a dermatology patient. That is, until they saw my swollen lips and heard me gasp, "I think it was my medication." Without even waiting to check my insurance information, they whisked me into an exam room, tossed me on a gurney, and began making scary declarations such as, "her throat is closing up!" They rolled me onto my side and simultaneously jabbed me with needles in my butt and upper arm. "This may be a little uncomfortable," one of the white coats warned. The warning came just seconds after my lungs seized up and my body jolted up so high that you could hear a bell ring, like someone had made the top prize in that sledgehammer game at the carnival. I gasped uselessly for air and then fell back against the bed to become completely unconscious and remain that way for the next three hours. I awoke to find that I was no longer dappled with hives but slightly mottled, and that they had shot me up with epinephrine and Benadryl at the same time to stop the allergic reaction. I had survived anaphylactic shock, and had my own epinephrine injector to prove it. I also had a prescription for Prednisone.

Prednisone is a steroid medication that can be used to control and stop allergic reactions. Prednisone is known for its propensity to make people bloated and moon-faced. These are common side effects. But common side effects do not a Side Effect Queen make. My side effect was one that is generally not considered among dry mouth, nausea, and increased appetite, which made it decidedly Side Effect Queen-worthy.

Given that my allergic reaction did not stop for several days, the doctors gave me a prescription for a very large dose of Prednisone. The medication is already known for its propensity to cause "mood changes," as the side effect listing says, but there appears to be a dose-dependent effect. That is, the more you take, the crazier you get. I had already become so agitated that I threatened to hit a classmate for biting into an apple at what I considered to be an inappropriate decibel level. However, it was my degree of paranoia that really took the cake.

On the fifth or sixth day of my prednisone regimen, I was suddenly overcome with the desire for cake. I am not even that big of a fan of cake; I tend to prefer more sophisticated snacks, such as Funyuns. But that day, I was in the Predni-Zone. I needed cake--no, cakes. I needed cake and I needed it faster than I should contact my doctor if I experienced itching, rashes, or hives. And I needed to be quiet about it, oh yes, very quiet, or someone might steal that cake. I drove to the corner grocery store with my headlights off and I bought an iced carrot layer cake--the biggest one they had, with those gigantic orange carrots iced over the top. Furtively looking around me, I then sprinted to the snack food aisle to procure a product called Raspberry Zingers, which are to Twinkies as Boone's Farm is to Veuve Cliquot.

Shutting my car door as quietly as possible, I stole into the house, made a quick stop at the kitchen, and ran upstairs, jealously guarding my cakes from my nefarious roommates, who I was sure wanted to steal them. Once upstairs, I took out my fork, opened the plastic box top, and tore into the carrot cake. I did not cut any slices. I hadn't even brought a knife. I just stuck my fork right into that gigantic cake and started scarfing it down. I was deterred from my mission only when I heard a noise in the hallway, which I was sure was the footsteps of a roommate who had smelled the cake and was coming to take it away from me. I dashed away from the door and ducked on the side of my bed, where I continued to shovel forkful after forkful of cake into my mouth. I lovingly and longingly licked one of the frosting carrots right off the top of the cake. When my body begged me to stop pouring sugar into it, I covered the cake and hid the rest of it in my closet, in the laundry basket.

After a period of rest and a feeling of triumph in my clandestine cake actions, I started in on the Zingers. Quietly unwrapping each from its plastic pouch, I peeled away the cakey outer layer and savored the rich cream filling. I did not place the wrappers in the trash can, as that would constitute proof that I had cakes. Body complaining after three or four Zingers, I put the wrappers and the remaining cakes back in the box and squirreled them away under my bed. I must have eaten one more than I thought I had, because the next time I checked, one was "missing." I became incensed, stalked downstairs and accused everyone of going under my bed and stealing my Zingers. My roommates looked at me in horror. "Kari," one said softly, trying to calm this odd beast in front of her, "Nobody has stolen your Zinger from under your bed. That's a private apparatus, and I would never touch someone else's Zinger." I shouted, "Show me your hands! Who has frosting on their fingers?!?" They stared at me. My lip twitched in anger, realizing that nobody was going to admit their indiscretion. I stomped back upstairs, took my next dose of Benadryl, and fell asleep, only to twitch myself awake every so often, thinking of my roommates' betrayal. Over the next several days, I repeated my cake routine again until it was all gone and I was satisfied that nobody would kill me in my sleep for my baked goods.

In an upset that overthrew even the woman who became manic after taking too much antidepressant and bought a steam boat, Cake Hoarding is how I won the title of Side Effect Queen of 2000. My trophy reads: "Side Effect Queen of 2000 for Cake Hoarding (with Paranoia)." Prednisone's manufacturer took note of my story and added it to their package insert side effect listing, so that it now reads: "Side effects that may go away during treatment are difficulty sleeping, mood changes, increased appetite, and indigestion. CONTACT YOUR DOCTOR IMMEDIATELY if you exhibit cake hoarding behaviors." I'm currently on Prednisone again for another allergic reaction, albeit not as bad as the last one. I'm waiting excitedly to see what kinds of bizarre things I'll do. Perhaps I'll beat up anyone wearing pink, or rub my face on stucco. I'm not sure what will happen, but while I'm doing whatever it is, I have one request--keep your hands off my Zinger.