Prednisone has rocked my concept of medicine. When I was ill at Oxford I would have given anything to take a pill and have what I was experiencing go away. But with prednisone my wishes have been fulfilled much as Brendan Fraser’s are in Bedazzled (a movie my sisters and I watched repeatedly as children), where Liz Hurley as the devil grants Fraser seven wishes, and then proceeds to fulfill them so that what he has wished for becomes worse then he could ever have imagined. I guess Faust would have been a more high-brow reference here, but honestly I relate more to Brendan Fraser.

 

From my limited understanding, prednisone as a corticosteroid mimics the hormone cortisol in your body. Cortisol, is not just released when we are stressed, as I had initially thought of it based on pop-science literature, but actually plays a fundamental role in nearly every process in our bodies. Prednisone is a flame thrower, it isn’t nuanced, it hammers down your immune system and your immune system’s modes of protecting you.  When I was on high doses of prednisone I was a very hungry zombie. No matter what time I went to sleep I would wake up a few hours later, physically alert but mentally wiped. On high doses of prednisone even those buttery soft yoga leggings left bruises where the waistband made contact. And I ate, good god did I eat.

 

And this is really at the heart of my issue with prednisone. Am I terrified of getting diabetes, of my hip bones rotting in their sockets, bleeding gums and stomach ulcers, all of the terrifying side effects which were the reasons I initially refused to take it ? Yes, I’m scared of all those things. But honestly, what I hate the most, what makes me hesitate every morning when I take my medicine, is my moon face. I hate my moon face. Moon face, where this project gets its name, is one of prednisone’s special side effects. Cortisol plays a significant role in weight regulation and metabolism, which is why you read all those advice tips and buzzfeed snippets about ‘stress causing abdominal fat’. Prednisone not only tanks your metabolism but it makes you unimaginably hungry, like stoner hungry, like flashbacks of when I had the munchies at fourteen and ate an entire baguette and the not lesser half of a block of cheddar cheese. That sort of hungry.  And where does that baguette and cheddar go, they go to your face, you start to store fat abnormally, you develop moon face.

 

But wait, there is an irony to this, because my illness caused a similar munchies hunger, when I started to get sick I wondered if the thyroid antibodies that doctors have consistently flagged but haven’t been an issue before had suddenly decided to attack. I was hot all the time, I was jittery, I had a resting heartbeat nearly twice what it had been previously, and I ate and I ate, yet I shrank. Doughnuts for supper, wake up starving and half a kilo lighter. I was getting into a routine of having a crumpet every hour, on the hour. But with my next round of blood tests, antibodies yes, but thyroid still relatively fine. I’d entered some sort of upside down, where the more I ate the more weight I seemed to lose. I was scared.

 

The reason I was scared then, and I’m scared now is because my relationship with my body and with food has been one of my proudest achievements as an adult. I had battled a family legacy of disordered eating and I had won. The intuitive eating authors owe a good share of their wealth to me, I have touted it as the bible, that and any Eucerin product are my most vehement recommendations. But what do you do when your appetite, which had become a well-known friend becomes a stranger and betrays you, what if your appetite was hopped up on drugs and decided not to speak to you, but instead just began to incessantly push you toward various pastries. What if, as I’d gotten into the habit of doing, you asked your appetite, do you want pasta, do you want spinach, bread, is today one of those days when you need cereal for supper? And normally the response would be varied, no vegetables today, I want pasta, I want to feel that full starchy feeling. No, actually soup, soup with tiny pasta, the kind the Yaya used to make the kids I nannied in Barcelona, that’s what I want today. And I listened happily and obliged, I trusted my appetite, I liked my hunger, I liked my fullness. But what if when you asked your body what it wanted to eat it just said “Yes.” White veined chocolate from Easter two years ago? Yes. Strange combinations of things dipped in hummus? Yes. No preference, just yes. I live in a semi nauseous fugue, I take another medicine to lower my stomach acid so the steroids don’t rip it up, and this means my digestion is painfully slow and I am nearly always painfully full, but my appetite doesn’t care, it’s a stranger, it doesn’t want to have a conversation.

 

My clothes don’t fit. Slowly more jeans go further back in the drawer, I can’t quite concede to buying myself new clothes for something that I think will be temporary, I have a sustainability vs comfort battle. I listen to podcasts, I start to convince myself I’m fatphobic, I feel like my hesitancy to return to the fridge within minutes of my last snack is blasphemous, I’m an intuitive eating sinner, I’m estranged from my hunger, I am at war with my fullness. More than anything, it’s a daily reminder that I’m sick, that I’ve lost control over the fundamentals of life. Every time I dress, every breakfast, every lunch, every dinner, and all the snacks in between, I feel like a stranger to myself.

 

 I have a memory from not so long ago, of when I first moved back to London from Barcelona, I remember walking out of a yoga class onto the sunny street, I had just met the person who I believe will be the love of my life, I had a new job, I was back with my family in my city, I felt propelled with happiness, I felt it singing in my skin. I thought of that feeling throughout lockdown, I think of it often now, I know I will feel it again. Many years ago one of my closest friends went through a bad breakup and I found a poem for her, though this isn’t a breakup, the words keep finding me, and I believe that one day I’ll look in the mirror (or perhaps more realistically, zoom window) and see the same person that felt that joy that day. My moon face will fade. I will speak with my appetite again. I will feast on my life.

 

The time will come

when, with elation

you will greet yourself arriving

at your own door, in your own mirror

and each will smile at the other's welcome,

 

and say, sit here. Eat.

You will love again the stranger who was your self.

Give wine. Give bread. Give back your heart

to itself, to the stranger who has loved you

 

all your life, whom you ignored

for another, who knows you by heart.

Take down the love letters from the bookshelf,

 

the photographs, the desperate notes,

peel your own image from the mirror.

Sit. Feast on your life.

 

Love After Love, Derek Walcott