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Define flare

Posted , 12 users are following.

audrey80537
audrey80537

When someone says they are experiencing a flare is it a degree of the pain they originally had when first diagnosed or is it all of the pain back again.  

Twice when I believed I was having a flareup it was nothing like the original pain but very uncomfortable. 

Before prednizone my pain level was 10 being the worst possible pain I had ever experienced.

On recent "flares" it was more like a 4.after I had decreased.the dosage.  When this happens how long should we wait before we increase dosage.  It gets a bit confusing and maybe I didn't wait long enough.  Audrey

 

0 likes, 13 replies

13 Replies

  • tina-uk_cwall
    tina-uk_cwall audrey80537

    Posted

    Hello Audrey, often we confuse withdrawal with a flare. 

    Withdrawel us when we have been on a dose of prednisolone for a given time and our body gets use to that dose whether it needs it or not. Then when you reduce to the next dose our body gets the hump. By the evening/ following morning of the new dose you will start feeling a little painful. In my case by the first evening my neck felt a little nigglely, but by the next morning the niggles had reduced and most of the niggles had gone in a week. But what's important is throughout this time the symptoms did not increase.

    a flare however is where our bodies have a level of inflamation but our new reduced dose is not enough to cover and control it. And because of that the inflamation slowly or at great speed in some cases pushes beyond the level of prednisolone and we experience a flare up of the PMR symptoms.

    Basiclly withdrawel gets better within a couple of days to a week, and a flare gradually gets worse as more and more of the inflamation gets the better of the prednisolone.

    when I had a flare I didn't increase for 10 days and in my opinion I should have increased  by day 6.

    hope that's of some help. Regards, christina 

    • Mrs.Mac-Canada
      Mrs.Mac-Canada tina-uk_cwall

      Posted

      Hi Christina,

      Well said,  I agree with the 6 days instead of 10.  What dose were you on at the time and what did you increase to?   We're you able to get back to your previous dose soon after the increase?

      Thanks, Diana🌸

    • tina-uk_cwall
      tina-uk_cwall Mrs.Mac-Canada

      Posted

      Hi Diana, I was very silly and quite cocky about this PMR lark. I had done so well reducing from 15 to 12.5 to 10 to 9 so I thought I'd be ok reducing to 8mgs. By the first evening I had niggles in my neck that by the next day had spread to my shoulders and from then on in each day the pain appeared somewhere else. Finally it hit my hips but I still thought I'd be ok and things would die down, it didn't so on day 17 I upped my pred back up to 9mgs and within a week I was back to my normal self  and read on this site someone doing one day old one day new so I thought I'd  try that so the next week I began one day old dose one day new. So in all I was only on my upped dose of 9 for about 14 days when I attempted my second reduction, this time one day 9mgs next day 8mgs, but within 3 days all the signs of a flare had returned but not quite so bad but each day I hurt somewhere else and each day the pain increased so by day 10 I upped my dose to 10 to really let some pred get to work on the flare. 

      The problem was I attempted my second reduction too quickly following my flare, the flare was not quite totally  under control and I then tried to reduce again. I stayed on 10 then 9.5, then 9, then 8.5 each dose for 6 weeks. But from 8.5 I adopted the dead slow and almost stop method and I only ever reduce by .5 so really I'm reducing even slower. I have been following the dead slow and almost stop method since 8.5 to 8 and I've now been on 8mgs completely for 2 weeks. All the best, christina 

    • Mrs.Mac-Canada
      Mrs.Mac-Canada tina-uk_cwall

      Posted

      Thanks Christina, I am at 9mg after a flare. Using the DSAS method and supposed to start 8mg this week but am on antibiotics for a UTI so think I'll wait till that's over with and decrease by 1/2mg increments to be safe.

      Good luck with your decrease and slow and steady we go..  It is so hard to be patient sometimes😕.

      Hugs, Diana🌸

    • tina-uk_cwall
      tina-uk_cwall Mrs.Mac-Canada

      Posted

      Diana, good luck when you presume your reduction, and yes very wise to not reduce now. Hope that infection clears up too. Regards, christina 
  • ptolemy
    ptolemy audrey80537

    Posted

    When I have had flare ups after being told to reduce too quickly, the pain is awful close to pre pred, I feel totally exhausted and also feel as if I have a bad bout of flu, in fact I feel like death! I have even been thinking of making a wax model of the person who got me to reduce too fast. 
  • jennissw
    jennissw audrey80537

    Posted

    For me, when its withdrawal I ache, have fatigue and some pain back in shoulders, hips, neck and knees. I wait two ot three days for it to start and then if it only lasts a few days I know its withdrawal. If it goes on for longer I go up to 1/2mg or eve 1mg from the dose that suited me for about 3 days then back to original dose.

    I am so sensitive to wothdrawal that I literally do 1/4mg every other day) for 10 to 12 days and then another 1/4mg every other day for another 12 days...long drawn out yes but so far successful. I am currently on 8.75mg one day and 8.5 the next...had 3 days of withdrawal and now okay. Next week Ill be on  8.5 every day. As  am then going away Ill stay on that (if I succeed) until I return.

    Slow but sure is the way to go

  • audrey80537
    audrey80537

    Posted

    When you were at 20 mg how slowly did you go down?
  • carol20979
    carol20979 audrey80537

    Posted

    Audrey I to am very sensitive one quarter sounds good I will try it.
  • jennissw
    jennissw audrey80537

    Posted

    I started on 15 and could not do the 12.5 and then 10 drop. I had sever nausea trying. I then did 1mg a month until 9mg and then had to start doing the 1/4 a month. Even then I find it hard. 
  • EileenH
    EileenH audrey80537

    Posted

    You can cause a flare just by overdoing it - you are trying to do too much for the dose you are on.

    The others have covered all the other options - read the replies to this link for a discussion about slow reduction

    https://patient.info/forums/discuss/pmr-gca-website-addresses-and-resources-35316

    • Diana112
      Diana112 EileenH

      Posted

      Thank you Eileen.  I had just reached that conclusion regarding my flare.  I think it is the lovely weather which has tempted me to do too much gardening.  It really is difficult to maintain a sensible balance when you live on your own tho I know reducing the pred is more important than a nice garden so time to stop and enjoy now.
  • audrey80537
    audrey80537

    Posted

    Just remember Diana, "weeds are just misplaced wild flowers" and have a beauty of their own.  😃

    Audrey

     

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