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Wait or go back up with pred

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karenjaninaz
karenjaninaz

Called my rheumy about my slightly elevated CRP -sed rate OK.

Day before that forgot my 3 mg evening pred dose. Woke up with a stiff neck. As soon as I realized the omission took those 3 mg with my usual 7.5 am dose= 10.5 mg AM then my usual 3mg evening dose. I wonder if that omission set me back along with so. Elevated CRP of 9.2. My rheumy asked me how I felt. When we spoke over the phone I was feeling OK.

This AM slight stiff neck and shoulder ache which comes and goes along with transient scalp discomfort which I always get from time to time.- transient. Recent stress last week of family funeral with very long car drive31/2 hours each way plus stress of seeing estranged daughter. 

How far up should I go back on pred and how lond before trying to reduce again. I am on 10.5

0 likes, 10 replies

10 Replies

  • EileenH
    EileenH karenjaninaz

    Posted

    Given the stress you were under and travelling and the fact you feel not too bad my own approach would be to wait a week and get the CRP done again if you can. A single raised marker shouldn't trigger a kneejerk reaction to increase - but a trend should. Perhaps you are developing a cold?

    Or, if the morning symptoms get worse maybe try a few days of 12.5mg and back to your usual 10.5mg - that shouldn't be a problem.

    • karenjaninaz
      karenjaninaz EileenH

      Posted

      Thank you Eileen,

      My doctor will test my CRP in 2 months. Today I took 325mg aspirin. I see my GP Internist next week.He is also a rheumy but my main rheumy calls the shots. The standard here in the US is to be followed by a rheumy and a gpinternist. They do talk to each other and we all have access to electronic medical records.

      I will probably do 12.5 for a couple of days to nip this in the bud.

      Probably being ~ 10mg might make me more vulnerable to the aforementioned stress.

    • EileenH
      EileenH karenjaninaz

      Posted

      I'd want my CRP checked sooner than that if it has gone up now - in 2 weeks at least, just to see. If it hasn't gone any further up it won't matter and you needn't bother again.  But as I say, it is the trend that is most important.

    • Anhaga
      Anhaga EileenH

      Posted

      You know how we have the guideline to not reduce by more than 10% at a time?  Is there any kind of similar suggestion for a percentage increase if fending off a flare, etc?
    • EileenH
      EileenH Anhaga

      Posted

      Most of the doctors I know suggest adding 5mg to the dose at which the flare occurred. But that I think is for an established flare you can tell is a flare. If it is just the symptoms appearing as you try to reduce they say go back to the dose you were last OK at - which is why I say to hang around for at least a few weeks at a new dose to be sure it is still enough.
    • Anhaga
      Anhaga EileenH

      Posted

      OK, so a "flat rate" 5 mg rather than a percentage.  Just curious.  Thanks.

  • karenjaninaz
    karenjaninaz

    Posted

    I went to my internist today for a regular follow up. He does not treat my PMR; my rheumy does. He is however a rheumatologist as well. I asked to have my sed rate and CRP repeated because they both went up; the CRP into the slightly high range and the sed rate into a higher normal. My young rheumy said to continue to reducing just go by how I feel. My internist was concerned about the trend.

    I am thankful to Eileen for suggesting a retest. I will know in a couple of days- on-line what the trend is.

  • karenjaninaz
    karenjaninaz

    Posted

    My CRP and sed rate, done yesterday,  went down into middle normal range. Debating whether to try alternating with 10.25 / 10.5 for awhile because I have slight morning stiffness which I did not have at higher doses but I am pretty comfortable most of the day. I sometimes have a back of the neck ache. I get that from hidden sulfates  in foods- Yesterday I put molasses, which has calcium, in my coffee. 

    I want to prevent a self induced flare.

  • karenjaninaz
    karenjaninaz

    Posted

    No stiff neck this morning but hip bursitis seems to emerge again. It interfered with sleep last night requiring frequent turns. I am on 10.5 and was considering 10.25. I take 7.5am/ 3mg pm. Maybe I should take a little less am and add that 1mg to my evening dose. Other than my breathing issues I'm reasonably comfortable all day.

     My repeat CRP and sed rate down to normal.

    • karenjaninaz
      karenjaninaz

      Posted

      I shifted one 1mgm to my evening dose from the morning dose; this improved my sleeping comfort. 

      My doctor prescribed a handicap parking placard for my car. One of the criteria is inability to walk 200 feet without stopping to rest. I stop to rest at 100 feet because of breathlessness. In cold weather it's terrible.

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