Adrenal insufficiency with PMR

Hey Bonnielee  I certainly am not even going to attempt to answer any of your questions as I am not qualified to do so. I highly suggest that you ask these questions of your doctor....and if he doesn't give you satisfactory answers then get another doctor!

I will tell you that before my trip to Mexico last January I expressed my concern to my Dr and he suggested that it wouldn't hurt to "up" my prednisone before the trip just to be safe and not sorry.

ASK YOUR DOCTOR~

 

Hi Bonnie,

I understand it takes a while for our bodies to start producing Adrenal like it did before.    

I have more fatigue and headaches while tapering down.   Finally after not feeling that great for 5 days, feeling better at 7 mg.    It was hard getting from 8 to 7.5 and now 7.    I think it can take time for adrenals to recover all the way.   If your doc agrees, I would go back up a little to give your body time to adjust.   I understand it can take a long time tapering at these doses.

I wouldn’t assume you won’t get better, but just that it takes time where you have to go slower.

I hope you feel better for your trip!   😀

If you are functioning OK and not suffering fatigue or feeling so ill that it prevents you doing anything then it is best to stick at the dose you are at because that is the only way that your adrenal function will be encouraged to catch up. It is a gradual process - as you reduce the pred dose, the body has to make a bit more cortisol to top up the decreasing pred to keep the corticosteroid level fairly constant.Once it starts doing so - and it DOES sound as if it is - then raising the pred dose may upset the balance again. The odd day of a bit more - to cover travelling or for medical/surgical  procedures - won't matter but more than a few days may. 

You are just over 2 months post major surgery - it is likely you are still recovering, We are none of us young (in medical terms) any more and have a chronic disorder that probably makes recovery harder for all sorts of reasons. If it had been me I don't think I would have continured reducing so soon. You are at a low dose, it isn't doing much damage and it isn't a race. It also sounds as if your PMR is still there - major medical procedures can cause a flare in many people so even if he dose was enough pre-op, it may not be post-op. 

The adrenal glands do get smaller - simply because they aren't needed to work and just like unused muscles they shrink. Once you start using them again they bulk up. But they don't work all at once - they have to get into training to work effectively. The slower you reduce the pred dose the easier job they have to get up to speed.

You probably would do better on the trip with a bit more pred - but it is really something to ask your doctor if you can  because, as margaret 53690 says, no-one here is medically qualified. Did you feel better at 6mg? And do think about your PMR symptoms.

And just a thought: I can't get the house clean, but I took a week-long trip from Europe to S Korea and dealt with OH being in hospital for a couple of days afterwards perfectly well. I don't like to walk too far - but I can and do drive from central Europe to the north of the UK without any more pay-back than most people would experience.

By the time of my hip replacement I was down to 1 mg. Pred and told to stay there until at least six weeks later.  All was well in that department but I do remember saying to my doctor that I was needing an afternoon snooze which is unheard of. He said I must remember that my body would have been shocked by the op and I must give myself time to catch up so I should think that yours is entitled to a bit more time after spinal surgery.

Hope the trip goes well and gives you a lift.

I have to say that I have had a lot more fatigue my second time tapering down to 1.5 than I did the first time.  I suspect that because I had to raise my dose last year to deal with increase of PMR symptoms the gradual return of adrenal function really was set back, and surprisingly severely.  Now, perhaps a few days at a higher dose, rather than the several months of my experience, would be less damaging.  But in the absence of actual symptoms I wouldn't risk it.  

Thank you all for your input, especially Eileen, who is knowledgeable, and always makes such sense to me. For all who mentioned talk to the Dr., my Dr. Is useless. When told about crippling fatigue, told me to get sleep study, then dismissed me. When practically crawling into office (for regular 2 mo check up) in about 9 pain from back, she told me we were here about PMR not back problems and I was dismissed. I should have said "excuse me?" Sarcastically, but, I pick my battles, carefully. Can't waste my time and energy on her. She's from an Eastern European country..and tries to be intimidating. Getting another Dr is not a great idea because I live in rural Idaho where there is a big shortage in specialsts..not taking new patients, not taking Medicare patients, retiring and such. I was told I was lucky to get into her. Mostly, she dismisses anything I say and is the one, who like a broken record, says I have to get off Prednisone quickly. Two years seems too long to her I guess. She goes strictly by inflammatory numbers which have been high normal. Normal is normal, apparently, and I'm just a hypochondriac. I figure as long as she gives me Prednisone I'll put up with her. She wanted me on 5/6 alternating days for 3 weeks, then 5. I had too much trouble with 5 so went to 5.5. Still shoulder pain, although tolerable, leg weakness when walking, can't lift even a hairbrush over my head without struggling to get my shoulders working. Every chore exhausts me.. I think she may fall into the category of Dr who is used to excelling (as a Rheumy), but, PMR is just too frustrating and nothing works well to cure it, so she dismisses me as a complainer. Ooooh how I hate that! Did I do better at 6 mg? Don't think so, but back pain interfered during that whole time. I used to be able to ignore most things and press on. Now just putting the laundry in or putting dishes away sends me to the recliner or bed. I am so sick of myself😋. I wonder if it's just age, I'll be 72 in couple of mos, or my chronic kidney disease, depression, mild aortic stenosis, high blood pressure, under control, or all of above. I want to get FIXED. Is there no hope for the next 10 or so years left in my life to have fun??? My camper and truck sit idle. Surgeon won't let me go until, maybe Spring. Because I look young the Drs think I have lots of time to waste. Thanks for listening. I don't have anyone I can talk to about this. Nobody wants to be around chronically sick people and God help you if you complain or grunt when you rise from a chair😚 you guys know how it goes. Your comments and support will be much appreciated. Thanks, again.