Posted , 14 users are following.
BY 7 pm i was doing so much better. ALL my aches and pains were much reduced. However this morning I am hurting again -not quite as bad. Is this how it goes?I guess i just expected to feel better each day.
0 likes, 18 replies
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lynda62707 douglas13827
Posted
no Douglas....this is a REAL process! I found that out the hard way. started at 15mg pred in May and am only down to 12mg in Nov!
it's been quite an "interesting" journey so far!
best advice? hang in there!
douglas13827 lynda62707
Posted
thankyou. i started on 30 mg.
yesterday. i could barely walk in the morning as pr seeme to attack an old knee injury . i was hoping for a quick fix i guess.
Dirk_St._Clare lynda62707
Posted
i started on pred 15mg 2 years ago now down to 3 mg its a slow process, you will get there in the end.
marg44743 douglas13827
Posted
hi Douglas, similar thing to me when i first started with 15mg of pred. advised to split the dose. EG
10mg am and 5mg night. It worked for me. Good luck.
douglas13827 marg44743
Posted
MARG,
thank you.. I will talk to my gp and ask to split the dose.
EileenH douglas13827
Posted
You are probably better to wait a few days and see how you get on - as I explained in my other post. THEN try a few days splitting the dose and THEN ask them. Some doctors think it is not a good idea, some even claim it is dangerous (no it isn't) and others take the huff at patients wanting to take some form of control. What they don't know won't upset them 😉
EileenH douglas13827
Posted
A new batch of inflammatory substances is shed in the body each morning about 4-4.30am. As a result you develop early morning stiffness that will last until the new dose of pred kicks in. That is why it helps to take it as soon as you can in the morning - the sooner after 4am the less inflammation will have developed so the less there is for the pred to do. Another factor is that the antiinflammatory effect of pred lasts for between 12 and 36 hours depending on the person - if you are towards the 12 hour end you will feel it in the mornings more than someone who is nearer the 36 hour end. That can be helped for some by splitting the dose, about 2/3 in the morning and the rest later in the day and that prolongs the effect to the next morning.
The pred hasn't cured anything - this is an ongoing process. First you do a spring clean with the higher doses of pred and then you find the lowest level that keeps the inflammation cleared up each day. But you are right - you should feel some better each day and you may even get to a point where you are OK for 24 hours even without splitting the dose. But don't go rushing around as if you are back to normal because you aren't - overdo things and you will suffer next day!
douglas13827 EileenH
Posted
Eileen,
Just read your post. Thank you for the info and suggestions. I have taken 30 mg after breakfast at 6 am for 2 days now and pnly noticed feeeling better around 2 pm. AND woke up last night around 2:30 with pain in my knee and very stiff in the shoulders. SO i may try taking 20 mg at 2 am and 10 mg at noon. Does that sound about right?
doug
EileenH douglas13827
Posted
You may need to experiment a bit - the 10mg at noon may be late enough - it may not. You just have to try it out.
r.d.s26296 douglas13827
Posted
HI THERE DOUGLAS
EILEEN IS THE EXPERT on this forum REGARDING PMR AND GCA ...
EILEEN HAS MORE KNOWLEDGE ABOUT PMR THAN MOST RHEUMIES AND DOCTORS ...
HER ADVICE IS VERY VERY GOOD ...
Michdonn douglas13827
Posted
Douglas, I solved that problem by splitting my dosage. Take the largest percentage after breakfast and the rest at bedtime. This worked very well on the large dosage and I have found not necessary on smaller dosages. I think you have to play around and find out what works for you. 🙂
Michdonn douglas13827
Posted
Douglas, I solved that problem by splitting my dosage. Take the largest percentage after breakfast and the rest at bedtime. This worked very well on the large dosage and I have found not necessary on smaller dosages. I think you have to play around and find out what works for you. 🙂
TheRadman douglas13827
Posted
Hi Douglas,
if it helps I am a doctor with PMR. I have been on steroids for around 6 weeks now and I split the dose.
I started on 15mg which really helped the night-time pain but was not enough to clear up the morning stiffness which was really causing problems with work. I increased to once daily 20 mg which was a bit better but still left symptoms in the morning. It occurred to me that splitting the dose would make sense and shortly after I read accounts on here of folk who had done just that with good effect. Some medical colleagues were concerned that night-time doseage would increase the suppressive effects on the body's natural cortisol secreting system but to be honest you are likely to be on steroids for a long enough time that this is inevitable in any case. In any case if splitting avoids having to increase the total dose to get control that is likely to be a lot better for you in the long run. Others cautioned that night time doses caused insomnia in their patients treated for other conditions but not in my experience especially when you have know what untreated PMR can do for your sleep.
I ended up with a split of 15mg in the morning and 5mg last thing at night which made me essentially symptom free. After around a month at that level I have just tried reducing the evening dose to 4mg so far without problems.
The Radman
EileenH TheRadman
Posted
From general experience you might find keeping the nighttime dose stable and reducing the morning dose works for longer.
And do please keep talking the talk to your colleagues!!!!! They might be converted - and make life easier for many patients!!!
TheRadman EileenH
Posted
I did try reducing the morning dose by one first but this did lead to a mild recurrence of symptoms which l had to go back to 20 mg to suppress. This way round seems to be working for me so far, I think the next attempted 1mg reduction should be via the morning dose however.