Lesson learned.............again.
Posted , 15 users are following.
Sometimes I think I'm my own worst enemy. I've been doing pretty well in recent months, only having to deal with a few relatively minor issues. I take Prednisone doses at 6 am and 6 pm each day, usually +/- an hour or so. Have some Prednisone side effects to deal with but that's really just part of dealing with PMR.
Yesterday evening I finished a long day at work and was pretty fatigued. We had dinner about 7 pm and afterwards I relaxed in the recliner watching TV. I did my very common routine of falling asleep about 9:30 and woke up about 3:00 am. What was different was waking up with sore shoulders and thighs. I first thought that maybe it was from work but then started wondering about the Prednisone. Did I take it at dinner at 7:00 pm? I must have - I never miss taking the Prednisone! That can't be it. Or could it? Did I take it? I struggle out of the recliner and go check the pill box. Darn, I didn't take it!!! I immediately took the Pred dose but knew I was going to pay for being 8 hours late taking it. And I was right.
By 4:30 I was as crippled as badly as I've ever been since having PMR, barely able to get out of the chair and only able to take 1 step at a time on the staircase. Was feeling very miserable. Even laying in bed was too painful. At 6:00 I took my next dose of Pred and by 8:00 am the pain and other issues were retreating. By 10:00 I was feeling very well again but worn out of course. I worked from 10:00 to the end of the day but kept myself to desk work as that was the most I could handle.
I'd like to say this is the first time I've done it to myself but I did the same thing about 3 and 6 months ago. I think the evening dose is the hard one sometimes when you're busy into the evening and more so because I've never had to take pills in the evening before now. My only question is if the pain, swelling, etc is from a quick, short flaring of the PMR or is it the adrenals? I have a hard time thinking it'd be the adrenal glands after only 8 hours missing a Pred dose.
Just feeling a bit dumb about this self-inflicted pain episode. Thanks for letting me vent here.
0 likes, 27 replies
EileenH TheRaven
Posted
"My only question is if the pain, swelling, etc is from a quick, short flaring of the PMR or is it the adrenals"
Neither. The PMR is active all the time until it goes into remission although it may vary from day to day or week to week in activity. All the pred does is mop up all the inflammation that is created every morning by the new batch of cytoines shed in the body about 4.30am. The antiinflammatory effect of pred lasts anything from 12 to 36 hours depending on the person. So your return of pain was because the antiinflammatory effect had worn off by then having missed the second part of your split dose. When you take pred it doesn't work instantaneously - if it is prednisone it must first be absorbed in the stomach - and that varies depending on how much food is there - and then processed by the liver to make the active form prednisolone. By the time it reaches the peak in the blood it is 2 hours - then it can work. Prednisolone is absorbed and ready to go in 40-60 minutes usually.
I don't carry my phone in my pocket but I have it in my handbag somewhere around. I have the alarm set for an afternoon dose of something else (pred is immediately before bed, no probs!) - and the alarm just gets louder until I switch it off. I can hear it from 2 rooms away. That does cover the vast majority of situations! You can also get dosette boxes with an alarm.
Twopies EileenH
Posted
Hope I'm not bugging you...I take pred at 8:00, but I don't perk up until around 3:00 pm or so. Some of the soreness and stiffness gets s little better before then, but my energy not so much. Ever heard of this? ( I'm at 7 mg...)
EileenH Twopies
Posted
Are you on ordinary white non-coated pred? There are some people where it seems to take ages for it to start to work but I don't know why. I had that problem with Medrol but not anything else.
8am is very late by our standards - the sooner you take it after 4.30am, the less inflammation has been created for it to have to mop up and so the quicker the "clean floor" can be achieved. Lots of people wake early and take it about 5am and then settle down for another couple of hours to let it start to work. Less inflammation - quicker result usually.
Some people who have found it takes such a long time to take effect have tried taking their pred before bed - and so it is working by the time they get up. It is worth a try - it doesn't always affect sleep and if you are taking a long time to absorb it it shouldn't anyway.
celia14153 EileenH
Posted
Is it good to take Pred early in the morning without food? I take it at 8 with breakfast including yoghurt. I'd like it to cut in earlier but unsure about the food thing. Thanks
EileenH celia14153
Posted
celia14153 EileenH
Posted
Yes, I'll try that, good idea. Incidentally thinking of you and even more grateful that you take time for us. You are a veritable étoile (just back from Brittany). 🌟🌟🌟🌟🌟x
EileenH celia14153
Posted
celia14153
Posted
I bet you do! Brittany is perfect. Spacious, beautiful old villages steeped in history, mellow sunshine and silver skies when it rains. So peaceful and relaxing. Place to go when you get through this? Also chocolate patisserie to die for and cheap bon vin 🍷🛳🍫👍🏻
EileenH celia14153
Posted
No - we need warmth! Brittany has similar rubbish weather to the UK! We have 3 weeks in Malta booked for November - but I suspect we'll spend it in bed...
celia14153 EileenH
Posted
Could be worse! Yes - soak up that vit D..🌞🌞🌞
kathy67492 TheRaven
Posted
Others will offer excellent advise about the dosing, etc. I just want to Congratulate you in working full days!!! I have been retired all thru my PMR and cannot imagine how difficult it would be to stand, sit, whatever through a whole day at work...and no nap! I admire your fortitude😊💗