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Modified DSNS

Posted , 15 users are following.

rocketman42
rocketman42

As most of us do, I would like to start trying to taper my prednisone dosage. I understand and appreciate the value of the DSNS regimen but am looking to try to shorten the process somewhat.

I am thinking of starting at 1 day new and 4 days old and then stopping at

1 day old and 4 days new. 

I am aware that everyone is different but was wondering if anyone has had success with this scheme or something similar to this.

Thanks

0 likes, 47 replies

47 Replies

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  • julian.
    julian. rocketman42

    Posted

    above about 10mg/day it was relatively easy. A couple of days to reduce a couple of mg and feel stable.

    getting from 5 to 3 was in 1/2 mg steps over more than a year.

    the lower I get the slower I reduce.

  • EileenH
    EileenH rocketman42

    Posted

    If you had read my text properly you would have seen I do actually suggest that - and yes, there are people who have done it. The only way you can tell if it will work for you is to try it  The DSNS approach has been recommended for people who come on the forums complaining they struggle to reduce - but everyone is different and many people reduce successfully starting with alternate days of old and new.
    • rocketman42
      rocketman42 EileenH

      Posted

      Eileen - Thank you for your response but I did read your text properly.

      What I am asking for is folks who have used this or some other similar "mini" protocol to chimne in witht their experience.

       

    • RD_Swede
      RD_Swede rocketman42

      Posted

      Hi Scott

      If you Google "the Ragnar method"you will find a post on patient.info posted by me in February 2017. It describes how I tested av new regime and succeeded to reach 0. It also mentions the DSNS method.

      As you see, I am one of those persons you wanted information from. I have been free from pred for more than 8 years without problems. I think I succeeded due to my long time out. I thought it was better to take it easy and I had no flare ups. Good luck

    • EileenH
      EileenH rocketman42

      Posted

      Fair enough - but what I was saying is that it doesn't really matter what OTHERS  experienced, I used to have to use a long drawn out approach to avoid discomfort, now I can do it with a shorter one. It's what works for you that matters.

    • rocketman42
      rocketman42 EileenH

      Posted

      Totally agree that it doesn't matter in absolute terms of whether it will work for me or not ( only time will tell ). However, it very much matters from a motivational and psychological standpoint to hear others voice how something new to me may have worked for them.

      As always, your insight is appreciated.

  • nick67069
    nick67069 rocketman42

    Posted

    Here are specifics from my taper

    15--> 12.5  1 new, 1 old 3new 1 old ... done

    12.5->10 "short DSNS" , 1n 3 old, etc

    10->9  same

    9--> 8  same

    8--> 7.5 same

    7.5-->7   1 new 4 old

    7--> 6.5  1 new, 4 old

    6.5 -->6   1 new 4 old

    6 --> 5.5  1 new 4 old

    5.5 --> 5  1 new 5 old

    5 -->  4.5  1 new 5 old

    4.5 --> 4.0  1 new 5 old  ( currently in the middle of this transition)

    It is my experience that the lower the dose, harder  the transition is... Sometimes, if I feel I need more time, I would repeat steps in the transition until I feel comfortable to continue ( example, if I am in the middle ( at 1 new  1 old )  I may repeat the same step several times, until it feels fine to continue.  Bottom line, experiment and find what works for you...knowing that the main purpose of DSNS is to let the body adopt to new dose gently.

  • Michdonn
    Michdonn rocketman42

    Posted

    Hi scotth42, I am going to try 3-1 DSNS to go from 20 to 10, then 6-1 from 10 down. Hopefully to zero, time will tell! I very active and PMR pain free on 20 mg. I will post my progress. Keep smiling 🙂

  • liz12234
    liz12234 rocketman42

    Posted

    Hi Scott, I tried 4days instead of 6 it worked for a short time then i had to go back up so now im on 6days and down to 3- 3 1/2mg i try very hard not to panick at every ache an pain. To those who read my previous post m having x ray on my neck and hip on aug 2nd meanwhile given exercises to do. Physio on Jan 5th 2018!
    • Michdonn
      Michdonn liz12234

      Posted

      Hi liz12234, nice to see that someone tried a mod DSNS, I plan to try 3-1 from 20 to 10. Good luck on your way to zero. Keep smiling! 🙂

  • Guest
    Guest rocketman42

    Posted

    Hi,

    I started 1 year ago with 10 mg, so probably lower than most of the others on this forum.

    One time I started at 1 new, 4 old,...and I felt good. When I tapered from 1.5 mg to 1 mg I used the 2nd half of the DSNS method and it worked also.

    I had one flare up in January when I wanted to get off Pred too quickly, therefore right now I do the full DSNS 1mg/0.5 mg. Better safe than sorry. Listen to your body! Good luck!

    • Michdonn
      Michdonn Guest

      Posted

      Hi magy84286, great to see you were successful on mod DSNS. And I agree listen to your body, I do not reduce if I have any PMR pain. Good luck on your journey to zero. Keep smiling. 🙂

  • koen1
    koen1 rocketman42

    Posted

    Hi Scott, that is exactly what I have been doing for the past 7 months. It works out that you can make a step every month in a gradual way if you do this. I went from 60mg to 20mg now. Will begin tomorrow with 1 time 17.5mg and then 4 days 20mg etc.
    • rocketman42
      rocketman42 koen1

      Posted

      Thanks to everyone who chimed in. J

      ust want to confirm that everyone who does 1new, 4 old ( or something similar ) progresses through the front end of the cycle and then also does the back end of the cycle before settling in on the new dosage on a daily basis.

    • koen1
      koen1 rocketman42

      Posted

      I do. It takes 26 days for me. The almost immediately start with a single day of the next lower dose.

      noooonooonoononnonnnonnnno

    • rocketman42
      rocketman42 koen1

      Posted

      Yup....by my calculation is should take 26 days to complete both ends of the cycle. Started it yesterday and keeping my fingers crossed.
    • Michdonn
      Michdonn koen1

      Posted

      Hi koen1, so you are going to reduce by more than 10% by going to 17.5. I was going to 18, maybe I being too conservative. I could get lower quicker if I stay with the 2.5 reductions. Decisions!

      Keep smiling as we push on! 🙂

    • Michdonn
      Michdonn koen1

      Posted

      My 3 - 2 will take 16 days, koen1! 🙂

    • julian.
      julian. Michdonn

      Posted

      just picking up on "lower quicker".

      the first thing that has to occur is the PMR heading towards remission, the underlying disease activity reducing. Can't reduce the pred faster than that.

      the second bit is getting used to a reduced pred level. Giving the body (and mind) time to adjust. Distinguishing between withdrawal and pmr effects. Kidneys time to adjust.

    • Michdonn
      Michdonn julian.

      Posted

      Yes, julian we must give our bodies time to adjust to not having Predinisone. Our adrenal glands have been shut down and now have to back to work, apparently some of our bodies need more time to adjust. Well , here we are crawling our way forward. But I still got a smile on my face! 🙂

    • EileenH
      EileenH Michdonn

      Posted

      That particular aspect is immaterial until you get below 10mg - down to there they don't have to do much or you would have an extra excess. Above that you can reduce at the rate your body accepts - and really the only way you know is trying. If the doctor said 2.5mg at a time and your body accepts it that is fine and you can reduce fairly fast. When it doesn't - then you try less. But you can do the DSNS with 2.5mg at a time too - a lot of people have.

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