PMR and really bad day

thanks! its a crapshoot, isnt it? theres always that worry in the back of our minds that we might be headed towards a flare. i suspect that contributes to the thinking that going up a little might power through.

when i read about the pitfalls of yoyoing back and forth on the pred, im never sure what that means. is going up for 1/2 mg a day now and then, say once a month, considered yoyoing? dunno!

I wouldn't consider .5mg now and then yoyoing. Following the DSNS method means we do a little of that and it works so I would say it isn't much different. Others may not agree. I hope you find a solution that works for you.

oh! that makes sense, doesnt it? never thought of it that way.

I think yoyoing happens when people are sent back to the beginning with a flare when a smaller increase would have dealt with it. Then they get into a pattern of taking too much and dropping too quickly. Taking just enough to deal with a flare means it's easier to come back down to the right level again without triggering another flare (or pred withdrawal). I'm sure the occasional small increase to deal with a problem isn't yoyoing, but make sure you've got the flare under control before heading back down.

never thought of that. i see what you mean. and i think i did that--a year ago i was having pains in my legs at night so i went up to 10 for 3 days to calm things down. but instead of going back to where i was--6--i went back to 7. probably would have been ok to return back to 6; it wasnt a disaster but cost many months of getting back to 6 using the dsns method. looking back, ive wished i had gone right back to 6 to at least try it out.

Just my story, where I've tried two different ways to deal with flares. My mistake last year was to not go up far enough to deal with a flare. It wasn't a particularly serious one, but it was getting there. At the time I was attempting to get to one from 1.5. Instead of doing what the doctor advised, going to five, I only went to three. This was not enough. Eventually I went up to seven, which is five mg higher than my last securely best dose of two and that worked. But I wasn't able to get back to 1.5 again, and it's been well over a year. It took a year to get back to two. When I felt a bit of a flare a few weeks ago I wasted no time - went straight to seven, stayed there for two days, and dropped one mg at a time every two days or so. At two I stopped and have been here for a few weeks. I may cautiously try 1.5 again in a while but, lesson learned, one is not enough.

A riveting story! Im going to save it because a man i know has pmr; he got down to 4 mg, had a flare and went all the way back up to 20 and started all over again with the slow tapering. its taken him forever to get down to 6, his current dosage. perhaps if he had nipped it in the bud as you did, he wouldnt have had to start all over. thank you!

I've heard that standard advice is to increase the dose by 5 mg. This certainly seemed to work for me. So had your friend gone to 9 instead of 20 he might have been all right and back to 4, or at least 5, within a couple of weeks.

this is all very intriguing to me....I've only had one (what I think was) flair, and at that point thru advice from my doc, went up 1mg, which didn't really help at all!...but then again, my journey w/prednisone has been so complicated....??

I'm sooo Confused!😰

If you flare because of overshooting the dose it is very unlikely going back 1mg will do much. There will be accumulated inflammation to be cleared out and that will need a bit more. THEN you may be able to drop back to the dose where you flared plus 1mg - obviously the dose where you flared was not enough. BUT, if you were reducing relatively quickly the dose that was n longer enough may be 2 or even 3mg higher.

thanks Eileen...sorry in the delay of my response, but I've been unable to get on this forum for hours (Ooops..there's an error and a Big red apple!)....

anyway, as always, I appreciate your input and will take your advice.

thanks. about how frequent do you do that? not trying to be picky, just trying to figure out what might work best for me.

Whenever I feel that something is off... Usually is triggered by me being overly enthusiastic with yard work or some new activity. I try to rest ( nap) immediately after activity for 30-60min. Normally muscle pain (or fatigue ) should go away. Sometimes it takes 2-3 days. If it takes longer, then something is not right and I have agitated ( awaken ) PMR . Then I try to add to my dose before it gets out of hand. How much is a a big question. If it is "mild" I will try 1 or 2mg... If it is relatively serious I may try +3-5mg for few days...

I made a mistake recently in June this year and waited too long ( because I had upcoming appointment with rheumi) and it took me several months to recover. I was at 3mg. Had to go to 9mg for a while and I am still +2mg from the level I flared up.

Don't be afraid to try things, keep good notes. You have to find what works for you.

fiddlesticks! i like exact science and based on everyones remarks, there aint nothing exact about it. i gotta get with the program, go up a little now and then. get over my fear of making a mistake. sure sounds like you and others go up a little as needed without dire consequnces or problems. thanks for your reply.

I struggle with the fact that it's not a case case of take 2 tablets in the morning and then I'm hunky dory til 2 more the next day. Other conditions can be controlled in that way although diabetes is not and thyroid can be a bit unpredictable. I guess maybe that's how many are so PMR is no different in that respect and is dependent on so many factors like how much we do and the amount of rest and exercise we do. It certainly is not an exact science but neither are we humans.