PMR, prednisone
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I am now about 16 months into the PMR, coming off of a flare (reducing 7 mg to 6 mg) and I am following the valuable advice of this forum! I have noticed, since the flare, that my days of exhaustion are unpredictable. Eating right, resting, activity level, stress...one day I can barely get up mid-day, the next day is ok.
Is this typical "flare consequences"? Thanks for any input.
1 like, 38 replies
Flutterbie57 kathy67492
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tina-uk_cwall Flutterbie57
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If that is the case then you will probably know very quickly, within 2 days, sometimes by the first evening that there is pain returning to your joints and large muscles, then over the coming days the pain simply increases as the inflamation takes more and more control. You should know within a week if the symptoms are getting worse or subsiding. The only way to stop this is to increase our dose of prednisolone back up to the last dose that did control it. My rheumatologist suggests upping the preds to 20mgs for 10 days to really get the inflamation back under control, then reduce back to the last dose that controlled the PMR prior to the last reduction that failed.
withdrawel is when we have been on a dose for some time, perhaps 6 weeks and we taper down as normal but because our bodies have got use to and feels nice and comfortable with that dose it then gets the hump because we have not given it what it wants, whether it needs it or not. Again the initial symptoms are as a flare only over the next couple of days they lessen as our bodies do adjust to the new lower dose. I stay on each dose for 6 weeks, that allows each dose yo really do its job and I also follow the dead slow and almost stop method of reduction but only ever reduce by .5. Yes I hadn't flare just prior to Christmas and believe me I don't ever want to have another one. All the best, christina
kathy67492 Flutterbie57
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kathy67492 tina-uk_cwall
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tavidu kathy67492
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tina-uk_cwall kathy67492
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I then stayed on 10mgs for 6 weeks then reduced, 9.5 six weeks, 9mgs six weeks, then I started Eileen's dead slow and almost stop reduction from 9to 8.5, then from 8.5 to 8mgs.
however, when I saw my rheumatologist only 3 weeks ago he said that what I should have done when I had the flare was to have increased my preds to 20mgs for 10 days then to have reduced them to the dose I was on prior to my flare which in my case was 9mgs. I will try that next time.
personally, because you didn't up the preds to 20mgs as suggested by my rheumatologist, I would perhaps reduce to 9.5 for 2 weeks, then 9 for 2 weeks then 8.5 for 2 weeks then reduce to 8 and then start your reduction regime again by staying on each .5 dose for 6 weeks, or start at 8mgs Eileen's dead slow and almost stop method.
i have based my suggestion only on the fact that you didn't up the dose to 20mgs so therefore I would still be just abit cautious. Also by reducing by only .5 it is easier to detect a flare and get on top of it quicker. I am not medically qualified and like you I make mistakes whilst on this PMR journey of recovery. All the best, christina
MrsO-UK_Surrey Flutterbie57
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kathy67492 tina-uk_cwall
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ptolemy kathy67492
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tina-uk_cwall ptolemy
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ptolemy tina-uk_cwall
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EileenH ptolemy
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Many doctors suggest adding 5mg to the current dose that failed for a week which is a bit less scary. Going back down you should be wary and not go quite to the dose that failed.
ptolemy EileenH
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tavidu kathy67492
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kathy67492 tavidu
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