Taper

Thanks Eileen, I was just hoping I could stay at 13 but, I will try 14. Thanks.

You need what you need. Or there is no point at all...

It doesn't mean you won't get lower - just not yet.

Thanks, I know you are right, it is just disappointing.

Hello Eileen , I'm interested in your reply to Mr.Bella as I started to reduce from 15mg too 13mg Pednisone on Monday, currently on alternate days. I'm experiencing stiffness and some pain but have read somewhere that its not uncommon to get this for a time after are reduction and to persevere. Have you heard of this?

However if correct, this wouldn't apply to Mr Bella who is still experiencing symptoms as he's done 18days at a reduced dose .

There is something called steroid withdrawal which is experienced usually when you try to reduce from a higher to a lower dose in too big a step. It is your body protesting at the change, it misses its buddy pred. It usually starts immediately you change the dose and then improves over the following week or two as your body gets more used to the new dose. It is very similar in symptoms to a flare so it is difficult to decide which except that a flare takes a few days or more to appear and then steadily gets worse.

The way to avoid it is to reduce in smaller steps - and it is really rather unfair to your body to switch from 15 to 13 dose from day to day, it has no idea where it is, No reduction should be more than 10% of the current dose - at this stage, not more than 1,5mg. I would reduce by 1mg at a time and I would use this approach:

https://patient.info/forums/discuss/reducing-pred-dead-slow-and-nearly-stop-method-531439

I'm biased of course - but it does work and patients find they have fewer problems.

EilleenH, good to see you are still giving out the good information. I am still doing okay, have another procedure next Monday, hope i can ski after that. This has been a great winter so far, one or two storm a week. How your weather in the Dolomites? I been following. Brexit drama. And of our course our government shut down, It gets my mind off not skiing. Thinking positive 😊

Hope you get back to skiing very soon x

You don't get rid of me easily 😉

The view is very wintery today as it snowed lightly overnight and now the sun is shining with barely a cloud in the sky. It's been a bit mixed the last week for fair-weather skiers - but we are safe here unlike in Austria where the avalanche risk has been very high.

Thanks Celia, I hope so!🙂

EileenH, unfortunately avalanches are always a risk when you have a good snow year. There was an avalanche at another NM ski area yesterday, two people caught in it one died in hospital. And they had set off charges to mitigate avalanches. Stay well! 🙂

These are threatening homes as well, one part of Innsbruck was under close watch the other day. It is actually very bad as it keeps snowing due to orographic lift - not usually like this, it is usually one at a time, these are happening one after another with maybe a day or two between with up to 2m of new snow each time and also falling in the valley so roofs are threatened by the weight, especially when the temperature rises a bit.

Austria and Innsbruck always make me think of the Chalet School series - schoolgirls were always getting lost in the mountains threatened by avalanches. Real life much scarier..

It prompted me to look it up - as I remembered it being in Switzerland, but you are absolutely right, it started in the Tyrol before WW2! And eventually went to Herefordshire where I grew up. Did they still call it the Chalet School there??????

Found this: Herefordshire

The Chalet School Goes to It saw the School moving again, this time to a village near Armiford - Hereford in real life, in the Golden Valley. Here the School remained for the duration of the war, and indeed just afterwards, covering the titles from Goes To It until Three Go. An article on the Herefordshire locations will be appearing in the GGBP edition of The Chalet School Goes To It which will be published later in 2010 (please do not order yet). But the School was situated in Michaelchurch in the Golden Valley, and Hereford is very well described.

60 books in the series!! And I think I read them all!!

Oh my God EileenH up to 2 meters with each storm. I have never seen anything like that. I think the only area of the states that has snow like that is upper NY state. They people living in that ares would a full time job just cleaning the roofs. The young man who died was from back up in Massachusetts, where i worked and lived. He was only 26 years old. The person still in hospital, I think they were under the snow to long. They were not wearing beacons. We had another 6" last night. And today not a cloud in the sky, you have to feel the NM sun in the winter warms you to the bone.

🙂

A newspaper article from 5 days ago said the weather-related deaths in Europe had already reached 26 - not all avalanches to be fair but a lot have been. People think that because the risk level is 3 from 5 that means it is OK to go out, rather than that THEY will be the trigger for an avalanche rather than them going off spontaneously. I never did that sort of skiing - but I know about the warning system and I listen to the weather reports.

Some of the avalanche deaths this year have been due to total stupidity - the four or five at Lech in Austria were supposedly professional German skiers (whatever that means) but there were announcements and signs all over the place saying not to go out and they crossed onto a black run that was closed because of the risk. A wife notified the rescue services when her husband didn't return in the evening - and the mountain rescue then went out in the late evening risking their own lives. They could find the bodies, they did all have the gear, including airbags, but retrieving them was risky. Sorry, but they should have been left for the thaw - what if the rescuers had been caught too?

I probably have been to Golden Valley - the other end of the county to where I lived - but I do remember buses from a company called that who did school transport!

I don't disagree EileenH, the young man here was skiing in bounds. The ski patrol had set charges that morning and opened the shoot. We always have a number of deaths each year with people skiing in the back country. I never ski out of bounds plenty of great skiing in bounds. There are a lot of so called Pro skiers, instructors, guides, patrollers ,etc. Which means they should have known better. Some of the rescuers here are paid, but most are volunteers who risk their lives, you right not fair! 🙂

Today there have been 3 deaths within about 20 miles of where I live: an off-piste skiing trigger where a 21 year old died, an ice-climber caught in an avalanche but I don't know the details - and a Russian tourist who fell off a balcony, Horrible...

EileenH, I do not understand people go off-piste or out bounds with all great skiing in bounds. I have not seen ice climbing here in NM, but I sure there is, but back in New Hampshire, quite the sport. One club has a large ice mound in the front yard. Most winter deaths are from auto accident, snow shoveling, etc.

You are Soo correct! Horrible!

Thank you Eileen for your very helpful reply. A few days on and my symptoms have eased a little so I'm thinking its steroid withdrawal rather than a flare. I'm certain that I read somewhere )?on here) that alternate day doses of prednisone was one way to reduce, will see if I can find it. But I take your point on the body not knowing where it is! As I seem to have improved I plan to repeat this last weeks dosage in the forthcoming week and as you suggest make smaller reductions thereafter. Thank you for your advice.

No, not alternate day doses in its usual sense (one day double, one day none) and the only people who suggest alternating old and new doses with big differences are doctors who have never done it themselves! Not the people who reduce regularly and with success! There are people who talk about it - usually before they discover how hard it can be. Using the Dead Slow approach we bang on about on the forum you do get to a point where you alternate the old and new doses but the difference is usually only 1mg and you have tried a few days of the new dose before you get there. It is all about reducing the impact on your body and making things more comfortable - this isn't a short journey, why suffer more than you must? And it also makes it easier to decide if it is steroid withdrawal or a flare.

A friend has Myasthenia Gravis and he takes pred every other day very satisfactorily. I think doctors just get muddled with the various illnesses that need pred and just merge them into one in their little brains.

Oh yes, ADT works well for some things - but it has been said it doesn't work so well for PMR and should not be used for GCA.