To increase or not to increase my prednisone.

Jean, oh dear, that 5 mg drop is more than likely to land you back in the same place you were in before the increase.  I think you should drop by no more than 1 mg, possibly every few days, or once a week, depending how you feel.  Last thing you want is to yoyo, which is likely to cause you to have a higher total lifetime dose of pred.

true.....that's why I probably will suggest to my rheumotologist that we go to 13mg instead of 10 and from there see what happens...luckily, she is open to  suggestions

That would still be too fast for many. The guide from top experts fot reducing the dose in a TAPER, not reducing to zero, iis not more than 10% of the current dose. Which is 1.5mg at 15mg, falling to 1mg by you get to 10mg. It isn't a race to lower the dose, it is a means of finding the right dose for YOU and YOUR symptoms, not for MrsI'mon5mgaday who lives across the street. And it isn't slow when it works and you don't have to keep going to a higher dose to manage the pain.

I totally agree.....the CRP can be "normal" but you can still be in pain....increase the prednisone to a "comfort" time  as you were BEFORE PMR

Not everyone is totally pain free on any dose - you have to bear that in mind. You have to look at the sort of level of pain relief you get at a typical PMR dose of 20, max 25mg. Pain remaining after that is probably something other than direct PMR. Some may go after a few months, especially bursitis, and that might also respond better to a steroid injection. But you can't expect 100% freedom from pain.

Do you really think the Lyruca helped with the PMR? My dr first thought I had fibromyalgia and Lyrica didn't do anything for me. Only predisone has helped.

Good luck!

If you have back and shoulder problems and painful hands they COULD all be linked. If you have tight muscles they can cause the nerves to the arms to be trapped or irritated. Perhaps a physio or massage therapist could assess the state of your back and shoulder muscles? Something called myofascial pain syndrome is caused by the same inflammatory substances as PMR except they are concentrated in small areas of hardened inflamed muscle fibres  - and that is what causes the problems.

I finally had to get with my rheumatologist. She's pretty good. She suggested I go up to 12 mg (I'm at 10 mg now) for one week then down to 11mg then back to 10 mg after another week. So I think I'm going to give that a try. I'm hoping that, that works. It just kills me because it took me four tries to get under 11 mg. And now here I am back again.

When it takes so many attempts to get down a dose - it usually means you really are on the borderline of enough/not enough. And even a tiny bit too little will let the inflammation back up again...

Yeah I'm starting to get to that point where I realize I am meant to be at 11 mg and not any lower. I'm just hoping my rheumatologist can accept that

As I keep saying - some people only absorb 50% of the pred so it stands to reason they need a higher dose than the ones who absorb 90%! But the doctors are taught the bioavailability of pred is 70% - the average. Really not quite the same is it!!!

Very interesting statistic but how can one know what your pred absorption percentage is?  I would guess that persons who are only absorbing 50% are most likely to be the ones that need to split their doses morning/evening.  Otherwise the single morning dose of pred won't do the job for a full 24 hours because they haven't gotten the full dose because of poor absorption?  Or am I misunderstanding.

My rheumy is pretty good but even he needs to be "guided" a bit each time I see him. (He is leaving in 45 days though - darn) At the last appointment I had, I purposely appeared to have thought out loud wondering if it might be a good idea to try splitting the dose again but keeping the mg level steady for now.  Amazing - 2 minutes later the rheumy said that's what we should do! LOL!  Since then it's been 13 days pain free and virtually inflammation free too.  I will be reducing in another 17 days but I've learned here about not being in a rush.  If the rheumy were to try to reduce me too quickly I would just say no.  

I think the exchange of information about PMR on this forum is SO important and useful.  I hate to think how many of us would be suffering needlessly or getting improper treatment without the info shared here.   Knowledge is power as they say and what we learn from these conversations here is probably more important than what we learn from the doctors in my humble opinion.

We can't know - it is based on pharmaceutical studies where they will have measured the plasma level after people took a given dose. That is the reason they titrate the dose - you start with a dose that should work for everyone and then reduce stepwise to find the lowest oral dose that works. In other drugs where the bioavailability varies from person to person they may start with a low dose, see what happens and then add to the dose. An example of that is warfarin for anticoagulation. Either way, you take the dose that works for you.

No - how long the antiinflammatory effect lasts is a different pharmaceutical property I think. It lasts for 12 to 36 hours depending on the person. So you could only absorb 50%, but find your right dose and still go 24 hours or more. 

Thanks Eileen, that helped clarify things.  I had a feeling that measuring absorption wasn't just another standard test result from the doctors office blood draw.

My thought on absorption and dose splitting sounded good - but was wrong lol.  I guess if it was that simple we would be tested for absorption and not do trial and error dosing.

No, no - not trial and error 

It is a recognised technique and called titration! Did you do chemistry at school?

I think I was enrolled in boy/girl chemistry.  Regular chemistry class?  I must have - I remember the lab catching fire.   

It wasn't you that caused it though I hope