Many posts and replies cover the tapering of preds down to a low maintenance level and what to do about flare ups along the way and these are invaluable but not so much has been written about
the weening off of the last, say 1.5 - 1 - 0.5 mg - how do you know that it's time to take that final leap into Club Zero and that the PMR is truly in remission (apart from taking that leap of faith and keeping your fingers crossed).
I find even less written about the possibility of over treating i.e. where you could actually be taking a dose appreciably higher than your condition actually requires at that point in it's course. An example of this being:- perhaps because of the standard starting dose being 20/15 you are stuck with tapering from this number when, in this hypothetical case, the level of PMR, only requires, say, 9. For months then the patient is effectively over treating, possibly inducing side effects that might best be avoided.
Another scenario is that a patient could be patiently following all the slow tapering advice and still have some way to go to reach Club Zero but that the PMR has already departed the body and so again effectively they are not only over treating but treating a condition that is no longer there.
In short I suppose I'm asking "how do you know when it's gone"
From my post, shooting at hypotheticals like this, you may have identified me as a non sufferer of PMR and you would be right. I am, I hope, a supportive 'other half' , trying to understand the course of this condition and get a handle on the why's and wherefores.
(My wife is 8 months from diagnoses and start of preds. She is just tapering 9 to 8. - we follow pmrPro's slow approach. No flare ups to date ; Pain well controlled but fatigue ++ hits in every 3 or 4 days.)
Last query: With all this concentration on getting the tapering right, am I given to understand that the PMR condition is also tapering in it's intensity throughout it's progression and we are just trying to be that one smidgeon above the pain management level with the pred or have I got the wrong end of the stick on this?