Gca flare currently on 40 mg should I up my prednisone to 50 ? 60 ? Been on 40 2 months seeing rummy Thursday for 1st appt ??

[Determineddebbie]

Advice needed gca mega flare I've been on 40 prednisone for 2 months 1st appt with rummy this Thursday . Should I up pred to 50 ? Now

[polkadotcom]

If you are having a GCA flare and are new to it all, the best place to go (on a Sunday) is your nearest A & E dept, or possibly a walk-in centre if you have one near.

All you need to do is tell them that you are worried about your eyesight and pain and steroid dose. Don't hang on till Thursday.

[SheffieldJane]

Hi Determineddebbie, I would be really scared to up my dose of Prednisolone by so much without medical supervision. There is a case for letting your Rheumi see you at your worst. But if you can't bear your symptoms I'd get yourself off to A& E. Another opinion and the culture of emergency services within a hospital setting can produce real focus on your condition, in contrast to routine appointments. This can sometimes produce new and helpful insights. Sorry that you feel so rotten but Prednisolone is only your friend up to a point, it can really make you feel appalling and it's potentially a dangerous drug.

[Determineddebbie in reply to SheffieldJane]

Yes I agree thank you

[PMRpro Ambassador]

Depends what is flaring - but A&E is your best bet rather than just increasing your dose without medical approval. Was it you who said in your other post you'd been for a bike ride yesterday - is it the PMR side of things that is worse?

[Determineddebbie in reply to PMRpro]

Yes

[Celtic PMRGCAuk volunteer in reply to Determineddebbie]

Debbie, if you have no sign of returning head/jaw pain, or any problems with your vision, but your increased pain is confined to your body, then this sounds more like a flare in PMR symptoms. In that case, as PMRpro has already alluded to, this is probably the result of over-exercising via the bike ride yesterday. In these very early days of treatment, it is essential to have plenty of rest and not overdo things. The Pred is not curing anything (sadly there is no cure at present), it is just damping down the inflammation that causes the pain until the disease itself goes into remission and that can take anything from two years upwards. If you overdo things on a 'good' day, PMR has a nasty habit of coming back to bite on the next.

On the other hand, if your worsening symptoms are those of GCA - particularly affecting your head/eyes, then immediate advice at A&E is the answer.

[PMRpro Ambassador in reply to Determineddebbie]

Celtic has already said it. If it is just the PMR symptoms that are worse, you don't need more pred, you need more rest. You wouldn't take pred for sore muscles after a run would you? You have to wait for the muscle soreness to go away. In PMR the muscle pain is worse and takes longer to go, pred won't help that. It is a very powerful drug and not one to be played about with just because you have sore muscles.

If it is GCA - headache and so on - that are worse then you need a doctor and that probably means A&E at a hospital which preferably has a rheumatology department, such as the one where your appointment is on Thursday.

[Determineddebbie in reply to PMRpro]

Yes as I said I can't travel today so will st it out till Thursday thank you for taking the time to reply to me it's a great help to be among people who understand