New to PMR

Hello everyone, this is my first post.

I was diagnosed with PMR one week ago today. My C- Reactive Protein was at 91. Been on 50mg prednisone for 7 days, and will be going down to 20mg tomorrow morning. Doctor wants me to reduce to 15mg after 2 weeks, and then 10mg after the following two weeks. I am having my gallbladder removed on Monday morning. Does anyone have any advise on surgery, and reducing meds.



11 Replies

  • Our trusty helpers will be along soon but I would say this is way too early to be reducing by such amount especially facing surgery next Monday - surgery will place extra stress upon your body without factoring PMR into the equation.

    Every blessing is sent your way in the meantime:)

  • Hello, I went down by a third of my preds, and had a flare up. Now I am going down by 1mg a month, very slowly. My GP said that I must go slowly now. So I old of thought that with the pending op that you would be reducing too quickly. Good luck

  • Starting at 50mg for PMR is very high, 20 mg is a fairly common starting dose but reducing down to 15 then 10 as yours doctor has advised is almost certainly going to cause a flare up. I think you need a new doctor. Sorry but slowly reducing is the way to go never more than 10% at a time from 15 mg a day. Doctors don't seem to care if you are in pain caused by there fast reducing regime's.

  • I had my gall bladder out years ago and all I can say is it was like a new lease of life .The operation once done and got over with is well worth it . No more symptoms .Its such a relief .I had open surgery and because I didn't know any better was trying to pull myself upright with my arms .Strain on the stomach muscles . If you get the nurse to show you how to put your legs out first and then your body comes up with that . Easy . Every little helps ;-)

  • Did your doctor suspect GCA? 50mg is very high for PMR. As others have said this is a huge reduction and then you are not on the lower doses long enough to clear up the inflammation. Worried that you will be back at the beginning again with a really nasty flare.

    I don't know anything about what your dose of Prednisolone should be for your operation.

    Let us know how you get on. X

  • Hi Gil,

    As others have said 50mg is a high starting dose for PMR, but I guess Dr wanted to give inflammation a good blast because if your high CRP readings. Not sure if that's affected by your gall bladder situation, so may not be a true "PMR" reading. The short, sharp approach may work with some illnesses, but not sure how successful it is for PMR. Certain the fast reduction advised from 20mg down to 10mg is very likely to cause a flare, which is obviously the last thing you need whilst recovering from an operation.. That is just going to add more stress, and make the reduction even more difficult.

    Personally, would have thought you need to recover from op firstly, and then consider reductions, maybe 2.5mg a time, although that may be a bit difficult, I think 5mg a time is certainly asking too much of your body.

    Good luck with your operation.

  • Forgive my bluntness but if your diagnosis is correct that Med plan sounds crazy.

  • Just to say hello .. I too am fairly new diagnosed nearly a month ago. My fist dose is 3 x 5mg tabs daily for a month, then back to doctor tomorrow . Such a vast difference in medication ..

  • 50mg sounds excessive even for a relatively high CRP. Mine was 250 and I had 20mg of pred which made me feel like a new woman! However, raised CRP can be an indicator of infection/inflammation anywhere in the body. I have a theory that my chronic sinus infection is causing my CRP to stay at 22. GP sceptical but rheumy tends to agree. Is it possible that your gallstones have caused inflammation which in turn has raised your CRP?

  • The drop from 50mg to 20mg should hopefully be OK as you have taken pred for such a short length of time. As others say most people start on 15mg or 20mg, so you are on a very high dose unless GCA was suspected. Reducing becomes more difficult after two or three weeks, also the pred creates cortisyl, so your adrenal glands can take a holiday and not bother to create any themselves until you get down to around 7.5mg when they have to wake up again. You should stay on 20mg until you are sure the inflammation is under control. A CRP blood check is a good idea before you reduce. My rheumy wanted me to reduce 5mg to 15mg after three weeks (My CRP started at 123 and was then 90) and in my case it was a disaster, some lucky people seem fine on the other hand. I think I would hang on until you have your op and everything is OK anyway.

    Also you should be taking vit D and calcium supplement to counteract the side effects of pred and also get a Dexascan to check your bone density. Your doctor should be aware of this.

    Good luck with your gall bladder op. Have you told the surgeon you are taking steroids?

  • I'm assuming this is a GP who has done this? It bears no relationship to any recommended procedure for PMR and I think you need to find a specialist who has some better idea. You also need to discuss what is happening with your surgeon and anaesthetist. That is the most important thing to worry about this week!

    It is possible that the very high dose may help- but PMR is a chronic disorder and it is long term lower dose pred that is required rather than hitting it hard and then reducing quickly as your doctor seems to want to do.

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