Jaw Bones

[jevuki]

saw the dental surgeon and am having bone removed on the 18th, saw the doctor and he wants me to reduce quicker than the dead slow reduction, he suggests 2mg instead of 1. I am currently at 16 but reluctant to go so quickly any suggestions?

[Celtic PMRGCAuk volunteer]

Jevuki, as the general rule for reducing is never by more than 10% at any one time, then how about meeting the Dr half way and trying a reduction of just 1.5mg? Meanwhile, lots of good luck wishes for the 18th.

[jevuki in reply to Celtic]

thanks

[PMRpro Ambassador]

It depends why you are reducing - if he wants you off/on a lower dose of pred for the surgery the 2mg at a time isn't going to pose the same problem. You will almost certainly be faced with some pain/discomfort if you have to reduce any quantity, whether you do it 1mg at a time or 2mg at a time. I presume he wants you on well under 15mg? And it isn't long to the 18th!

[jevuki in reply to PMRpro]

The teeth surgeon is fine with whatever I am taking, its the doctor who wants me to reduce to get down to possibly get off the prednisone...

[PMRpro Ambassador in reply to jevuki]

He can want you to reduce faster all he likes - as long as the autoimmune cause of the symptoms we call PMR is active you either need the amount of pred you need or you stop and accept the pain that will inevitably return if you reduce too far. If you reduce too fast you will suffer pain due to steroid withdrawal.

If it were me, I would explain to the doctor that it is YOUR pain, not his, that PMR requires pred to manage it and reducing quickly tends to cause flares requiring a return to a higher dose - exactly the opposite of what he wants. And you could try what Celtic suggests for now - unless he decides you shouldn't do half mg changes. In which case, 1mg at a time it is!

You could quietly try the 2mg change in the framework of the dead slow approach and see how you feel on the day you have dropped by 2mg. If it isn't too bad the first time it might work. I wouldn't tell him I was trying it in advance though!

[jevuki in reply to PMRpro]

Thanks that is what I am thinking of doing

[piglette in reply to jevuki]

If the tooth surgeon is happy I would just take your time if there is no other good reason to reduce quickly. I really begin to wonder about some of these doctors.

[TooSore]

Another thought - isn't it best to wait and reduce after the surgery? I don't think it's wise to rock the boat so close to the stress of the dental work. Maybe talk with the surgeon about healing time and relying on symptoms of course.

[jevuki in reply to TooSore]

Thanks I will