I was diagnosed with PMR and GCA in July 2015 and started on 40mg of Prednisolone. Following the tapering programme given to me by my Rheumatologist, by December 2015 I had reduced to 9mg without any problems.. too fast I hear you cry. Due to a head injury and an overnight stay in hospital, a consultant increased the Pred to 15mg to deal with the trauma, despite the fact that the trauma itself caused me no problems whatsoever. I tapered back down to 9mg by April 2016 when I started to feel unwell with the original symptoms returning, although not as severe as originally, which was backed up by an increase in my ESR and CRP levels. Weekly visits to the GP ensued and each time it was suggested I increase the Pred by 1mg or 2mg each time, but for 6 weeks this made no difference whatsoever, until in the end it went up to 20mg before making me feel better. I then resumed a taper programme with the intention of achieving 1mg a month, so that by December 2016 I was down to 10.5mg and feeling OK for most of the time. Since reducing to 9mg in February I have really struggled with a lot of pain and discomfort in the mornings, but have stuck it out because I know that I am going to feel better by lunchtime and I am desperate to reduce the steroids. Today I feel defeated and have to admit that the only way I am probably going to feel better is to increase the Prednisolone dosage, which I really didn't want to do for so many reasons, including my Rheumatologist wanting to put me on Leflunomide imminently.
My reason for boring you wonderful folk on this brilliant forum with my background info is to ask for your opinion, as in view of the struggle that I had last year with a flare up of symptoms and having to increase to double the amount of Pred that I was taking before I felt well again, I am not sure that increasing from 9mg to say 10.5mg is going to make much difference. Should I therefore consider taking a larger dose for a few days, which I understand from an earlier feed on this forum is possible, to control the current inflammation then drop down to say 10mg/10.5mg? If I am completely honest, the last time I felt well and fairly symptom free was at 12.5mg, which was in October 2016 and this was reflected in my low ESR and CRP inflammation markers. I have monthly blood tests for ESR and CRP, both of which have been steadily rising as I have reduced the Pred each month. I can almost guess the blood test results each time from the way I feel.
I apologise for my lengthy post and Thank You in advance for reading my post
Best wishes Liz