TAPER: I checked out he TAPER PLANS. (The ones they... - PMRGCAuk

PMRGCAuk
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TAPER

I checked out he TAPER PLANS. (The ones they “print” out on steroidtaper.azurewebsites.net)

My problem with BSR & BHPR is they don’t taper under 5 by 1/2 mg dose.

My Problem with DSNS is it doesn’t suit for a weekly schedule (or I’m all confused). I’d like to have it visually displayed for a week at a time. That’s how my pill box goes.

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DSNS is approximately a monthly plan - and one way to do it is to use a diary or calendar and 2 colours of highlighter pen and start on the first of the month. Then decide where on the scale you want to start: let's say with 4 days old dose.

On the 1st mark the date with the colour you are going to use for the new lower dose. Count 4 days, the dates 2/3/4/5 and mark them with the old dose colour.

On the 6th you will take the new dose, mark it with the new dose colour. Mark the next 3 days, 7/8/9, with the old dose colour.

Continue with one day new dose colour on the 10th, 2 days (11,12) old dose colour, 13th is new dose, 14th old dose.

You have arrived at alternate days old/new. Now you build up the days of new dose:

15/16, new dose

17 old dose

18/19/20 new dose

21 old dose

22,23,24,25 new dose

Then ask yourself - do you really still need any old dose? If not, stay on the new dose until the end of the month. And start all over again on the first of the month with one day of new dose...

You can use just the single sheet if you always fill in the days at the end of the month with the new dose.

If you want to go more slowly, start at the beginning with 5 or 6 days of the old dose and each time spend one day less of the old dose.

Then every week sit down quietly and fill your weekly dosette box according to the calendar. There are monthly (4-weekly) ones - so you could do a whole month at once if you wanted.

Yes it sounds complicated but when you actually DO it is isn't really. It has the advantage of a long time to having consecutive days of new dose without looking at how to add an extra day each period of 7 days.

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I love the tapers. And yes it does take a bit of concentration as I am not on a schedule to start on the first of the month... The one thing I would love is if the schedule followed the layout of that our weekly pill boxes and calendars. At least the ones sold here in the USA.

Taper layout is: Mon, Tue, Wed, Thu, Fri, Sat, Sun,

Pill boxes& calendars: Sun, Mon, Tue, Wed, Thu, Fri, Sat.

As I'm typing this I realize that I could just re-label my pill boxes to correspond to the taper. HeHe. Shame on me.

Also, if there were a way to include a notation of the day of the taper, eg. 4/38. but again, this is something I can do myself. Just lazy I suppose.

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Thanks. I get it now. I wrote out the Austrian method last week & this is the same thing. Only he starts with 6 days old & this is quicker. 3 or 4 day start. The markers sure help & that’s what I’m already doing now. Much better looking at this as a monthly thing. If I take longer (say 5) then I still have 2 weeks left in the month before I need start another “new” dose. The markers will help me explain to my doctor.

The gentleman who posted the photo showed a 6 day start which would be 52 days for a change of dose. Wow! So much to choose from. (4, 5, or 6). I’m inclined to think “darn” slow, not “deadly”.

Thanks!

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How does this work if starting at a higher dose, say at 60mg? Or is the DSNS method mainly for lower dosages which need a slower drop? I know at higher dosage one is supposedly able to drop quicker? Thanks for any input. I really appreciate all the comments.

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At the higher doses most people manage 5mg at a time without problems though there are people who need to do 2.5mg at a time more often. The basic rule is a step down should never be more than 10% of the current dose.

DSNS was originally developed for below 5mg and then we realised there were people who were struggling even at 15mg - and one lady had to do 1mg at a time from over 20mg after a too fast reduction had led to a flare that was difficult to get under control. By going at 1mg at a time she got well below 10mg. Having had a bad flare because of over-enthusiastic reductions seems to make a lot of people really struggle - I don't know if it is physical or psychological, expecting the pain to return. But it happens.

You can use the DSNS approach with any size drop though - dropping overnight from every day one dose to every day 5 or even 10mg less can make people very uncomfortable with steroid withdrawal rheumatism. DSNS helps smooth out that drop and lets the body get used to the change more slowly. If it hurts less than can only be a good thing!

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It can be a bit confusing unless you keep a record. I have to take insulin twice a day and I chose to record these doses and blood glucose levels in a note book. Using the dsns method after a failed taper at .05mg for a month. So i started dens method using the notebook to list which days I Swapped doses. It was the only way I felt I could keep track of it. I just check every morning what dose I should take. I do this in pencil so if I feel wobbly I have extra day at 10mg but still drop. When I take the dose I either write over the note in darker pencil or pen.

Because I have a list of the day and dates of each dose I just fill my box in line with that. First week is easy but you just have to go with the flow and realise in the following weeks you will have to put different doses in the box across your 7 days pill box.

I filled my box for a week starting today so had 10mg today, 10mg Sunday, 9mg Monday, 10 mg Tuesday, 9mg weds, 9mg Thursday, 9mg Friday. This is my crossover week so hopefully tapered until 9mg. I will stay there for a week or two to see how it takes. The drop took 28days.

Hope that's not too confusing.

You are trying to fill a 7 day dose strategy on a process that doesn't fit 7days neatly because after first week the dose will be broken into fewer days between old and new doses.

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I’m glad I don’t have the insulin to worry about too. I’m mathematically challenged. At 75 I’d never make it :) Appreciate your time.

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Once you write it down its clearer.good luck chosing your method.🌻

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I actually started this already. At 6 (to go slower). But the coloured markers help & easier to explain to my doc because she thinks I’m at 4 & I stayed at 5 & decreased by 1/2.

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Good

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Mine thinks I am at 9mg already but it didn't hold first time. So far I haven't felt the steroid withdrawal sign I usually have dropping by 1mg so this is crucial week in this drop.

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Below 5 mg what has been the most successful? Doing 4, 5, or 6 days of the old dose. 4 days old & one day new START seems not so DSNS. And I assume reducing by 1/2 is preferred here.

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There is no answer to the first question - everyone is different. I knew I was very sensitive to dose change so did the longer version - others are not so bad.

The smallest amount you can do is best - but it depends on your tablets, some must not be cut, others don't come in a 1mg dose. Then you should extend the taper period, repeat a step if one feels wobbly. But there are no fixed rules.

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