FLare after having surgery

[CEAGLE]

Had been reducing dosage to 7 mg. prior to having surgery now have major pain on one hip/quad. I know I am flaring and have increased my dose to 12 1/2 mg but still have pain and stiffness. Any suggestions how much more to go in dosage?

[PMRpro Ambassador]

Really something to speak to your doctor about - because part of the reducing the dose pre-op was to help with healing and infection post-op. Are you fully healed now?

If you have pain just on one side it is less likely to be just PMR flaring. You don't say how long you are post-op or for what: do I assume rotator cuff and about 4 months?

[CEAGLE in reply to PMRpro]

I was reducing rapidly before surgery to help with healing process, had that surgery 11 days ago. Still slightly swollen from a large lipoma removal.

Had rotator cuff surgery 4 months ago which went well but no flare from that but I stayed steady on my dosage prior to surgery.

I could tell prior to this last surgery I was starting to flare because I was trying to reduce too rapidly then the recent surgery has made a big flare.

[PMRpro Ambassador in reply to CEAGLE]

Hardly surprising - all the best to get it under control. YOu will probably have to be a bit patient though.

[CEAGLE in reply to PMRpro]

Thanks PMRpro. Rheumatologist said could go up to 15mg. Would you go that high? At 12 1/2mg now

[PMRpro Ambassador in reply to CEAGLE]

If that is what it needs, yes I'm currently back at 15mg after having been OK at 8 or 9mg. I won't compromise - if I need it, I need it. It isn't just PMR - but I feel OK at 15, not at less.

[CEAGLE in reply to PMRpro]

Helps to know. Thanks so much.

[Lafontainepam1 in reply to PMRpro]

PMRpro, I thought you were on 5mg, I know like myself you have had this for years. I now have severe back issues, with spinal stenosis keeping me pretty much confined to not much standing or walking. Of course my Dr. Wants me to keep reducing. A few weeks ago I overdid, which left me in much pain and could hardly move. Went from 5 to 10 for a few days then tapered back to 5. I now see higher milligrams make the quality of life so much better. I have osteopenia, this is why my Dr. Wants me off. At 69, I am stuck again with the same question, what do I do??

[PMRpro Ambassador in reply to Lafontainepam1]

I got to 5mg for several months - but trying to go lower didn't work because of overwhelming fatigue so I went back to 5mg and then a few months later I had a very strange flare. I went back to 15mg for a few months, I simply could not reduce without the symptoms returning. After about 7 months I was back to 8mg which the doctor was happy enough with. I have got to 7mg again but the fatigue reappeared. Then another strange flare started in April - bad at 7, OK-ish at 8, fine at 9. The flare got worse about a month ago and needs 15mg. There are cardiology problems mixed in that need the pred dose - and the rheumy just looked bemused so I have had to wait for a cardio appt: Monday.

I have osteopenia - I'll lay odds all of us have osteopenia, it is normal for our age. How BAD is your osteopenia? My bone density hasn't changed significantly in 7 years on pred - it isn't inevitable - and is still slap bang in the normal range at -1.3-ish.

What should you do? Find a doctor who is willing to treat the patient and not the lab results - I don't much care what the pred MAY do in 10 years time - I have to be able to live NOW. If 8mg of pred is good enough that is a physiological dose of corticosteroid, the amount your body produces in the form of cortisol anyway. A couple of mg more is neither here nor there. Someone said in the last couple of days that their rheumy says quality of life is paramount - and that is the entire point of pred. Pred is there to enhance QOL and if they aren't interested in that, why start us on it in the first place?

[Lafontainepam1 in reply to PMRpro]

I will check to see what my results are with the bone density. We can only get them every two years with Medicare. I know she said last year, that my back looked bad, but that was because London bridge is certainly falling down, with my disks and etc.!!

What is your age, if you don’t mind me asking?

I have to tell you that I appreciate your support and input you always give me, as well as others, through the years.

[PMRpro Ambassador in reply to Lafontainepam1]

I'm 66.

[Lafontainepam1 in reply to PMRpro]

Every year after 65 is different in my book, it is a challenge by all means😎