From 15 to 14

[3daysinjuly]

I tried my first reduction after a month on 15mg. I only had stiffness from my elbows to the hands in the morning. I guess what I am asking is should I accept that ( which would not be difficult) and stay on the 14mg. I am really wanting to taper and after a month on 15mg perhaps a little stiffness can be tolerated. I will ask Rheum this week. But I value the forum here.

[piglette]

You may have steroid withdrawal for the first couple of days or so but that should go away. If you have gone too low it normally would show up in a week or two. If you have pain then you may have reduced too much. Trying to sit out the pain is a total waste of time as the PMR will win.

[3daysinjuly in reply to piglette]

In the morning when I go to throw off the comforter with my arm, I feel it. Tolerable, but I hate that to be what I wake up to.

[piglette in reply to 3daysinjuly]

I hope it improves. Take the reductions slowly and you should be OK.

[PMRpro Ambassador in reply to 3daysinjuly]

Is that before or after taking the pred?

[3daysinjuly in reply to PMRpro]

That is before, when I first get up. Then I take the pred with breakfast.

[PMRpro Ambassador in reply to 3daysinjuly]

Two suggestions: either wake early and take your pred and settle down for another couple of hours until it works, or try splitting the dose. A usual option is 2/3 of the dose in the morning and the rest at some later point. That takes the antiinflammatory effect to over 24 hours so it get ess early morning symptoms.

[3daysinjuly in reply to PMRpro]

Yes, remember that is what I had been doing. 10 in the am and 5 at night. And it worked great. Then I got it in my head that taking all in the morning would make it easier when I started to taper. So maybe another bad decision on my part.

[PMRpro Ambassador in reply to 3daysinjuly]

There you are - try it again

[blueisgreen in reply to PMRpro]

Does it make it harder to sleep if you split your dose between morning and evening?

[PMRpro Ambassador in reply to blueisgreen]

Yet another question there is no answer for. Some people can't sleep well when on pred whenever they take it, others can take it all in the evening and sleep like a top. And others need to take the bulk early in the day and the rest as early in the day as works to take them over to next morning or they can't sleep.

The pred I take is taken at 10pm with food in the stomach. It releases at 2am and is at its peak in the blood at sometime around 4am or a bit later. Sometimes I wake then and am conscious of a tingling sensation, sometimes I don't. No hard and fast rules.

All you can do really is try and see what happens.

[PMRpro Ambassador]

Were you pretty good after that month on 15mg? That is the bottom of the range starting dose - was it enough?

[3daysinjuly in reply to PMRpro]

Yes, I would say I was pretty good other than some hand and elbow a.m. stiffness. I walked 2 miles every day for the last 2 weeks without problem on the 15mg. Had blood work done yesterday for the upcoming rheum visit.

[PMRpro Ambassador in reply to 3daysinjuly]

The only thing to look out for is that arm pain worsening - if it stays the same it should be OK, But more then you maybe need a bit of time at a higher dose first.

[3daysinjuly in reply to PMRpro]

Right. On a side note, I am discovering that if a person has a little OCD, it sure doesn’t help to have this.

[PMRpro Ambassador in reply to 3daysinjuly]

Probably not...