Flare or done too much

[Rosina1871]

Hi

Been on Pred since January this year. Started on 20mg for three weeks then down to 15mg for the last five. I’m doing ok. Very little pain and trying to pace myself. However, yesterday I felt awful. The DF , shaky and generally very unwell. I’m putting it down to going to my keep fit class on Wednesday night and also lots of family stress at present. My class was gentle exercise but I think I may have overdone it. I will be speaking to my doc this morning as I’ve just had another blood test and was hoping to lower Pred again. I wondered if my “bad day” was down to overdoing it or was it a flare. Is a flare just regarded as pain or can it be just feeling awful. Thanks. This forum is great

[SnazzyD]

On the face of it, you’ve probably over done it. The Pred isn’t there just to remove the pain so you can carry on as normal (ish), sadly. Whether your over doing it has caused a flare or you’re just exhausted is hard to say. A flare is when the inflammation has increased to a level that the Pred dose isn’t effective. It’s possible you are entertaining a virus or the stress has been a step too far with your current activities as well. It’s tricky because exercise helps stress; it’s such a fine balancing act. At 15mg there’s no way my Pred muscles or energy levels would allow a keep fit class, even though I started out super fit. I found that the Pred weakening effect was cumulative and wasn’t as apparent in the very early weeks. I only had GCA and started on high doses, but what I’ve seen on this forum is that the lower starting doses of PMR seems to make people more likely to over do it because it’s not as intense and also there’s the flushof relief from being pain free. The PMR gurus will be along but personally I would not reduce until you are well clear of this episode especially as you are in the early phase of the condition especially as you’re not pain free. I’d give it a day or two of total rest with no change, if your pain levels haven’t increased a lot, to see if you can get away with it, but that’s just me. Stand by for more advice!

[Rosina1871 in reply to SnazzyD]

Thank you very much. Good advice as always

[borednow]

Please slow down!! Your body is trying to tell you something. Please listen to it. It's a long job is this and you have to be kind to yourself. I certainly wouldn't even think about yet another reduction until you get to the "very little pain" bit again! And rest. Hope you feel better soon.

[Rosina1871 in reply to borednow]

Thanks for your reply. I’m not really getting pain, just aches which are completely manageable. It was just the DF and generally feeling unwell that knocked me flat

[borednow in reply to Rosina1871]

You're not on your own there! Been up since 8am, cup of tea, checked HealthUnlocked and now absolutely kn.....ed!! And it's only 9.38!! This is not boding well for the rest of the day. However, onwards and upwards. More tea Vicar??!!

[PMRpro Ambassador]

If you do get permission to lower again - please don't do 5mg at once again because it would be asking for trouble!! I think Snazzy has covered all I'd say.

[SheffieldJane]

The family stress is a killer in my experience - even anticipating it brings on symptoms in me. That coupled with extra physical activity and there you have your culprits. I would wait a while with my taper until the situation resolves, if it can. Otherwise, I find that you need to distance yourself to an extent, very hard I know.

[Rosina1871 in reply to SheffieldJane]

I think the family stress is the main culprit. Before that I was feeling much better. So difficult to control that sort of stress. Bloods normal. Doc suggested going down to 12.5 and see how I go. May stick to 15 for a few more days. Thanks for all tier replies. Appreciated