Help please!

[Nerak12]

After nearly 2 years of PMR & Pred I have in the last month finally got down to 8 mgs of Pred. After about a week I could feel the inflammation ramping up again in my shoulders and across my chest and into my arms, so went back up to 9 for a few days, then 8.5 for a few days and just about to drop to 8 when 3 days ago i sneezed about 6 times and I started to cough. I now feel like I’ve been hit by a train and if I wasn’t on pred I think I would have a rip roaring streaming cold. Today I’ve taken 9 mgs but my PMR discomfort is worse than usual and going up the back of my neck into the bottom of my scalp. It did this back in February and I ended up back at 10mgs for a month. Any suggestions please as to what to do? Shall I just stay on 9mgs and wait for the virus to subside or increase to 10 again? The cough is not too bad and I’m not coughing anything up at the moment - touch wood. I just feel crap to put it bluntly. My Rheumatologist keeps suggesting Methotrexate to help me reduce my steroids, but I’m not keen as have history of ulcers. At the moment I rarely need to take Ranitidine, so I’d prefer to keep it that way to ensure I get the calcium into my bones (borderline osteoporosis). It’s all a balancing act, so advice from the aunties appreciated please 😀

[PMRpro Ambassador]

You are flaring - and suspiciously GCA-ish. I think you should have stayed at 9mg for longer and maybe try a slower drop. But I'd say you have achieved your goal for now - the lowest dose that manages the inflammation at present.

[Nerak12 in reply to PMRpro]

Thank you PMRpro. I don’t feel the 9mgs is controlling things at the moment, but I’ll give it until tomorrow. If no better I will try Blearyeyed suggestion. I have only been decreasing by 0.5 and staying on the dose for at least a month. I think it’s back to DSNS method for me once things settle down. If the pain goes up any higher I’m straight off to the doctors/A &E. Thanks again. It’s so frightening when you’re jogging along quite nicely and a banana skin suddenly appears!! X

[PMRpro Ambassador in reply to Nerak12]

In that case - 10mg at least but I'd had the impression 9mg was just enough, 8.5 wasn't.

[Nerak12 in reply to PMRpro]

Morning PMRpro. Shivered my way through yesterday evening despite regular paracetamol until temperature came down about 11pm. Took a couple of extra mgs pred last night and the full 10 this morning which has kicked in and am now resting in bed as PMR pain still worse than usual but bearable. Still coughing. Beautiful sunny day here, so really resent being confined to bed. OH doing the dog walking. As the virus leaves my body can I expect the PMR symptoms to reduce too? How long should I stay on 10mgs? X

[PMRpro Ambassador in reply to Nerak12]

Until you feel really well again and the infection is gone - and if that is less than a couple of weeks, you should be able to drop back to 9mg easily.

I said yesterday I was staying in bed - wish I had as I'm shivering at the weather: 10C and chucking it down. It is probably snowing at the top, certainly below freezing up there! A couple of days ago it was still summer

[Nerak12 in reply to PMRpro]

Thank you for your speedy reply. It seems to have changed to Autumn overnight here too. Central heating on last night and this morning. I’ve got 1 leg in and the other out of bed trying to get the right temperature balance at the moment. I’ve got a painter and decorator finishing off some work today, so I hope he doesn’t fall off his ladder when he comes up to do the bedroom windowsill 😱

[PMRpro Ambassador in reply to Nerak12]

It is more like late November here! And that is winter - there are roads closed because of snow or only accessble with winter wheels - chains!

The world has gone mad ...

[Nerak12 in reply to PMRpro]

You echo my feelings. We could be in for a very tough winter here - in more ways than one! X

[PMRpro Ambassador in reply to Nerak12]

Yee-ees. I have Sky News on, not because I want to watch it but every day seems to bring another surprise ...

[Nerak12 in reply to PMRpro]

I’ve become addicted to BBC Parliament channel on SKY (504). It gives me a good excuse to put my feet up in the afternoons, but so gripping last week that OH had to get his own supper when he got in from work!! Not always good for the blood pressure though 😜

[PMRpro Ambassador in reply to Nerak12]

No - couldn't do that! About the only positive is there are no ads ...

[Nerak12 in reply to PMRpro]

😀

[Blearyeyed]

If you feel like you have an infection , adding to the burden of going lower on your Pred dose than you could cope with, it may well be worth increasing to 10 mg until that subsides ( upto a week) then going back to 9 and waiting a few weeks to settle and restore your strength before you try to go down in very slow steady reductions at only 0.5 mg a step.

Hope you feel better soon xx

[Nerak12 in reply to Blearyeyed]

Thanks Blearyeyed. 10 it is. Xx