4 o'clock here in UK anyone out there?

4 o'clock in the morning, and I've been awake and in pain for hours. Last Tuesday had surgery in neck to remove half thyroid and very large goitre, very straightforward and successful. But oh how the PMR kicks in, can't sleep, every muscle aches. Now well into my 5th year of this condition, and beginning to get very cheesed off!!!!!!!!!!!! I've managed to reduce pred (again) to 10mg, so shall I wack it back up again, until after the surgery wounds have healed?

[Nitrobunny]

I’m sorry you’re in so much pain. When I am in a great deal of pain from physical stress on my body I do raise my dose to help me get through what is sure to be a mega flare. I don’t know if the same would apply to surgery as I’m not a doctor and can’t give you medical advice. My doctor is great about letting me make a judgment call when it comes to dosage. I keep track of what I’ve done and fill him in when I see him next. I hope you can get comfortable enough to get some rest. Be well ~

[Hidden in reply to Nitrobunny]

Yes, me too I manage my own pred levels, and every time I get below 10, it gets harder. I use DSNS, which works until I get to about 6, then I fall off the planet and go back to 12-15, start again. But this time after surgery is new, and not good at all. Thanks for being up and about, or are you on the far side of the pond?

[PMRpro Ambassador in reply to Hidden]

But if you are repeatedly getting stuck at 6mg that is your body telling you that you have arrived at your destination: the lowest dose that does the job as well as the starting dose. Probably 7mg.

Slow down as you approach 7mg - and listen hard for the stop point. Then you won't need to keep going back to such a high dose - which in the long run makes it all the more difficult.

[Hidden in reply to PMRpro]

Well I know you are the voice of experience, which makes your view a little gloomy. Looks like you're saying 7mg is going to be a permanent maintenance dose. I will consider this very carefully. Thanks for your opinion. R

[PMRpro Ambassador in reply to Hidden]

No, not at all. I'm saying it is where you need to be NOW. It doesn't mean you won't get lower, just not yet.

Having accepted a realistic and safe acceptable to doctors dose - instead of shooting up and down like a yoyo - you then wait a couple of months and then, using a slowed taper, try another 1/2mg. If it works - great, wait a month to be sure and try again. If it doesn't, wait another couple of months and try again.

But what you have been doing has increased the total dose far more than if you hadn't forced the drop, stuck at 7mg for a bit and not let in a flare.

[Hidden in reply to PMRpro]

Ok got it. Thank you.

[Nitrobunny in reply to Hidden]

I’m on the far side of the pond. Dallas Texas at the moment 😊

[Hidden in reply to Nitrobunny]

Helpful for us this side when we can't sleep! Thanks for listening. Been to GP, adjusted pain relief so hoping for a better night tonight.

[Nitrobunny in reply to Hidden]

Oh good! Hopeful you will get some peaceful and restorative sleep.

[Rose54]

Stress from Surgery is bound to have a effect

So is any stress

I like you have just increased back to 15 but if that's what it takes its the only thing to do

Hope you managed to get some sleep

Take Care

[Hidden in reply to Rose54]

Yes managed another couple of hours, thanks for your reply

[Yellowbluebell]

It is ususlly reccomended by others that you increase your pred whilst going through a stressful period and this is definitely one of those times. I would be inclined personally to go up to 15mg until things have settled down and you are pain free. Dont be in a rush to taper. Good luck.YBB

[Hidden in reply to Yellowbluebell]

Thanks

[PMRpro Ambassador]

First thing I thought - MORE pred for the moment! Hold on - it will improve but not fast enough!

I had a flare in early May because of missing a day's tablets while in hospital (long story!) and then a few days later had a cardiac pacemaker inserted. Not quite the size of op you've had but they do pull the muscles around and the bruises were mega!! The first couple of days felt like staggering from one painkiller infusion to the next. And night time was particularly sore. And some people go home within a couple of days!

Get well soon!

[Hidden in reply to PMRpro]

Do hope you are better now. Feel a bit of a fraud sometimes when you see what others here have to put up with.