Pred Doses before and after a flare.

[Mellow-Yellow]

May I have some advice please.I am approaching my three year anniversary(🍾) with PMR.

I tried to decrease from 4 mg to 3.5 three weeks ago using the DSNS method,which has been marvellous so far.

Before I reached my second week,ie taking it twice weekly,I started to experience PMR aches and pains.I went back to 4mg but the pains and discomfort actually worsened.

I had some stress the previous month with my husband in hospital,but I also understand that the lower I drop the more likely I am to hit a blip!

I increased to 5,but as no relief,now over three days up to 7.

My question is please..how long do I stay at the higher dose,and do I then just drop back to 4 where I was ok?

Most grateful for your thoughts.

[DorsetLady PMRGCAuk volunteer]

You can stay on higher for 1-2 weeks, most find a week is enough - and then drop back down. You may be okay to drop back down to 4mg - but it might be wise to go to 5mg for a week, 4.5mg a week, then restart the slow taper at 4mg.

You are at a good low dose, and at 3years your PMR is still active - as you’ve discovered - so no point in trying to push it.

Good luck.

[Mellow-Yellow in reply to DorsetLady]

Thank you,this is so helpful.😊

[SheffieldJane]

I wonder if going up to 9 mgs ( an overall increase of 5 mgs) would catch this flare? I have successfully come straight down after a week or so. Otherwise it would be another taper. It can be like snakes and ladders, particularly with high stress. Even an argument can bring on symptoms for me.

[Mellow-Yellow in reply to SheffieldJane]

Thank you ..more options gratefully received!

[ignatz in reply to SheffieldJane]

OMG- is PMR really all that related to stress? "It can be like snakes and ladders, particularly with high stress. Even an argument can bring on symptoms for me."

[jinasc]

Hi

I would hit it hard with 10mg for two or three days, then go back and drop 1mg each week and see how it goes. In the great scheme of things, a few more pred to help you is not going to harm you and you may find that doing that enables you to control the flare and get back to where you were within 6 weeks.

A beloved partner in hospital = Stress.

It does take it out of you and I wonder if when you were stressed you just ignored it and now it has caught up with you.

[Mellow-Yellow in reply to jinasc]

I think what you say makes sense ..both with dosage and stress..I was probably temporarily distracted to concentrate on said patient- plus a good dollop of brain fog ! Thank you .😊

[Robinsnest72]

I was on 6mg of pred and really not feeling well. Lots of pain and my blood markers were increasing. I keep a diary so I looked to where I felt good and that was 9mg. Stayed on 9mg for 10 days then dropped to 8mg for 10 days then to 7 mg where I have been for two weeks. Had blood work done yesterday and numbers have come down. Went to Rhemy today and he said I did it exactly correct. He recommended I stay on 7mg for a month and then drop to 6&1/2 for month and then 6mg etc. Will go at it again.Feeling pretty good right now.

[Mellow-Yellow]

Thank you so much..and pleased that you are feeling good again! I am very lucky as this is the first real flare for two years..the DSNS method has worked a treat and this forum is invaluable..7 mg seems to be ok at the moment although felt strangely spaced out on it yesterday morning 😳🙃 Onward and upward!