Hi, I'm just looking for a bit of advice. My uncle has been on 5mg of Prednisolone daily for 4 weeks for his PMR. He's received a sheilding letter from his doctor, initially he didn't even know why he'd got it as although he's 70 he's active and in good health. Him and my auntie are now stuck in the house for 3 months and are very worried. More so because they recently lost their son so not being able to get out is worsening their grief and my heart is breaking for them. I've since read that it's only those on a higher dose for longer should have got the letter. Obviously he'll need to speak to his GP before doing anything but they are closed over easter. Does anyone on here know anything about it? I really appreciate anyone getting back to me. Thanks.
Prednisolone 5mg: Hi, I'm just looking for a bit of... - PMRGCAuk
Prednisolone 5mg
It is less the current dose as the history - if he has been at 5mg and above for the last few months that is what matters. I find it difficult to imagine that he has only been on 5 mg as a starting dose 4 weeks ago? I'd need to know a bit more about the history to say more than that though.
Does he take any other tablets? For blood pressure for example? Has he had a heart attack or angina?
This might help you work out what he should be doing and convince him accordingly -
I think it would be a good idea to ask the doctor for clarification. Whilst it is true that steriod treatment means that people are regarded as being higher risk I have not received such a letter and I an on 15mg. I have always been comfortable with the situation as I thought that those letters were for people who were at greater risk that that caused by streoid treatment.
Not sure the letters are anything to go by. My granddaughter is definitely very high risk with her history - but hasn't had a letter. It doesn't matter at the moment, she is self-isolating with her boyfriend's mother who is on chemo - but it will matter if she needs to go to work.
I have been on Prednisolone for PMR since Christmas and have reduced from 15mg to 12 and a half mg and then to ten mg. When the GP phoned me the Coronavirus was already happening and because I was over 70 and had guardianship of a child with asthma I was already self isolating as much as possible although I need to walk the dog out early in the morning and doing social distancing. The GP did not give me any further advice and up to now I have not had a letter apart from the information one from Boris Johnson
I would have thought that anything under 10 mgs would be medium risk, not high risk unless there are other conditions to consider. I have had PMR for 4 years and have had no letter. He needs to contact his Dr. asap.
Thank you for your replies. I really it. I misunderstood when my auntie said he was on 5mg, she meant he takes 5mg 4 times daily. This was upped 3 weeks ago, before he had been on doses between 5-15mg since last July so it appears he is in the high risk group unfortunately. Thank you for getting back to me and hope you all stay safe x
He should be taking his 20mg dose all at once, not spread over the day. It is important to get to high enough a blood level of the pred for it to be able to work to combat the daily dose of inflammation which is created every morning. That may be why they needed to raise the dose.
Thank you. He's still getting a lot of pain so that may the reason why.
I would think so. If he gets up in the night at around 2am for a loo run, he could take the pred with a bit of yoghurt. That way it's in his system ready for the daily inflammation dump. I hope he manages to get relief with the full dose, it's not like pain killers where you take it every 4 to 6 hours. Good luck!!
I too received The Letter. I am now only on 5mg pred a day. I also have blood pressure medications. I had just had my bloods checked and thought maybe my markers had shot up. I rang the doctors surgery asking why I had received the letter. Well...I had been on methotrexate last year but not for long as it gave me lung problems so my Consultant took me off them and I had follow up lung tests. However my surgery sent me the letter as the NHS told them too and it was because someone somewhere thought I was still on methotrexate needless to say I am in lockdown but not shielding.
But you do have both PMR AND hypertension AND have been above 5mg for some time.
I was diagnosed October 2015 pmr/gca and started on 40mg pred a day. In Feb 2018 I got to 1mg and had massive flare up back to 12mg a day. In February this year I was down to 1 mg a day and flared again but not as bad as 2018 and have been on 5mg a day since then. I am staying on this until end of April then thought I might try to reduce 1/2mg to 4 1/2mg a day for a month. You have me wondering if I should actually ring the hospital to ask if I should be shielding ?!*
At the least it should be stringent distancing - which does at least allow you to go out for a walk as long as you avoid other people. But no visitors or visiting. I don't have such complications - here we all have to stay at home the same! Only food shopping allowed. Until today we could only exercise within 200m of the front door. To be honest, I doubt you will find anyone to answer the question - but you could try!
Shielding is just a designation for the socially isolated extremely vulnerable. But you will probably be much better off just adopting a safety first approach. Either isolation or, as pmrpro says, stringent social distancing. Remembering to wipe shopping down, washing clothes and hands, not touching your face, keeping away from ft and friends, so no visiting will do as much to.keep you safer as anything. When we have had people on 20mg and a dmard told by a nurse it's ok to just social distance (😳🙄). Another medic telling someone on less than 5mg they needed to lock themselves up, you just have to take a look at your life over the past few years, the pred dose throughout and your willingness to risk your life on the chance you might not get it. If you can get food and meds, and if you feel you can walk safely, then it's not so bad.
I did like the mantra that appeared over the weekend: Your front door is better protection than any mask! I wish to live long enough to be able to catch up this few months of discipline. Just a slightly longer Lent 
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