PMR flare. Should I up my Prednisone?

[HelenDaisy]

I had sudden-onset PMR a year ago, and I've got down to 10mg Pred. since, other than needing 12mg for 5 days for a blip in Feb. I've been able to keep teaching my exercise classes and live fairly normally. I'm on anti-anxiety medication, but have recently stopped my sleeping pills, as we have a new puppy who I need to listen out for. (How lucky am I: a gorgeous new puppy!!)

That's my brief background. I've been under stress due to new ways of working, and issues related to coronavirus. My question is that the old awful pain and exhaustion is back, so am I correct in thinking 5 days on 15mg would 'see off' this flare?I'm seeing my rhuematologist in May, but until then I feel very much on my own.

[PMRpro Ambassador]

Not necessarily at all - if a flare is due to a brief blip it will usually do so but if the flare is due to an ongoing increase in stress leading to an increase in the underlying disease activity then it may not. The fact it also happened in Feb makes me wonder whether the 10mg is just a tiny bit too low and over time the inflammation is building up to a level that causes symptoms - it may be 10.25mg or een less you need overall but 10 just isn't quite enough,

The only way you can find out is to try - but I often say it is better to go back to very slightly above the dose at which you flared.

[HelenDaisy in reply to PMRpro]

Thank for your reply. I did take an extra 5mg this morning and do feel better now although some pain remains.

I understand what you mean about trying 10.25mg or 10.50mg, as I have been increasingly painful now I think back!

Do you think I should stay a few days on 15 to stabilise and then drop back to the lower dose?

[PMRpro Ambassador in reply to HelenDaisy]

Worth trying I'd have thought. I wonder if 10mg with 11mg one or two days a week would be enough?

[SheffieldJane]

You need to discuss the “ new ways of working” that clearly do not suit you.

I am glad you have a dear little puppy to love. If you have a choice at all, I would look at taking a break. Your body is telling you loud and clear. You are already unusual in being able to do a job like this. Good luck! X