Flare symptoms

[Maddy42]

Can flare symptoms be different to the original pain?

I have been tapering from 15mg Nov 18 and have made it to 4mg but unfortunately due to circumstances and me forgetting missed two day doses. I’m now experiencing wrist pain in the morning. I thought it may be more RSI related as I’m the age that spends hours emailing on my phone but it is significantly worse in the morning. I’m not experiencing any hip or shoulder pain right now which at it’s worse was unbearable.

I’m tempted to take a quick week at a slightly higher dose to try and calm the flare up or should I bite the bullet and go up to say 10mg and start again. I would ask the rheumatologist I’ve seen once but he says it isn’t PMR because of my age and wants me off the meds ASAP at a rate of 1mg per month no excuses.

Unfortunately my job is very stressful and personal life has been a little manic recently as well.

Any suggestions?

[SnazzyD]

Firstly, have you taken any dose at all? Perhaps see what 4mg does?

[Maddy42 in reply to SnazzyD]

Thanks, I went straight back to 4mg as soon as I realised with little effect.

[SnazzyD in reply to Maddy42]

It is possible that you do have RSI and the Pred is getting too low to mask it. Long term Pred does make injury and strain more likely. Even if this is a flare, I would start making changes, such as breaks or a check on ergonomics to avoid RSI as the conditions are ripe for it.

[PMRpro Ambassador]

Flares can vary yes, and wrists are always a sign of flare for me. But as Snazzy says - first try 4 (or maybe 5mg) and see if it works, it often does. If not, take 5mg extra for a few days, up to 7 days you can drop straight back to the previous dose. That won't put you too far back on your taper.

I take it you have re-read your original posts and responses?

[DorsetLady PMRGCAuk volunteer]

As SnazzyD says just taking your normal dose may be enough.

Most people realise either the same day or the next that they’ve missed a dose, so if you’ve gone 2 days it’s probably not desperate enough to go a lot higher. But you might need a little extra for a day or so...,.see how 4mg feels today....then decide.

As you’ve got a busy life, and always on the phone - why not set a up an alarm on it, so you don’t miss your daily dose again.

[123-go]

It's so easy to miss a dose and I have been guilty of this. My very organised OH printed me a simple sheet with the month's dates and dose. I tick off for each day and write by the tick the number of tablets left in the strip. Works ok for me as long as I have the sheet and pen at hand when I have my breakfast!

[PMRpro Ambassador]

The easiest way to not mess up a dose is to get a dosette box - I have to do mine daily as I have to take meds at 5 different times of day, it even requires alarms on my phone for 2 of them! And I am quite capable of switching off the alarm and NOT taking the pill!!!

But there are simple 1x daily ones which can be used for a pred dose for each day of the week. Sit down quietly one day a week and fill the days and it is obvious at a glance whether you took today's dose or not! Get a monthly pack and that's you for 4 weeks! Also makes tapering plans clear without getting in a fankle more than once a month!!

[tangocharlie]

Yet another rheumatologist who says it can't be PMR because 'you're too young'. You may or may not have PMR, but you can't rule it out based on age alone