A flare again and how to add the 5 mg extra prednisone ? Split or together ?

[Iwillwin123]

I have GCA and tapering the steroid using DSNS method, from 60 mg onwards and now at 3.5 mg.

I now have severe right hip pain, excess urination and foul smelling urine.

I have given blood tests for kidney function etc, but believe I have a flare.

Hence going by the wonderful advice here ,and am adding 5 mg to my current 3.5 mg dose.

My questions

1) Is it better to take 3.5 as usual in the morning and then 5 mg at 11.00 night?

Or then is it better to club both doses in the morning itself ?

2) I will stay with the added 5 mg for 10 days and drop straight back to 3.5 mg after that .Is this correct ?

TIA

[SnazzyD]

Hello, first of all have you had the urine addressed and a test for blood sugar levels (HbA1c) recently? Are you still on Actemra?

What symptoms make you think you are having a flare?

[Iwillwin123 in reply to SnazzyD]

I have sent all tests for HbA1c and urine tests today.

But I have this severe pain suddenly in my hip .

Hence felt this is a flare.

Am still taking Actemra every 15 days.

[SnazzyD in reply to Iwillwin123]

Have you been doing anything that may have tweaked something such as repetitive or unusual activity, however small? Did it come on suddenly or creep up?

[Iwillwin123 in reply to SnazzyD]

It just started suddenly . No warning at all !

[SnazzyD in reply to Iwillwin123]

Sorry to keep on asking questions, but there really isn’t much to go on. The problem is that there are other issues than can occur, not just PMR directly so unless it feels exactly like the PMR you know, it is worth scrutinising rather than just hitting it with more Pred. Were you doing something or did you wake up with it? Were you doing something at the time and it just went ouch? Does the pain travel? What makes it worse? Had you been doing anything unusual or repetitive in the previous couple of days? Do you feel well?

[Iwillwin123 in reply to SnazzyD]

I felt fine until this hip pain just started off 4 days ago . Even now I am otherwise ok except for the bad hip pain.

[PMRpro Ambassador in reply to Iwillwin123]

Then you need to have the hip pain investigated - there are several things it could be and some of them more pred wouldn't help. A single joint being painful really isn't suggestive of a PMR flare.

[Iwillwin123 in reply to PMRpro]

I see ...... ok will have it also investigated by an orthopaedic first .

I assumed that if the pain started with no reason or warning - then it would be a flare .

Thankyou for the input .