Pred increased to 30 mg. Symptoms OK (more or less). Dexascan problems.

[LBM1953]

Hi all fellow sufferers. Result of my bloods last week showed further improvement in my markers. CRP down to 13 from 22 (106 highest). PV 1.79 (2.06 highest). Platelets and white cells normal. Blood sugar 49 (50 highest). Symptoms generally OK apart from shoulders and left hand/thumb which are more of a nuisance than anything else, and get worse as my medication time gets nearer. Doc wants me to be symptom free ideally before discussion about tapering and increased my Pred from 25 to 30 mg as a final push to see if that clears it. So far it has had little or no effect on shoulders and hand, except make me feel a bit weird to begin with, (nothing untoward). Is it OK to have some residual symptoms as I do not want to increase Pred even further? Doc wants me to stay on 30 mg until next bloods (15th July). Question. Do my markers all have to be normal before tapering? If the markers are OK, I intend to get back to 25 mg as 30 mg has had little effect on the residual symptoms. Is it possible to do this in one go or say 2 x 2.5 mg reductions? Finally Dexascan. I have been referred but the hospital has no record of my referral and in any case waiting time is 12 MONTHS!!! Going to go private (there are even private waiting times) but this also need a GP referral (which I am trying to obtain). Question. The company do Dexascans for Spine and Hips, or Spine, Hips and Forearms. Does anyone know whether either of these are suitable? Thanks in advance to all you Sages. Regards. LBM 1953

[PMRpro Ambassador]

Spine and hips is the usual - the forearm may be for people who have fallen onto an outstretched hand and had a fracture.

I think there are places that do private without a GP referral.

Is that blood glucose or Hba1c?

Your doc may want you to be symptom-free - it may not happen. Not everyone is and I would suggest a bit longer at 25mg is preferable to going to 30mg (guidelines say up to 25mg). It took a few months (albeit only at 15mg) for the bursitis and tenosynovitis symptoms to resolve. How long have you been on 30mg? I would drop back to 25 in one step - that would be a normal step down for most doctors anyway. A better monitor for most people at this stage is to check the ESR and CRP (probably PV in your case) and if they are down to normal levels and preferably stable you could start tapering slowly, keeping an eye on them. The usual starting dose is 15-20mg so it will carry on working even at less than 25mg, just perhaps a bit slower.

[LBM1953]

Been on 30 mg for 3 days. Blood test was Hba1c methinks.

[PMRpro Ambassador in reply to LBM1953]

Then dropping straight back to 25 will be no problem

[MrsNails]

Hi LBMHave the shoulders been an ongoing issue both befitted your PMR Diagnosis & since & the thumb? Could that be an injury or arthritis?

30mg is a hefty dose, so watch your Carb Intake especially with a high Hb1Ac - I’m a ‘nightmare’ on 30mg totally over the top & then some OTT+++ but l was only on 30mg x 1week; then 20mg x 1week then back to 15mg

It’s not long until they repeat your bloods so hopefully he’ll reduce you again. Keep us in the loop & try not to over do it with the extra buzz from the Prednisolone.

Kind Regards

MrsN

[piglette]

If you are paying for the Dexascan yourself and not using medical insurance you should be able to book an appointment without a doctor’s referral. It is probably a good idea to let your doctor know of course, at some point. Just go on-line for private companies offering Dexascan and phone up or email them.

[LBM1953]

Looked at a couple of private providers and they both say GP or qualified healthcare professional referral is required. Waiting for feedback from my GP presently. Will inform...