Feeling desperate

[ancientprune]

3 weeks ago I was taking 6 mg of pred.Didn't know to increase pred before my dental procedure and it caused a flare.Inched my way by.05 mg backup to 7mg but symptoms are getting worse,feet and ankles swelling,stiffness and ache in back,shoulders and arms.can I up the pred and how much then start my taper again in a month?In 2 weeks I'm having more dental work so called my rheumy to see how he would advise me on increasing.Based on my 7mgs he told me to take 10 mgs for a week then go back to 7 mgs.Of course I only got to talk to his nurse and when I asked if I needed to taper back to 7mgs or just drop from 10 to7 she didn't know.Had also told her to ask him about fever and night sweats but got no response.I've written Sick Day Rules and if I increase pred would I go by doc's advice and take 10mgs for a week or go by SDR and double that dose until I'm better.I'm so sorry to carry on so much but this forum is the only place I can get help and I'm thankful for it.All your advice is appreciated so much.

[SheffieldJane]

I think if you increase to 14 to cover your dental treatment you ought to be able to return straight to 7 mgs without tapering. You are covering your extra cortisol requirements just for the procedure. This has worked for me before. I remember feeling a bit niggly but not like a full blown flare. 10 mgs might not be enough because of your current symptoms.

[ancientprune in reply to SheffieldJane]

Thank you so much ,for that advice.I was doubtful that 10 mgs would be enough,especially because of what happened before.This forum is a lifesaver

[HeronNS]

I believe one can be on a higher dose for a week or so if necessary and still drop back to the lower dose without tapering. Like SheffieldJane I think 10 would not be quite enough under the circumstances. Twelve (extra 5) or 14 (doubling 7) should be. Good luck!

[ancientprune in reply to HeronNS]

I wish our docs could have this disease just for a week to see what we go through.Thank you for the help.I knew nothing before I found this forum nd it has really been a godsend

[HeronNS in reply to ancientprune]

Me neither. I remember when I first had some withdrawal symptoms after about two months on pred I went on line in the middle of the night and found another forum, later this one, to ask what I should do. It was fantastic the help I got, the support I still receive. I was lucky in that I had a reasonable doctor but the best medical experience I had was with a locum one summer who has MS. She indeed understood the challenges of dealing with a chronic illness.

[PuttyPenguin]

Sorry ancientprune but I have no advice to give other than when I had dental surgery my rhuemie didn't know of any 'paper' suggesting that a patient needed to up their pred for surgery. It was my dentist who suggested that I did. As it was, I stayed on 15mg with no ill effects. But I'm really glad you've brought this up - it just shows how useless my advice has been from the rhuemie - this is the 3rd time he's given me 'uneducated' advice - and that advice on here is far more superior! I would take the advice given to you on here. Wishing you well.

[ancientprune in reply to PuttyPenguin]

Thank you. I'm not looking forward to it but it is necessary.This forum is such a blessing

[PMRpro Ambassador]

Try adding 5mg to where the flare has happened if the 10mg isn't enough. You can stay at that raised dose for up to 2 weeks and drop straight back to the previous dose without a taper - though some people do it in a couple of steps with a couple of days at each dose.

The trouble is that you don't know whether the disease activity has increased to cause the flare so you may need to test it out a bit. The fact you have the fever and sweats suggests that maybe this could be a proper flare.

[ancientprune in reply to PMRpro]

Thank you for your wisdom.It's very reassuring to have someone confirm what I've been suspecting.When the symptoms I experienced when first diagnosed began returning I began increasing pred.05 mg from 6mg every couple of days and am now at 7.05 withsome relief but feet are swelling.Tomorrow I'll go to 8mgs and stay there to see what happens