Does this seem right?

[ancientprune]

Last month's visit to dentist ended in a flare as I wasn't aware of need to increase pred.I was taking 6mgs and slowly went to 8.05 mgs since I was aching and stiff.Calls to rheumy went un answered until last week when he told me to take 10mgs ,I guess because I was still complaining about flare symptoms.Called him last week to find out how much to increase pred for upcoming dental this week and was told to take 15 mgs for 3-4 days then drop down to 10mgs.Does that seem long enough on 15mgs and how long on 10mgs before beginning to taper again?I never speak to him so can only question whoever calls from his office and she can't answer questions.I so appreciate all the help I get from this forum.When diagnosed I was told I had PMR,given pred and sent home.I'd never heard ofPMR so all I know is what you wonderful angels enlighten me with and it's been a blessing

[PMRpro Ambassador]

It sounds reasonable to me - I have never increased my pred for the dentist and have been fine so I think it is a suck it and see situation. If you still feel bad after the time of 15mg you can rethink but the pred won't stop a flare, only mop up the inflammation if it is there, The 3-4 days of 15mg is probably more to deal with any adrenal considerations under stress than anything else and you shouldn't need that for long.

[Mgt1234]

Hi, I had a wisdom tooth removed 17 days ago. I am currently taking 11mg Prednisolone (maintenance dose). I was advised to double my steroids the day before, on the day and the next day. I declined as I know I struggle changing the dose as I could trigger a flare up, PMR and GCA. I am pleased to say I was fine. I do meditate daily and have done for over 55 years so I think that certainly helps with managing any stressors, Hope this helps.

[MrsNails]

I always need additional Pred for Dental Procedures - on the old Blue Steroid Cards Dental Treatment is mentioned as something you must report to the Dentist up to a year after finishing treatment. Going to the Dentist stresses some people anyway but the actual treatment itself can cause your body stress.

Follow your Rheumatologist’s suggestion & see how you feel but having the 15mg BEFORE the Treatment will prevent the issues you had last time.

Myself l’d follow 15mg for 3-4days then 10mg for 3-4days then return to your previous dose.

After major surgery when l had Steroid Cover in Theatre my Rheumatologist put me up to 10mg for two weeks Post Op then back to 7.5mg

[ancientprune in reply to MrsNails]

Thank you for the advice but now my GP just called and told me to take 30mgs now an for.3-4 days after the dental work.I'm taking 8.05 and that seems like a huge jump.She states it's to mop up the residual from the flare I had last time.Now I don't know who to follow,rheumy at 15 mgs or GP at 30 mgs.

[MrsNails]

It’s very difficult as you now have more than one Medical Opinion - so unfortunately l’m really sorry but l don’t feel in a position to comment on who’s advice to follow.

Good Luck 🍀

MrsN

[Rugger]

I had an extraction when I was on 15mg and the dental surgeon / specialist said he would normally say to double the dose just on the day, but as I was on 15mg he said to take just 5mg extra.

It seems it's a case of "you choose"! You could follow the 'Sick Day Rules' on Pinned Posts.

Hope all goes well this week.

[PMRpro Ambassador in reply to Rugger]

That's in line with Sick Day Rules - double the dose up to a maximum of 20mg I think is what it says