Should I increase pred with covid.

[Chewy21]

I have had a positive covid lateral flow test and am doing a pcr test today, I think it will be positive I feel rough my head is killing and feels like I've swallowed glass 😢 has anyone here had covid I don't know if I should increase my dose while I'm ill or not? I am currently on 12mg and did take am extra 1mg yesterday because I felt like I had been battered. I have had both jabs.

[SnazzyD]

Sorry, you’ve got this. From my experience of it, keep an open mind! You can get all sorts from this but also it can be relatively straight forward. You are on 12mg so sick day rules for adrenal function don’t apply here. If you need to increase it needs to be under medical supervision. For example if you pop up the dose, depending on how much, your potential for secondary bacterial lung infection may go up because there is more immunosuppression. Also, if anything was to be brewing the symptoms may be suppressed. Therefore you would need antibiotic cover as well. IF you did need extra steroid for it, you may be given something other than Pred anyway. The feeling run over is par for the course and part of it, not just PMR related, so increasing Pred to help that isn’t a quick way out also for the reason stated. So I’d say stay calm, don’t think the worst, deal with one day at a time. Remember although there are lots of horror stories, there are many more better stories too.

[Chewy21 in reply to SnazzyD]

Thank you that's really helpful. I took the extra 1mg yesterday because my back and shoulders hurt so much but I have gone straight back to 12 this morning and hopefully that will be ok. I do expect to feel aches and pains my husband had symptoms a few days before me and is still aching. I do have scarring of the lungs from a severe bout of whooping cough when I was a kid and a bit extra from pneumonia a couple of years ago so it is mainly my chest that worries me so I will be keeping an eye on that and maybe contact my gp when I get my results for advice.

[SnazzyD in reply to Chewy21]

I couldn’t move for 4 days and then it stopped in order for other fun and games to begin. There really is no telling what will happen, it seems to like to roam around the body. I have a scarred lung from radio therapy and got a secondary infection as well as the rubbish Covid breathing for a few months. No hospital as back then they didn’t know about it so we had to muddle through on gut feel as to the best thing to do. Funnily enough I knew instinctively then that lying on my front was a good thing. When my bacterial do set in about day 10, it felt different in that apart from just feeling puffed my temp kept spiking after a few days of being ok. I suddenly started to produce yellow sputum that I had to cough up. After a week on co-amoxiclav that went and I was left with that feeling of not enough puff that was the Covid for three months. I did do sick day rules then because I was on 1mg Pred. BUT, I have no problems now. Anyway, my father-in-law with appalling lung function and scans bounced back in 2 weeks after being practically moribund.

At least docs are now a bit more informed. Do you have a pulse oximeter? Jolly useful for knowing if your oxygen saturation is ok or not, which I found sometimes hard to tell in either direction. It cost about £50 but so useful.

[Chewy21 in reply to SnazzyD]

Sounds like you have a rough time with it then, my daughter had a secondary chest infection after covid last year she has got asthma but antibiotics cleared that up quite quickly. I am worried about my husband because he has got copd. I do have an oxymeter bought one after having pneumonia. My levels were fine yesterday but I will be keeping an eye on it as my husbands has been a bit lower, not extremely but will be keeping an eye on his too. Its frustrating getting it now just when I'm due for a third jab and we had been so careful right through the pandemic.

[SnazzyD in reply to Chewy21]

Yes, falling at the last fence must be annoying. Hopefully you will be brim full of antibodies.

[Chewy21 in reply to SnazzyD]

Yes hopefully, thank you.

[Rugger in reply to SnazzyD]

I thought the 'Sick Day Rules' say that on doses between 10 and 19mg, to increase to 20mg. What I don't know is how and when to decide to follow the 'rules'! How sick should we be?

[Chewy21 in reply to Rugger]

I am not sure about it I increased just by 1mg days before yesterday but stuck to the 12mg last two days. Do feel rough today though so I might just increase by 1mg again later if the muscle pains don't improve.

[SnazzyD in reply to Rugger]

To me it seems sensible to seek medical advice once starts to enter immunosuppressive levels of Pred.

[Chewy21 in reply to SnazzyD]

I haven't had my results yet only from a lateral flow test. Although I think I would be a bit disappointed now if it turned out to be negative after feeling like this.

[PMRpro Ambassador in reply to Rugger]

Off the top of my head I think it is double the dose up to a maximum dose of 20mg. But despite the production of that information leaflet - a lot of doctors still seem blissfully unaware!!!

[Chewy21 in reply to PMRpro]

I would only increase if I felt I really needed to and apart from one day where I just did the 1mg increase I've stuck to my usual dose. I would check with my gp first if it gets worse though.

[Rache]

Sorry to hear your news, very galling for you when you have had 2 vaccines and been very careful. Hopefully your vaccines should lessen the severity of the illness as that is what the experts are saying.

I have had the same vaccines and do my best to avoid risk but I have two lovely granddaughters aged 5 and 7 and pick them up from school once a week. This worries me of course but I didn’t see them at all for a while during lockdown and would be very sad never seeing them at all. Whatever I do, the worry niggles are there. Some of the younger members of my family don’t seem to understand. I think they feel I’m exaggerating having had my 2 vaccines, even though I have explained the ongoing risks. It can feel very lonely trying to stay safe!

Take care of yourself and hope you start to feel better as soon as possible x

[Chewy21 in reply to Rache]

That is tough isn't it with grandchildren especially with cases so high in schools at the moment but I know what you mean we have been seeing some of ours lately, two already had it last year but none of the others have yet. I feel the same way some don't understand our worries with it I know my antibodies after both jabs were minimal. Thank you. 😊

[PMRpro Ambassador]

You need to ask your doctors - although 12mg should be plenty it won't be like the spike your body should produce in response to illness.

Frustrating about the third jab - but a dose of Covid is being considered by some as equivalent to another jab, you will develop antibodies to the infection too.

[Chewy21 in reply to PMRpro]

Yes my doctors are not there today so maybe I'll ask tomorrow I have stuck to 12mg for today so far and I expect to feel rough for a few days just don't want a flare. Yes when I booked the home tests they asked if we would participate in two antibody tests afterwards if we get a positive. One test a few days after and one a couple of weeks after so will be interesting to see the results as I know my antibodies were minimal after both vaccines.

[SheffieldJane]

Poor you! This has to be a question for your doctors. We are all in new territory with Covid. Get well soon, it sounds really horrible. 🌻

[Chewy21 in reply to SheffieldJane]

Yes my doctors are not open today but will be tomorrow if I feel like I'm struggling. Thank you, so far it's the headaches the worst.

[PMRpro Ambassador in reply to Chewy21]

There is always 111 for out of hours care. And sometimes they are better than the GP!!

[Chewy21 in reply to PMRpro]

I feel like I can manage it ok so far I know I'm bound to feel rough, I haven't upped my steroids today and seem to be coping ok. I will keep 111 in mind if I get any worse, thank you