Is it possible to have say 20 or 25mg prednisone for just one day, taken in the morning? We are hosting my sons engagement party slash surprise wedding tomorrow afternoon/evening here on our property and I’m struggling to get through a full day without a nanny nap. I know one dose will have me thinking I’m an energiser bunny and would get me through the the day/night but not sure if I should. I haven’t needed pred for over 18 months as my PMR has been stable but I have been on Plaquenil 200mg x daily for RA. Apart from stiffness on standing and this dreaded tiredness I’m actually quite active and mobile. I just know tomorrow is going to be huge, I am part of the wedding party believe it or not so the day is going to start with everyone here getting ready etc from mid morning. And I’m already exhausted…..🥴
Prednisone as a one off dose: Is it possible to... - PMRGCAuk
Prednisone as a one off dose
Hmm, two thoughts come to mind, if you do do it at that level you may find you feel rubbish as from nothing to 20/25mg is a huge jump and you may be affected in an unwanted way, especially your brain. We’re all different but id worry I’d become a hyper hostess that can’t stop talking, is over emotional, can’t think properly and is hitting the buffet like a mad woman. We’re all different but there is a risk it backfires. The other is a more long term concern is that if it is successful there may be temptation to do it again if you are able to persuade yourself that this time it really is an important day to get through, again. That is quite a hefty dose and whilst it may be out of your system in 24 hours, the effects can last longer and you don’t know what they are. I’d worry that my adrenal function might see it as any excuse to go on a go slow for a bit, even though the usual quoted period for that is quoted as about 3 weeks. I doubt any doctor would condone it but if you are going to do it anyway, I’d go for under 10mg, preferably no more than 5mg and take a more modest effect. I suspect you are having doubts because you’re asking here rather than slipping a few down and keeping it secret. I’ll be interested in other’s responses!
I appreciate your perspective here. And you’re right, I am hesitant to do it for both reasons you mentioned. I was on those devils tic tacs for nearly 3 years and the side effects and permanent damage has made me very cautious. In the past when I’ve had a short burst of pred it was either for a flare and only about 15mg which I tapered down using the DSNS method and it worked perfectly. The other was to treat a severe drug allergy rash. The dose was 3 days x 25mg and 3 days x 12.5 then stop. However I felt so good during that time with absolutely no pain or stiffness even from the RA damage.
I have never been above 15mg and that was taken to stop me being crippled. I would love to be off prednisolone. When I am I will try to never take it again. The thought of suddenly taking 25mg to stay awake through a party is completely alien to me.
When I was first diagnosed I started on 50mg. It took me 3 years to get off it. I have had a short burst here and there since but never a one off. I know 10mg doesn’t do the job, so I thought maybe hit it hard and fast just once. Might reconsider that idea.
Not a good idea as SnazzyD explains - maybe between 5-10mg - but a bit of forward planning and delegating jobs would be better.
Oh believe me I’ve delegated every possible thing I can. Everything is ready, not much to do in the morning. I’m super organised and I have a plan B for everything in case plan A goes sideways. It’s just I always seem to peter out around 2pm on a good day and I’m looking for a bed. Being in the wedding party means I’m with all the girls getting hair and makeup done and with it being a surprise wedding there are “costume changes” an hour into the engagement party. I’ll be so tired by then I’m likely to come out without shoes or something…
Get someone to help - otherwise there is always the risk you feel so unwell you spoil it for them too and that really isn't the idea. But there is the same risk of you take the big dose of pred - in theory it is OK but the practice isn't always the same.
If you haven't needed pred for 18 months - where will you get 20mg from? Old tablets are very likely to be past their expiry date.
You COULD do it - many patients get just 3-5 days of a high dose for chest infections or asthma, But is it advisable? Will it do what you THINK it will do or might it actually make things worse? You have RA - another autoimmune disorder and one that also factors in fatigue like most autoimmune illness.
I wouldn't - put it that way.
You’re right as always. I do have a secret stash of old pred of various mg dosage but on checking they are out of date.🤦♀️ The 25mg ones though I had last year to treat a rash ….see my reply to SnazzyD above. I know my sister often bursts with 5mg just for a day if she is going on a hike but I doubt 5mg would do the job for me and I don’t have any anyway. It would have to be 12.5 or 25 because that’s the tablet that’s in date. I’m taking everyone’s advice and abstaining. Maybe once I have a few champers I might perk up a bit🤣🤣
Champagne over Pred every day of the week - and delegate….
I with you! 🥂
I’m with you….see, told you I get tired after 2pm. And I’ve had a nanny nap today too.
Bubbles and delegation - perfect mix 
Sprinkled with the odd "No, I can't, so sorry" ...
You can sit and talk - I did at my daughter's wedding. And even disappear to a quiet corner - I did. It'll be fine.
Absolutely
20mg might give you wings but you may not be as normal as you think. I thought I was fine on that dose but I have had tactful reminders from family since that I was over the top and talked too much.
Another thought is that if you were to just be your current ‘normal’ and have a nap and not be like you’re running the United Nations or be on permanent display, would anyone even notice? Is this your expectation of normal service to others that is not expected by others? Your description of your planning was poetry to my ears, me to a tee. I am guilty of heinous levels of planning instead of trusting people will have a good time. I hope yours means actually there isn’t too much too worry about before you spend the day running about forgetting to be in the moment.
It might be worth your sister just doing a tot up of her cumulative dose over each month if she’s doing it often. Might be ok but if she’s doing for specific events the tendency is for one to draw a line under each one and not consider it as significant when it is over time.
I do become excessively chatty on mega pred. It’s just that it’s a long day and I need the staying power so I’m not nodding off in the corner. I’ve decided to go with the coffee and bubbles option, or vice versa….🙃
Good luck tomorrow Reeceregan, I hope the day goes well ☘️🎉🥂xx
Thank you very much. X
25mg is one heck of a dose - you never know how you might react - l was on 7.5mg Pred when l was given Dexamethasone pre & post each session of Chemo & believe me l was a nightmare l was so OTT it worried everyone around me but l was bouncing along……18months is a long time to be off Pred - l’d sit down today with a coffee, go through the plan to see if there’s anything you can delegate…..
Take a Deep Breath & Enjoy 🥂
I’m thinking start the day drinking coffee and finish the day drinking champagne might be the answer. With lots of food in between……😆
I'd try the other way round - bubbles for breakfast
Oh you’re positively wicked PMRPro! I always follow your wise advice 🤣🤣🤣
If you have to have orange juice for breakfast then diluted with prosecco please, Accompanied by scrambled eggs and smoked salmon (or even better smoked haddock ...). Now THAT is what I call an all-day breakfast 
That’s our ‘go to’ celebratory or ‘have houseguests’ or ‘just occasionally naughty’ breakfast😁. The combination can’t be beaten!!! I can’t have egg yolks on my OMS diet though (too much sat fat) so I have to put tofu & a touch of turmeric and ‘black salt’ (can’t spell palak namak??? ) in with my scrambled egg whites - just love that breakfast though 💕
The egg story about being bad fat has been thoroughly discredited and whole egg rehabilitated. But that doesn't get as much cover as the original incorrect theory did!
They never do, surprise that!
That’s true, but I’m on the Overcoming MS anti inflammatory (very low saturated fat) diet. It’s no meat or dairy at all (fish & seafood is ok) egg whites are ok but no yolk - no processed oils so nothing fried or cooked in/with any oil no matter how good it’s fats profile is. Basically a plant based whole food diet with fish and seafood thrown in. It’s not just the fats though - it’s some proteins in some meats that are suspected to rev up the immune inflammatory response which is what we're trying to avoid. It does have lots of reported success - it was started by professor George Jelinek, and he based it on the original Swank diet from the 1950 by professor Roy Swank - an MS specialist neurologist- published in the lancet in around the 80’s after 30+ years of research using his own patients, but by then it wasn’t accepted by some because it wasn’t double blind placebo controlled etc. As a lifestyle adaptation I guess it’s impossible to do that, but the epidemiology department in an Australian hospital is continuing to research this diet and lifestyle with 1000s of participating pwMS including lots I know - and lots of neurologists are just recently coming round to accepting it might well be a valid choice of managing MS - either solely or in conjunction with DMDs. When I was diagnosed there were no DMDs licensed for primary progressive MS so I saw it as my only hope. There are other diets out there but I checked them all out and none have the research to back them up like this one - and others are just charlatans trying to wheedle money out of desperate people. This one has a really humongous website and is a charity - it’s all absolutely free unless you want to buy a book (although they even give them away free to newly diagnosed people in the uk) or attend a residential retreat which obviously costs money - although I believe they do occasional funded places for people in hardship - sorry that was a massive novel wasn’t it??? I’ll be getting told off, as it’s not really PMR related. Although when diagnosed with PMR too, I did have to make the difficult choice as to whether to stick with OMS or try the recommended low carb one. I eventuality decided that as I’m stuck with MS for ever and if it started to progress more I’d be in real trouble, I’d better primarily tend to that, but the good side effects of the OMS diet is that you tend to lose excess fat anyway, ( my cellulite disappeared in abIut 6-9 months on it 😂,) and I’ve done fine with that. I wonder if the anti inflammatory effect of the diet has helped a little with my PMR journey 🤷♀️ I’m down to 1mg pred now after 2 years, although not counting my chickens on that yet as a flare is always a possibility lurking in the background 🙄.
No - you won't be told off, that is fascinating. And if it works - better still. I imagine it probably DOES help with the PMR. But you are right - observational studies are very unreliable.
For me it wouldn’t work like that. A big danger would be feeling awful or worse in an aggressive frame of mind. Can’t you factor in your self care nap with the help of friends and family? You’d be better off with a reviving glass of champers. Delegate and have a wonderful day!
The dawn has broken on the wedding day here in Aus and It’s a beautiful day. I’m just going to go slow and breathe! And chill the champers ….🥂
Have a Great Day 🥂
Have a lovely day.If you have less pain the tiredness will be less. Try arnica gell over worst areas- non sticky. I’m even using it if I have a frontal headache.
Enjoy every minute.
All the very best
I’m very intrigued by the surprise wedding. Who was in on it ? I hope it all went according to plan and you had a wonderful day . 🥂
I'm also intrigued. Never heard of an engagement that turned into a wedding, much less a surprise one. I very much hope that all has gone well with no unmanageable fatigue, and do please fill us in know the details of who knew about the wedding and why it was planned as a surprise.
Go somewhere quiet instead an have a nap. I have fine on many occasions. That is a lot of Pred and we never know how it will affect us. Have you tried paracetamol just to calm you down a bit 😊have a nice day either way
No ,please don't resort to pred in anticipation of fatigue.You can do this,you can be tired tomorrow.You have to trust your body,it will perk you up and keep you going with adrenalin and other hormones in response to the anxiety,fear ,dread that you feel now which joyously turns to excitement with all the fun with all the other people to keep the energy going!Not a downer but alcohol can make you a bit ?sleepy so keep the fluids going! I hope it all goes well for you and all,ENJOY your day,sounds like you have done all the hard work so well done you!Later you can congratulate yourself that you coped with it all! Best Wishes!
I upped to sick day rules for 2 days on second day I was awake for 24 hours yes 24 I will only use again in real emergency but I have been real rough with stomach flu. Awful. But it didn’t happen previously when I did so wait for more experienced people on here. I know nothing. Lol good luck with party.
You ladies are giving me wicked ideas. I’m invited to a wedding next month with 100 mile drive to get to it, followed by the ceremony at noon and hotel celebrations for the rest of the day. I’ve booked a room for that night at the same hotel but envisage fading away somewhat before the evening gathering ends. Can’t rely on the booze all day, I very rarely drink alcohol so would be drunk very quickly. However a bit more Pred !?? X
Can you stay the night before as well? Or at least break the journey staying elsewhere. Know it will make it doubly expensive -but travelling 100miles same day as wedding not a good idea. Presumably you can spend a restful hour or so in room anyway. Then you’ve got the return journey the following day -so you need a plan to pace yourself rather than rely on Pred.
You could take an extra mg or two with you, but really best to try and manage without unless really necessary.
I would travel the day before - that means you don't have the extra effort of the journey before you even start on the "do" and it takes away the worry about traffic and "will we get there on time???"
And I think tea might be preferable to alcohol as a crutch!
Thank you ladies , you are both right of course, I hadn’t realised it was the jubilee weekend when I booked the one night, so traffic might be a factor. Think I may see if another night is possible. I’ve just got nicely established with my Pred regime after a rough beginning so maybe err on the side of caution. X
Most definitely traffic issues - so take more time if you can - then you can enjoy the day -which is the main thing…
👍🏼👍🏼👍🏼
I wouldn’t take the pred as others have indicated. Forget worrying and enjoy the day. Use relaxation techniques. Sounds sooo exciting and you are organised. Am intrigued about the surprise wedding following an engagement party! Sure you’ll be able to snatch a short nap to keep you going. Have a great time and collapse the following day! 🥂🎉🥂🍾🎂🥂🎉🥂🍾🥂🎂
Good morning everyone. It’s Mothers Day here in Australia and it is the morning after the wedding. What a night. First of all thank you for all your advise and support. I didn’t take any pred, I tried ( but failed) to rest through the day but adrenaline just kept me going until after midnight. We’ll see how I go today but I plan to go slow from start to finish. For those of you wondering, we pulled off the surprise wedding like a dream. The only ones who knew were the bruise and groom of course, myself and my husband because it was held on our property, my daughter who was the MOH, and her husband, and the best man and his wife who had to travel for the occasion. It was a small affair with 50 guests, we had a marquee setup in case it rained with a large grazing table table full of wonderful food and fairy lights. Chairs scattered around with a few outside heaters as it was a cold night. Dress was semi formal so not over the top, The wedding party started the night in semi formal clothes, and as everyone arrived we mingled for the first 2 hours. The celebrant arrived in his semi formal wear 2 hours in,, and also mingled, introducing himself as the music person. A short time later, the bride, myself, and my daughter disappeared inside to do a very swift change into our wedding clothes. It didn’t take long, we had it down pat. We messaged the celebrant that we were ready, who had a very small portable microphone and while we were sneaking out of the house via the front door and around the garage to hide behind the hedge, (everyone was out the back of the property) he called everyone together and announced the party was a surprise wedding. The chosen wedding song started and I led out along our paved poolside walkway , followed by the MOH, then the bride. When I got to the end of the walkway I waited, then my daughter waited, then when the bride reached us we linked arms and the three of us walked the rest of the path either side of the bride and up to the groom. And so it began….The surprise and the wedding went off without a hitch, and now as I am having my morning coffee I will plan the easy day ahead, and start contacting family and friends who couldn’t make it. It was a great night and I didn’t notice the pain or the tiredness until I crashed into bed. It made for a good nights sleep though. X
Can’t believe I called the bride the bruise. Oh dear, maybe I didn’t sleep as well as I thought. And I am definitely paying for yesterday. So much pain as the day progressed. I will deal with it. Bed will be my friend for a few days I feel.
What a brilliant idea!!!
So pleased if all went as planned. Well done you for getting through a wonderful day. Congratulations. 🥂
Oh my goodness what a day!! What an amazing wedding! Lovely, so exciting for the guests!! 💕💕💕Interested to hear everyone’s thoughts on this, I too have a wedding coming up, but just as a guest. And it is a worry how to cope with a full day of festivities!! Great advice from everyone and so glad your wedding went like a dream! Thank you for your lovely details of the day!! Congratulations to happy couple! 💕💕💕
Just thought I’d update you on the latest development regarding the wonderful surprise wedding, My husband and I have both tested positive to COVID yesterday. Buckle up, we’re in for a ride!
No surprise really. Hope you don’t have too bumpy a ride…..
I think we were the spreaders. Symptoms started on the Sunday but we both thought we were just extra tired from the day before. Then the scratchy throat showed up in the afternoon and it was downhill from there. To both test positive on the same day though …🤔. Given we have no restrictions at all and close contacts of positive cases no longer have to isolate it was only a matter of time. No one else who was there have any symptoms or tested positive since so 🤷♀️
Be surprised if no one else gets it but look after yourselves and hope you get through it unscathed. A different memory for the wedding album! 🌺
He’s the surprise wedding with an extra surprise!
Where are you in Oz?
Near Newcastle, but on a property in a little bit of country called Stockrington. One street, half a dozen houses, but only 45 minutes to the beach. It’s peaceful but close to everything.
Sounds Idyllic. My son lives north of Brisbane on the Sunshine Coast - very hot though….
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