Update and advice needed

[Buenavista]

Hi,

Just an update on my husband and a little advice please. (He's just turned 71)

After having a massive flare of PMR and suffered with Carpal tunnel syndrome and sleep deprivation. He is finally in a better place. He has a bone density scan in September, should have been earlier, but he missed an appointment while we were visiting family in the UK.

Pred decrease.

1st May started on 40mg

16th May 30mg

14th June 25mg

16th July 20mg

25th July 17.5mg

14 August 15mg

Then he's coming down a little slower. The problem we have in Spain is, we can't get 1mg tablets, only 30mg, 10mg and 5mg of pred. He knows it's not a race, he has had PMR since 2011.

He is now back at working on our large Cortijo, 2 Apartments, olive trees ect. (With not much of problem, apart from the heat and a foggy head)

Is it normal to still have a foggy head on 17.5mg of pred?

He needs a knee replacement, maybe October/November time. How low does he need to be on the pred before they will operate?

Kind regards,

Buenavista

[PMRpro Ambassador]

Is it normal to still have a foggy head on 17.5mg of pred? - for a lot of people, yes. Very much depends on the person. I would say it had not real effect on me, didn't even stop me sleeping!

Dose for replacement surgery - depends on the surgeon. Some are very iffy and want patients off altogether - whethe it is going to happen or not. Others shrug. admit they often have to operate on long term pred patients and are much more laid back about it.

[Buenavista in reply to PMRpro]

Thanks PMRpro, much appreciated

[cycli]

Dear Beunavista. Others with practical experience long term will be along soon. He is same age as me but 11 years and still at that dose indicates that he has had a troubled journey to my way of thinking.. Given what you describe as his work schedule I am guessing this continued effort to keep going as normal has curtailed his remission and suppression of inflammation. More detail on his journey over the years and about how serious the flare would help us to give better advise. sorry he is having issues and welcome to the forum.

[Buenavista in reply to cycli]

No, he got down to 5mg for the last 4 years. His last rheumy said 5mg was fine to be on, it wouldn't do him any harm. And then he had a massive attack. Now he's come from 40mg down to 17.5mg. And he's been on this forum for 11 years. Thanks for your input

[cycli in reply to Buenavista]

so sorry for this return. Any idea what triggered the attack? knee? but could it simply be his work schedule? sounds like his rheumy is sensible.

[Sharitone]

Foggy head - yes! Even at just 4mg, my short-term memory is poor, though I can think things through better than I could at your husband's dose.Tablet size - are they plain (rather than gastro-resistant)? If so, can you use a tablet splitter to make a smaller dose? I think you should be able to split them into quarters.

Or maybe the members who live in Spain will be able to give you their solution.

[Buenavista in reply to Sharitone]

Hi, yes I'm splitting them, thanks

[piglette]

I assume you can cut the tablets? Your husband seems to have done quite a reduction since May. My orthopaedic surgeon wanted me down to zero for a hip replacement, after some negotiation he agreed to 5mg, I think he may have agreed a bit higher if I had pushed it.

[Buenavista in reply to piglette]

Thanks piglets, I'll speak with the surgeon. Yes, I have been cutting the pred he has.

[piglette in reply to Buenavista]

Best of luck.