Hello , after having PMR for eighteen months and been up and down with the Pred , I’m down to six at the moment, I have an appointment with a rheumatologist at the end of the month.
I was just wondering what to expect , do they actually do anything . I was told by a friend to expect injections. Is this likely ? Getting a bit worried now . ☹️
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Why would you (or anyone) expect injections? intramuscular injections CAN be used for PMR and even GCA but to be honest, I think in general tablets are more reliable and easier to taper unless you have a very reliable doctor. You have to use them correctly.
At this stage it seems a bit pointless! You are down to 6mg and if you are sensible and don't try heroics with the dose you should be fine now. You can carry on tapering towards an even lower dose and allow adrenal function a chance to wake up gradually.
Thank you, I totally agree with you. The thought of an injection never entered my head until it was mentioned, then I have to say it has worried me. I am happy to carry on with the Pred for as long as it takes. I did get down to two and a half at one stage then had a flare up so it slowly went back to seven. So I’m coming back down again.
Creeping up never works well - add 5mg to the dose where you flared for up to 10-14 days and if everything settles down you can drop straight back to the last dose where you are good, usually not the dose you flared at, 1mg above is usually fine. Slow works on the way down!!!
I have been on 6 for two weeks now , would you drop to five and half or five at this point ?
I wouldn't - the lower, the slower! As you get lower you are obviously closer to the dose you are aiming for: the lowest effective dose, the lowest dose that works as well as the starting dose did. It often takes 3 or 4 weeks to discover te new dose isn't quite enough - more haste, less speed.
OK thank you , I will follow your advice and stick with 6 a bit longer.
In the FAQ section you can find tapering plans - one by PMRpro (DSNS) and Dorset Lady's plan. It makes it easier for you to follow one of the plans.
I totally agree with Pro. Stick at 6 mg until you feel like you are relaxed again after your Rheumy appointment. You are bound to still feel a bit nervous until you see them even with good advice and that stress doesn't help you taper successfully.Even travelling to the appointment and having it can wind your system up a bit. Better stick on this dose if you are comfortable on it than risk a flare . It will also give evidence to the Rheumy that your taper is working well for you if you have symptoms under control when you see them.
Hello Anieand, I saw Rod Hughes at Chertsey about three years ago and he offered me a depomedrone injection to see if it improved my pain at that time. I was on 8mg pred and remained at that dose until earlier this year, so you can see for yourself that the injection didn’t change things for me. Maybe that’s what you might be offered.
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