Flare question

[winfong]

Didn't see this covered elsewhere. I had a post-Covid flare, so bumped my pred from 6 to 11. So far, that hasn't had much effect. It's been almost a week now. Should I up some more? Thanks

[PMRpro Ambassador]

Is it a post-Covid flare - or is it the Covid still?

[winfong in reply to PMRpro]

Post-Covid flare. All the same symptoms from before - mainly pain in hips, knees, and shoulders, with fatigue. Covid was more cold-like - sniffs, coughs, sneezes - and gradually disappearing.

[PMRpro Ambassador in reply to winfong]

Suppose one's concern has to be whether it has kicked the immune system so hard you are back to the start .. In which case - you need what you need.

[winfong]

Wouldn't you know - I'm finally feeling better today. Now, what should be my plan?

Previously (when bumping up worked right away), I'd get back down pretty quick. Should I do the same? Should I wait a few days before I do that, to make sure everything is okay? Should I bump back down gradually?

Any words of wisdom would be most appreciated, as I don't want to screw this up, and already had a bit of a rough ride with Covid and then rebound Covid.

[PMRpro Ambassador in reply to winfong]

It isn't uncommon for it to get harder to get flares under control - even just yoyoing the dose will lead to that. I do think I would be more cautious about the reduction.

[winfong in reply to PMRpro]

I think I did do some yoyoing, thanks to the rebound Covid

[Merryfield]

Glad you are feeling better. I'm all about talking to the doctor about the ups and downs of the medication...everyone has a different chemical make-up. I'm slightly symptomatic even on 40 mg s of prednisone a day. Switching over the Medral tomorrow to see if insomnia subsides.

[PMRpro Ambassador in reply to Merryfield]

I do hope it works for you but if you mean Medrol (methyl pred) then it can have worse side effects. I have had no trouble with prednisone or prednisolone but methyl pred was a very different matter. The "methyl" part if the structure is supposed to make it more effective as an antiinflammatory but it can also increase the adverse effects.

[Merryfield in reply to PMRpro]

Thank you. I will pay close attention. Doc thought it would be better for insomnia. All of this dosing is basically trial and error.

[PMRpro Ambassador in reply to Merryfield]

Beats me why he thinks it would be better for insomnia. Steroids are steroids ...

[Merryfield in reply to PMRpro]

dunno

[winfong in reply to Merryfield]

Well, I was feeling better yesterday. Today, not so much.

Definitely giving my endo a call.

[Darkchocolate1]

I had covid in September and had a fairly serious PMR flare following it. I had to go up 2 mg from 13 mg to 15 mg and 3 months later I am still at 15 mg. I have tried 14 1/2 mg and make it three days and the pain begins to come back. I guess it takes a long time to get back where you started before covid. PMR challenges all of our patience.

[HeronNS in reply to Darkchocolate1]

Try a slow taper next time. Even half a mg can take a bit of getting used to and there's no reason why you have to be in single digits to use a slow taper, taking several weeks to introduce the new dose. But only if the 15 really is what works and you don't need a tad more just now. I never encourage anyone to take more than the barest they need, but you do, as PMRpro said, need what you need.

[winfong in reply to HeronNS]

Thanks. I did a super slow taper to get to 6. I just hate that it feels like I'm starting over from scratch.

[HeronNS in reply to winfong]

I can relate to that feeling!

[Darkchocolate1 in reply to HeronNS]

I have tried the slow taper, 1/2 mg at a time and each time I get a flare going down the next half. It looks like I need 15 mg since having Covid on Sept. even though I was at 13 mg before Covid.

[HeronNS in reply to Darkchocolate1]

That is possible. It seems to take some time to get over the after effects of covid. My husband had covid in April and although he doesn't have PMR he's always had sinus and tendency to respiratory problems, and these have both definitely been worse since. He turned 80 this fall and that hasn't helped either!