confusing advice

[Morant]

hi, I have been diagnosed for several years now with PMR plus side hiccups of GCA ( which, thankfully I did not have). My steroid dosage has altered from 50 msg to 15 msg over the years. My inflammation rates plus liver enzymes refuse to go down. At present I am on 9mgs steroids. I saw a rheumatologist two weeks ago and he told me on no account was I to increase the dose. My GP, who I saw yesterday, wants me to go up to 10mg as he considers I am having a flare. I have an ultrasound scan on Thursday and more blood tests Friday. My question is, do I take the advice of the rheumatologist or do I take the advice of my GP. I am seeing both rheumatologist and GP in two weeks time to see how I am doing. I do not know whose advice to take.

[PMRpro Ambassador]

Were you better at 10mg than you are now? Though if you ARE having a flare it is unlikely that just one mg more will sort it out - for a flare due to overshooting the dose you need we would suggest adding 5mg for up to a week.

Who has assessed the situation better in the past?

[Morant in reply to PMRpro]

thank you for the advice. I did think just going up by 1 mg wouldn’t be enough.

[DorsetLady PMRGCAuk volunteer]

Agee with PMR on treating flare and which doc is most helpful? Personally I think I'd go with GP...

[Morant in reply to DorsetLady]

thank you for the advice. It is after all my GP who knows me better than the consultant

[DorsetLady PMRGCAuk volunteer in reply to Morant]

Quite...

[Seacat30]

If it was me I wouldn't change your dosage until after the blood tests on Friday. That is so soon and you won't have 'muddied the waters'.

[Morant in reply to Seacat30]

thank you. Sound advice.

[piglette]

I would disagree with Seacat, others may say I am wrong. I would not rely or wait for blood tests, I would go on how I feel as to whether I raised my dosage or not. If I thought I were having a flare I would agree with PMRPro and increase 5mg to hit the PMR on the head and then reduce back in up to a week or so, possibly to 10mg, rather than 9mg initially.