Predisinol 5mg pain back

[andfio]

Morning all, husbands pain back at 5mg he is on day 4 of this dose .previously he was on 20 for 2 weeks 15 week 10 week .should we give it a few days longer for adrenalin gland to adjust or contact doctor to put it up slightly.He had bloods no inflammation signs 5.1 prostate cane back but after inspection slightly unlarged but nothing suspect for someone his age 58.doctor thinks its pmr after a flu virus thanks

[PMRpro Ambassador]

If it is PMR then he needs pred for a lot longer than it sounds he has been given. You don't give a short course and everything it is tickety-boo. Was he OK at 10mg? Not that he was there long enough to really know, He needs to go back to 10mg and then reduce just 1mg at a time every 3 to 4 weeks until he finds the lowest dose that works which will be somewhere between 10 and 5 from what you say.

I can't explain just now - have a plane to meet - but someone else will explain in more detail how PMR should be managed properly.

[DorsetLady PMRGCAuk volunteer]

You don't give very much info to help us - but are you saying he had dropped down from 20mg to 10mg after 2 weeks... and then 15mg for a week, then 10mg for a week? or am I misreading that?

If i'm correct then that's not way for PMR, but if doctors thinks it's a virus it would be okay.,..perhaps.

First issue is to persuade GP it's PMR not a virus...if it is - what symptoms did he have? Many GPs are thrown by the no discernable increase in inflammation markers, but up to 20% of patients don't.

Maybe have a read through this, and then you do need to contact GP to discuss the whole situation - the most difficult area may be getting them to acknowledge it's PMR...

healthunlocked.com/pmrgcauk...

...just for info, return of pains 4 days or so after a reduction, is prime example of PMR flaring....so yes, extra required.

Good luck with GP, and let us know how things go please...

[andfio in reply to DorsetLady]

Hi he was on 20 mg for two weeks tge 15 for a week then 10 for a week pain free at all of them he has now been put down to 5 ,doctor just phoned and said yo stay at 5 meantime as he is too young to be on

[andfio in reply to andfio]

A high dose long time and just take paracetamol also he isn't in as much pain as at first.I think doctor trying to get him as low as possible in case he is long term treatment

[DorsetLady PMRGCAuk volunteer in reply to andfio]

Well if it is PMR - and that may be the difficult thing to persuade his doctors, who I have to say seems to be pretty clueless about the illness…. Afraid to say the paracetamol is likely to do diddly squat for PMR - but at least if he tries it he can report back!

Plus of course he’s not in as much pain as he was at the beginning- and that’s down to the higherdoses of steroids initially !

The GP might be trying to get him low, but if it’s too low to control his suspected PMR then all he is doing is piling up trouble. …

I really despair sometimes when GPs have this approach - sorry that’s not helping you or your husband…don’t suppose there is another GP in surgery who might have a better understanding?

[PMRpro Ambassador in reply to andfio]

It is all very well being scared if higher doses of pred - but you need ENOUGH pred and if you don't take enough, you might as well take none at all. If you aren't on enough , the inflammation isn't fully mopped up each day so you start from a higher baseline each day, In the same way as a dripping tap will eventually fill a bucket if the water isn't removed at at least the same rate, the inflammation will build up until it causes symptoms again. Paracetamol will do nothing for PMR pain - if it helps, it is unikely to be PMR.

[Sharitone]

I won't interfere with the good advice you're being given, but - too young to be on steroids for long?😮 So where does that leave young people who develop lupus and are on significant doses for the rest of their lives? If you need it, you need it, however old you are, and if your husband has PMR, he definitely needs it. Poor chap. Lucky he's got you!

[piglette]

I can imagine your husband’s pain is back if being treated with that sort of reduction in dosage. I would question as to how conversant your doctor is with PMR.

[Flivoless]

From my personal experience, assuming he does have PMR, that rate of tapering is ridiculously fast and will be a case of diminishing returns. Insufficient Prednisolone will see him continue to flare resulting in him actually taking more Pred overall.

[andfio in reply to Flivoless]

Hi he says he only feels it about 20 percent compared to the beginning and it wears off as day goes on we have to phone doctor in 14 days will need to see what stage he is at then as doctor wants him to continue on 5 just now just hope that is enough for a full flair up thanks

[DorsetLady PMRGCAuk volunteer in reply to andfio]

If relief is only 20% at the moment, I fear it may get worse as the next 2 weeks pass...

Although it's no consolation, he isn't the only one to have to go through unnecessary pain whilst waiting for a diagnosis... he will get there eventually.

[andfio in reply to DorsetLady]

They are saying it is pmr but this seems to be the way doc is going i will def not be allowing him to go lower at review in 2 weeks just don't know how to do it without seemingly telling doctor his job so hard to even see a doctor now he has had only one face to face the rest of time we phone him he phones back and that's good in our area

[DorsetLady PMRGCAuk volunteer in reply to andfio]

Certainly no reduction until next appointment ..I fully understand GP doesn't want him to take more than necessary - but it's not the usual protocol..

[andfio in reply to DorsetLady]

No sorry I didn't make that clear relief is 80 % so pain is down to 20 % of what he was getting

[DorsetLady PMRGCAuk volunteer in reply to andfio]

Okay...well that's better then...guidelines do say at least 70 % improvement...

Fingers crossed.

[andfio in reply to DorsetLady]

Thank you so glad this group is here

[MiniSpec]

I developed PMR after having a very bad bout of the flu just after my 59th birthday. That was 13 years ago, and I've been on Pred since just before my 60th. So tell your husband not to expect to drop the dosage that quickly. He'll probably do more harm than good doing that, and it won't help him in the long run.

It isn't a race to zero. He may find he needs Pred for many years to come but at a lowish dose. The aim is to find the lowest dose he can manage where he still has some quality of life, not to get off Pred only to find himself bedridden with pain and stiffness.

Anyway, wish him the best of luck from me, and tell him that although he'll have to pull his horns in regarding physical activity, if he's careful and paces himself well he'll still have a long and active life ahead of him.

[andfio in reply to MiniSpec]

Thank you it is hard for him to reign in as we both are farmers and you can imagine workload i am monitoring him and taking over other jobs when a farmer says he is sore you know he is really sore lol

[DorsetLady PMRGCAuk volunteer in reply to andfio]

Farming is not a job, it's a way of life...not one personally, but plenty of family connections.. so I know where you are coming from.

[PMRpro Ambassador in reply to andfio]

The trouble is - the GP may not actually understand that. Good doctors do - when a farmer says it's a 6 on the pain scale, others would be out of their tree with it.

However well/pain-free he was on the starting dose after 3 or 4 weeks, that is the guide for the rest of the journey. You should never feel worse after a taper step than you did at the start. As I explained elsewhere - if you are on even a tiny bit too low a dose - it will get worse, not better.