My first flare

[Booklist]

Hi everyone

Looking for some advice. I was diagnosed with PMR in December 2021 and started on 20mg Pred. By now I had tapered very successfully to 8mg and was considering a drop to 7.5 when disaster struck. I had a stomach upset for 2 days. I looked at the Sick Day rules - no fever, so stay at normal dose. 2 days later I had a flare, and I have never felt such pain. I increased my dose by 5mg to 13. My Dr was happy with this, and gave me an appt for another telephone consult on 14 March. My question is do I stay at 13mg for now, or begin DL slow taper as and when I feel ready. I still have some stiffness and discomfort in my neck and shoulder and am terrified at the possibility of another flare. but I know my Dr will want me to reduce my pred.

[PMRpro Ambassador]

How long have you been at 13mg? If the flare is just from being unwell, you may be able to go back to just above the dose where you flared and were fine before providing it is less than 2 weeks on 13 mg.

[Booklist in reply to PMRpro]

I have been on 13mg since I was ill, i.e.17 February. Before that I was comfortable on 8mg and doing DL's taper to get to 7.5, but I've definitely been on 13mg for over 14 days, as advised by Dr. I suppose she will tell me my next dosage when I speak her on 14th, but I feel she always wants to rush me.

[DorsetLady PMRGCAuk volunteer]

This link gives usual advice for a flare which you've followed , so it really depends on how you felt at 8mg -

healthunlocked.com/pmrgcauk...

if okay then maybe drop down to say 8.5mg [just as a precaution] stay there for a couple of weeks at least before you commence tapering schedule.

if you are uncertain, then perhaps a couple of steps, first to 10mg for around 5-7 days then to 8mg. You don't need to do a slow taper from 13mg, so long as you haven't been at that for more than 14 days as PMRpro has said.

[Booklist in reply to DorsetLady]

Thank you for your reply. As I wrote to PMR Pro, I have been on 13mg since 17 February.

[DorsetLady PMRGCAuk volunteer in reply to Booklist]

So 16-17days approximately - you may get a way with it…..maybe try the 2 steps down as I suggested…staying on the first step to gauge how you feel. And how you feel at the moment?

[PMRpro Ambassador in reply to Booklist]

Yes, I agree, you may not need to be very slow - I'd drop half way and see how I got on and then think about the other half in 2 steps10 days apart maybe.

[piglette]

How do you feel now? Did the increase in steroids sort things out? If so you can reduce down again quite quickly provided you upped the dose within the last two weeks as the others say. Also it is better to drop in two stages to make sure things are OK again.

[Booklist in reply to piglette]

Thank you for your reply. I have been on 13mg since 17 February so no quick fix!

[piglette in reply to Booklist]

Good luck with the reduction anyway!

[Booklist]

Thank you all for your good advice. Basically I think I'm terrified of triggering another flare. I'll see what the Dr says and how it fits in with your advice. I'm away for a few days next week so I'll wait until I am home again before making any changes.