Dealing with a flare...

[PPower]

I've read many posts about dealing with a flare and it seems that adding 5mg pred is a good place to start. My partner was down to 5mg and now she's getting tons of pain. Had her CRP and Sed rate labs done and in fact, her CRP is above range so we're now sure it's a flare. She first tried 9mg and by the end of the day, she felt quite good. Next day, we tried 10mg and again, it took most of the day to feel better (might've added a couple of tylenol too). Today, when getting out of bed she said the pain feels just like when she was diagnosed 6 years ago. We went up to 11mg because even the 10mg didn't work as well as she'd have liked. This time, she expressed feeling better in about 30 min. I think we've found her number (i.e. 11). Will follow other instructions written by DorsetLady. Many thanks.

[DorsetLady PMRGCAuk volunteer]

She may have found that a few days at 10mg would have sorted things -does take a few days to clear out accumulated inflammation-doesn’t always work with just one day of increased dose.

But you seem to have got there now -so good -but if it’s purely PMR then shouldn’t need Tylenol as well.

[PPower in reply to DorsetLady]

She has other things going on, like OA and bursitis. I think the pred wasn't working right away as we're used to when she's in a flare. Maybe she'll stay a couple of days on 11 and then go down to 10.

[DorsetLady PMRGCAuk volunteer in reply to PPower]

okay - but if she’s flaring regularly maybe you need to think about addressing that. If it happens repeatedly it does have a habit of getting more difficult to get back under control each time.

Is she on a slower tapering regime? If not, see this -

healthunlocked.com/pmrgcauk...

[PPower in reply to DorsetLady]

She does do a slow taper but not exactly like yours, I think we'll follow that exactly this time.

[DorsetLady PMRGCAuk volunteer in reply to PPower]

..and as PMRpro says when she restarts only 0.5mg a time..

[PPower in reply to DorsetLady]

Will definitely do that. Many thanks!!

[PMRpro Ambassador]

It is a common experience that after a flare due to too ittle pred that it is harder to get symptoms under control. Is it always at a similar dose that she flares? If so, that is your body telling you it isn't ready to go that low so stop before you get there and take a couple of months break before trying again and then with a really slowed taper and only 1/2mg drop.