Over 8 Years with PMR and still finding it difficult

[DavidMF]

Having spent 9 months since July 2020 moving from 5megs to 4 megs of Pred. I felt good and settled at 4megs. With life's ups and downs, each time I thought of trying another SLOW reduction. Something would change, not feeling great, Covid and it's after effects even though it was slight.

I then settled for 4megs and carried on with life i'm currently 78. 4 months ago I strained my right arm/shoulder, this has slowly got worse. Then 7 weeks ago or there about, I accidentally took 5meg tablets instead of 1meg, making my daily dose 20 megs, split 10 in the morning 10 at night.

It wasn't until about the forth day I found myself say "Wow I feel good" a minute later it struck me I'm taking too much Pred and checked my tablets and found the error. The boxes look so alike, I always carry a box of 5's just in case. My error, I thought for a while and then decided to cut straight back to my old regime. 2megs in the morning , 2 in the evening. Slowly I went back to normal.

Over the last two weeks my hand pains have returned, first my right finger, then my left. My shoulder is difficult to sleep with but 2 paracetamol help out. Other aches and pains are starting to arrive.

Am I just getting older, blood test test last week (Annual) all shows O.K. CPR not tested, but would it show?

Should I try 5 or 6 megs for a couple of days ?

Don't feel like burdening the Dr, even if they could understand.

Anybody else experienced this ?

[DorsetLady PMRGCAuk volunteer]

Might be sensible to try an increase for a week or so (a couple of days probably not long enough) - but not sure 6mg will be enough- but you won’t know until you try.

This link contain usual advice for dealing with a flare -

healthunlocked.com/pmrgcauk...

If it works -back to 5mg -not 4mg daily -then a slower tapering plan if not already and 0.5mg reduction at a time - rxsmpjes here -

healthunlocked.com/pmrgcauk...

[DavidMF in reply to DorsetLady]

Many thanks, Good reminder of the problems of reducing. Having held at 4megs for two years I was getting to feel guilty, I hadn't tried to reduce.

[DorsetLady PMRGCAuk volunteer in reply to DavidMF]

Don’t feel guilty… 4mg is a very low dose, and if that’s what you need, it’s what you need.

[SheffieldJane]

We have all done this. A dosette box keeps me fairly straight , it sounds like you need a bit more to cover your inflammation. I have just returned to 5 mgs after having a really over the top reaction to 4.5 mgs. Why not give the whole tapering malarkey a rest until the cherry blossoms and daffodils are all properly out?

[DavidMF in reply to SheffieldJane]

Thanks for that, I'll await the Daffs. but will try a small increase. Stress may have not helped,

[PMRpro Ambassador]

I would definitely try 5 or 6mg - but you might need 7mg. who knows. But be sure the pain doesn't improve with regular paracetamol first. It is swings and roundabouts and if it is something else the higher doses of pred can mask several things. I believe 1 or 2 mgs extra pred can be justified for a better QOL but you have to achieve a balance. And the GP may not see it the same way! Get your ducks in a row first

[DavidMF in reply to PMRpro]

Thanks so much, I've been getting over confident having 2 years at 4megs, not sure If I upset things with the extra doses. I'll increase tonight and for the next 5 days and see if I improve, otherwise it's off the the Dr and hope they can understand, or offer a better solution.

[Rugger]

I had been off pred for 8 months and then needed a tooth extraction at the hospital. They told me to take some pred to cover the procedure. I took 5mg for 3 days and then realised that my aching hip and shoulder were less painful! I'm now back on 5mg daily!! It took that episode to let me know that the aches and pains were actually a relapse of the PMR. I discussed all this with my Rheumatologist who is in agreement and we have a plan.

It sounds as if you need(ed) more pred, even though 20mg might have been overkill!

[DavidMF in reply to Rugger]

Thanks, not easy to get away from it.