Tapering from 40 mgs in Dec, to 10 mgs

[arvine]

so as ive posted, been on pred since oct 2016, started 40 mgs then, got down to 4 mgs, until last fall, started to have many issues, by Dec, rheumy though my symptons indicative of GCA, put me up to 40 mgs again, had MRi, apparently showed subacute stroke, then had catscan of head, neck, showed some changes in lobes, but overall, conclusion unremarkable, so thru these last mos, rheumy has me tapering quickly, dropping 5 mgs each until down to 15 then said to drop to 10, well I was having some side affects, think from big reductions, so only got down to 11 last 2 weeks, I decided to start on 10 today, question is, what is consensus on staying at 10 for only 2 weeks, then dropping 1/2 a mg going forward for 2 weeks, and following that reduction until I get down very low again, but when Ive tapered over the years, have used the dead slow method, and at times been on dose,ie 15 for few mos, etc, don,t seem to have PMR symptons too much, most of my pain issues now are my back, spinal stenosis, bulged disks, osteo and degenerative, and when active, seizes up with pain ever 20 min or so, being referred to pain clinic for back issue, hoping they can help with injection of cortisone or nerve block, anyway , as everyone knows, can,t take anything other than tylenol while on pred, for back, which barely helps, that,s why want to get off pred , so again, is your advice to continue dropping 1/2 mgs pred until I get down to 4 mgs again, then go on dead slow method again, which takes mos, as you all know, these reductions are much faster than what I was doing from Oct 2016 from 40 mgs until Nov/Dec /2022, so only been 4 mos to get down to 10 this time , as of today?

[PMRpro Ambassador]

You have been on pred long enough for your adrenal function to be suppressed - and that doesn't return overnight, The rheumy has reduced you as a good speed to not feel too bad while doing it thus far but from 10mg he intends you to go slower to all allow adrenal function to return, You have already noticed the difference with 15 to 10 so why do you want to go faster than he is suggesting at the point where slower is needed?

[arvine in reply to PMRpro]

ok, thank you, but think I,ll stay on 10 mgs for 2 wks, then start dropping only 1/2 from there on, aysnd see how I feel after dropping that 1/2 after few days, may need to stay on these doses little longer, ie stay on 91/2 for maybe 3 weeks, although this is not the tapering schedule Ive been doing for over 6 years, as I said been doing the dead slow method, that is new dose one day, next 6 days old dose, the next week, new dose 2 days, old dose 5 days, and on and on, until at new dose for full 7 days, at least that is how I have been reducing last over 6 years, reason I brought this up, is theses higher doses rheumy prescribed has only been over last 4 mos, that is to say, 40 mgs for one week, down to 30 for one week, then 20 for 2 weeks , 15 for 2 weeks, then he wanted me to drop to 10 , which I only dropped to 11, and been on last 2 weeks

[DorsetLady PMRGCAuk volunteer]

As PMRpro has said you need to go slowly from now on-as much for your adrenals as anything else.

You may be okay with your plan, you may not -but we cannot tell either way.

[Flivoless]

Personally, I wouldn't consider tapering every 2 or even 3 weeks at these low Pred levels. 4 weeks minimum for me.

[sidra1968]

I have all of those other back issues, also..the epidural steroid injections help a decent amount and I also ice the discs a lot. You can get those while on pred. Also maybe try baclofen, a muscle relaxer that many swear kills their pain, too. Didn't do much for me, but that doesn't mean it won't help you. Tylenol does nothing for me, either and I Iaugh when they suggest it like it's for some 30 year old who merely tweaked their back

[arvine in reply to sidra1968]

can I ask what type of injection you had, and was it guided, that is by ultrasound to target the proper disks, areas etc, thank you

[sidra1968 in reply to arvine]

Yes, they are guided by ultrasound, it is super easy, not painful at all and I walk out feeling like I am 30 again..I have to get them in both my lumbar area for Degenerative Disc Disease and also into my cervical spine for DDD, bulging disc and osteophytes - and I even had a spinal fusion from C5-C7 in August 2020 and STILL now have to get them again because the DDD and bone spurs just move to adjacent areas. There are TONS of videos on youtube. The lumbar ones don't even require anesthesia, the neck ones they put me under twilight but both only take minutes to do an are very common procedures. My pain guy does them 4 days per week, we are lined up like cattle lol

Here's an example but there are tons

youtube.com/watch?v=kLhCE21...(Not working as expected?)