More advice please!

[Smokygirl]

My wonderful friends. Just to re -cap. Bad Flare on 3mg, after four happy months on 3.5 mg

Then two weeks on 8mg, one week on 6 mg —- all well.

Then last weeks drop to 4mg. Immediate pains in biceps , day after drop.

I have persevered with 4 mg now for five days and still have bicep pains. Your thoughts please? Xxx

PS Perhaps I should add that I had a Covid booster in the middle of the week on 6 mg

[DorsetLady PMRGCAuk volunteer]

hi,

Vaccine may have caused flare unfortunately- so I’d be inclined to go back up to 6mg initially -hoping that will be enough to clear things…..if no discernible improvement after a week, then looks like you might need to go up to 8mg and start the process again. Hope not.

[Smokygirl in reply to DorsetLady]

Thank you again dear DL. I shall do that. If 6 mg works, how do I proceed after a week?

[DorsetLady PMRGCAuk volunteer in reply to Smokygirl]

Stay at least another week to make sure, then you may need to do as SnazzyD suggests and try smaller steps down. 1mg instead of 2mg to 4mg. Then back to 0.5mg steps.

A bit disappointing, but probably more sensible approach.

[Smokygirl in reply to DorsetLady]

Oh thank you again DL. Hopefully it goes smoothly with no hiccups

I shall go back to 6 today for two weeks ,then all being well try 5mg for a week then come back to you all for what to do next!!

[SnazzyD]

At first it sounded like withdrawal because of the immediate reaction but it should have eased by now. Sounds to me that you need to drop in smaller doses and take a bit longer. Things were already a bit choppy when you had the vaccine and previous stresses and strains. So drops of 2mg that might have been ok before, might be a bit ambitious right now.

[Smokygirl in reply to SnazzyD]

Oh Snazzy! I think you are right. What a bugger!!!!! It’s a strange thing, even after four years of PMR one still gets a mental block about reducing! Hope all is well with you! Xxx

[DorsetLady PMRGCAuk volunteer in reply to Smokygirl]

Dropping back down after a flare is slightly different though to ‘normal’ tapering - but I’m guessing the vaccine probably scuppered the plan.

[PMRpro Ambassador]

Basic rule: never change 2 things at once! And the vaccine is a change.

[Smokygirl in reply to PMRpro]

Yup! Unfortunately I had already started the drop when a Pfizer booster was offered to us. I am wildly allergic to Moderna and Pfizer is scarce here now so I was happy to take it up. Life gets in the way!xxxx