Am I heading for a flare ?

[Louisnhoe]

Good morning to you all..I think I may be heading for a flare having just reduced from 4.5 to 4 mg..in April I had been stable on 5mg for around 5 months and ESR was OK at 16..I successfully reduced to 4.5 using DL's slow method and stayed there for 2 months with no problems..I am now at about 10 days into every day new dose at 4mg and ESR now 25..I am having a few niggles and feeling that I am heading for a full flare if I don't do something about it..can I just go straight back to 4.5 or should I add 5mg for a week and then drop straight back to 4.5 where I was fine ? I'm going on holiday in 3 weeks time and really don't want to be dealing with this whilst away..incidentally this happened at exactly the same point last year! So annoying to be a year on and not much progress..! TIA

[DorsetLady PMRGCAuk volunteer]

Would go for your second option….and get it under control pronto. If you just go back to 4.5mg and it doesn’t work [and you won’t know until you try] you could be just prolonging getting back on track.

Enjoy your holiday, and when you return maybe think about why you aren’t making much progress- if you consider that’s necessary - but if you’re not being hassled by doctors, just accept things as they are.

[Louisnhoe in reply to DorsetLady]

Thank you..yes that's what I thought re addi g the 5mg..maybe my 'sweet spot' is 4.5mg for the foreseeable future..I know ESR is not everything but it is usually a good indicator for me that my PMR is alive and poking me when I overshoot the dose which is probably what's happened here..the niggles are tolerable especially after my morning dose but start appearing early evening so I guess that is my sign to deal with it..I know it's not uncommon for some if us to get stuck at a certain level but some progress would give me such a lift ..thanks again for the reassurance and in the meantime 'onwards and upwards ' literally..unfortunately..!

[PMRpro Ambassador]

I think you need a few days of adding 5, especially with the holiday coming up.

[Louisnhoe in reply to PMRpro]

Thank you. I will do that and then back to 4.5..how many days with the extra 5mg do you think ?

[PMRpro Ambassador in reply to Louisnhoe]

However long it takes to feel better but I doubt you will need more than a week, if that.

[Louisnhoe in reply to PMRpro]

Thank you..yes I have been here before! Have just taken my first extra 5 and thought perhaps a week and then maybe a couple of days at 6.5 then back to 4.5..it worked well before..thanks again..