Thoughts on Flare

[Skier321]

Hi friends if you are starting to flare how do you know how long to increase 5 mg for either one or two weeks is it based just on how you feel.? You then go back down to dose just above flare dose. Thank you

[DorsetLady PMRGCAuk volunteer]

This contains advice advice for a flare - you need at least a week on higher dose , but you can stay for 2 without impacting on return to just above dose where you flared..

healthunlocked.com/pmrgcauk...

[Skier321 in reply to DorsetLady]

Thank you for your support

[PMRpro Ambassador]

How you feel really. If you haven't settled the flare symptoms by a week you probably need a few days more before going back tp the last dose you felt good at.

[Skier321 in reply to PMRpro]

Much appreciated as always

[Skier321 in reply to PMRpro]

I was just thinking could I perhaps be having issues with adrenal fatigue I was at 3.5 mg and just went to 3. When I am moving around gardening etc I am ok just doing things slower. However when I sit or lay down for a half hour or so I struggle to get up and moving. In the morning I am ok. Perhaps not a flare so now what do I do?

[PMRpro Ambassador in reply to Skier321]

"I struggle to get up and moving."

In what sense? Stiffness and discomfort as you might expect in PMR or just lack of oomph?

[Skier321 in reply to PMRpro]

A combination of both. So I am a little frustrated given it took a year to get from 8 mgs to 3 mgs.

[PMRpro Ambassador in reply to Skier321]

I think I would take a tapering holiday for a couple of months - amazing what that can do by taking away the pressure to be getting the dose down. And actually - 5 mg in a year at this level is not bad at all.

[Skier321 in reply to PMRpro]

I was happy given I started 2.5 yrs ago at 40mg but I have had two prior flares. This feels alittle different some pmr stiffness and muscle aches with fatigue. So back to 8mg for a week to see what happens then down to 3.5 for awhile if all ok? I take prednisone here in Canada takes about 4 to 5 hrs to work, so I always need to plan ahead.

[PMRpro Ambassador in reply to Skier321]

That is quite a long time - it takes 2 hours to get into the system, an hour to be absorbed and an hour to processed in the liver to prednisolone, the active substance.

What time do you take it? Have you ever considered the 2am timing so it is there by the time the inflammatory substances are shed in the body and they never get a hold.

[Skier321 in reply to PMRpro]

Yes prednisone takes longer because as you said it needs to be converted in the liver I have thought splitting but once in the morning has been working well for me

[PMRpro Ambassador in reply to Skier321]

Except you complain it is taking a long time - the middle of the night dosing or splitting will both improve mornings immeasureably when you get it right.

[Skier321 in reply to Skier321]

I have taken it at 2 or 3 am if I need to do stuff at 8 in the morning

[Skier321 in reply to Skier321]

You are right it feels better. During my tapers sometimes I would go 27 hrs between doses and all was good. As you have said in the past this affliction has a mind of its own and affects folks differently. Working on staying positive and following this wonderful site with your wise advise helps us all walk down and through this bumpy road a little easier

[PMRpro Ambassador in reply to Skier321]

Splitting can achieve the same effect and avoids the nocturnal bit ...