Flare advice

[Grandmaziggy]

Diagnosed December 23 and started on 15mg, not started tapering yet. Feel 85% better most of the time but still a bit of background aches and stiffness at time's. Last couple of day's felt like a bit of a flare, just wondering if I can up to 20mg for a couple of days then go back to 15mg? Or would I have to taper? I've read people mention on here about upping their dose temporarily, or would I need to contact my GP? Due blood's next Monday to check ESR and CRP

[SheffieldJane]

we tend to temporarily up our dose to help combat illness or extreme stress. Your experience so soon after diagnosis may indicate that you possibly needed to be on 20 mgs from the start. I definitely did and began a taper in about 6 weeks later, when everything felt more settled. Only you can explain how you feel, 85% is great relief but you are thinking of a temporary booster dose. This indicates that you are on a dose that is too low. It is best to treat generously initially and make a good strong start. Dotting about with your dose doesn’t help in the long run.

[Zebedee44]

Sheffield Jane has given good advice and I would add that you may have been feeling good enough to increase your activity and do some of the jobs that had built up as your PMR developed and slowed you down. The stiffness and pain will remind you to respect your body and take things steady.

So before you increase your dose maybe think about what you have been doing and take it down a notch. It may well be that the starting dose was never quite enough to mop up the build up of inflammation and that you are starting a flare, but this might be dealt with by just pacing yourself. Best wishes, Chrissie

[DorsetLady PMRGCAuk volunteer]

If you have 85% relief, most doctors would see that as successful… but a bit more would be nice for you.

But as you feel slightly worse over last few day, have you tried to return to ‘normal’ life -or done something more strenuous or stressful?

We do suggest sometime upping dose in a flare situation, but as you are so early into PMR you shouldn’t be doing that without medical advice.

As you are having bloods tested next week, I’d hold off until they are done, and then discuss with GP. The results of them might correspond with the symptoms and confirm that you actually do require slightly more Pred. If you up the Pred before the blood tests you may well skew the results, and that won’t help your cause.

[Pixix]

15mg didn’t help me 100% at first. After 3 weeks I discussed it with my Dr & I tried 17mg. It made all the difference. I didn’t want to go up to 20mg, if I didn’t need to. But we are all different, & need differing levels of pred!

[PMRpro Ambassador]

I wouldn't up the dose until you have the blood test done and spoken to the GP. Taking more just now would mask if the 15mg isn't quite enough to clear out all the accumulated inflammation - which is what it sounds like to me. A shorter time at 20mg is often preferable to a long time at a dose that is a bit too low to do a good job.

Have you done something different or more in the last week to cause a bit of muscle soreness? Can be as little as lifting a heavy shopping bag!

[Grandmaziggy in reply to PMRpro]

I had to go to my late Mum's bungalow on Sunday and give it a good hoover all the way through, prior estate agents coming to value it. So maybe I did over do it, I had felt really well that day too. It's gone on all week since and it is upper body pain, arms, shoulders and chest. Thank you PMRpro I will get my blood's done Monday and see what comes back from those.

[random901 in reply to Grandmaziggy]

"a good hoover all the way through" ... hmmm ... of all the housework tasks hoovering is what sets my pain and fatigue off immediately, and it lasts for days!

[Grandmaziggy in reply to random901]

I know it's probably that that's done it. It was just unavoidable as my Mum passed away in November and it needed doing before the estate agents came and unfortunately my sister was away in London so couldn't do it. I'll know next time.

[PMRpro Ambassador in reply to Grandmaziggy]

Sorry to hear about your mum.

But as random901 says - absolutely the worst thing you could have done. The best back doctor I have ever had years ago forbade me to hoover or even sweep or wash floors. Those activities are the worst things you can do if you have back problems and the arm actions will have really gone for PMR-ravaged muscles. I have a cleaner for an hour a week - every week she vaccuums and does one other job I struggle with - changing bedlinen, deep cleaning my tiny kitchen.

There are ALWAYS cleaning companies or one-person businesses who will find a one-off couple of hours to do that sort of thing and it is worth every penny of what it costs.

Anyway - this is the dreaded DOMS: delayed onset muscle soreness due to overuse of muscles which happens in response to far less muscle use than you are used to in the past and it can take a long time to improve. Try paracetamol, that might help, or topical creams though not too much of ones with NSAIDs in. Good old wintergreen (if you can bear the smell) or more modern rheumatic creams might help. I doubt more pred will - the pain is due to tiny tears in the muscle fibres not PMR inflammation and they must heal before the pain goes.

And actually - estate agents ignore a bit of dust in an unoccupied house. That doesn't affect the value on the market. The hoovering is needed before people VIEW. With an uncluttered arrangement of furniture so the rooms look bigger. We've just been doing the other way round. I personally don't care about dust or even a bit of mud in an unoccupied house, that isn't what I'm looking for, One agent was telling us that totally empty houses don't sell quickly - they had had one on the market for months until they told the seller to put SOMETHING in the living room. An old TV, a sofa and a small coffee table to make it LOOK a usable space, and it was gone in a couple of weeks. Coincidence? Maybe, but the agent didn't think so. People have no imagination - you have to help them!

[Alchemy8]

Thank you for your thread Grandmaziggy. It really helps to learn that hoovering is a killer on the muscles (hadn't linked it with DOMS - just getting older) and I would add weeding to the list! I have the same situation as you - in my case gradually clearing the marital home and all the accumulated STUFF. Hard and emotional work, let alone the physical activity. Needless to say it doesn't look as though much has happened over the last 7 months but to my mind it has!

[PMRpro Ambassador in reply to Alchemy8]

I'm still summoning up the energy ...