How to handle a “mild” flare

[NCStateLine]

Hi

I was diagnosed mid- January ‘24 and my Rheumy is a bit on the aggressive side. Started at 20 mg and felt amazing. After a mo th we dropped to 15. All still great .He wanted to go 10 and I convinced him to go 12.5 and then 10 - 2 weeks each and now we are at 7.5. He said if you feel good feel free to drop to 5. I remain at 7.5. I have stayed active mostly walking activity. According to my Apple Watch about 5.5 miles per day which is what I have always done. No issues whatsoever until after a couple of weeks at 7.5

in the morning I wake up with biceps/ triceps that feel like I lifted weights the prior day and I didn’t. I have also noticed stiff hands - sort of like you get on a long hike when the blood collects there and your fingers swell. And my hands are more swollen as my wedding band is tight. None of this impacts me much - it’s just noticeable.

I am not in misery, just know that for sure we aren’t going lower for a bit. Certainly not while I have these early hints of a Flare. I am thinking the big drops for sure are over and maybe a few months at the current level to see if it improves? And then if does to reduce by 0.5 or 1 from then

Does that make sense or should I consider an increase as in the Flare protocol ?

Thanks very much for your help

[PMRpro Ambassador]

Does it clear completely after you have taken the new day's dose of pred? Is it getting worse of staying just the same? What time do you take your dose? Have you thought of trying 8mg instead of the 7.5mg?

Each of those could have a bearing on this morning return of symptoms and your answers could have a bearing on what I would suggest.

[NCStateLine in reply to PMRpro]

I take my dose at 7 am every day and It clears up after a couple of hours. I have had no issues with sleep or any sign in hips, glutes. And it is staying the same. Haven’ t considered 8 yet as all the pills I have are 5’s and 2.5’s. I see rheumy in two weeks and for sure will get some 1’s. I was thinking stay at 7.5 for another month and see if it improves with time, and when stable go by 1/2’s from here on out- slowly. Thanks for such a quick response .

[DorsetLady PMRGCAuk volunteer in reply to NCStateLine]

I was thinking stay at 7.5 for another month and see if it improves with time, and when stable go by 1/2’s from here on out- slowly

Does sound feasible, but you need to make sure that 7.5mg really is enough... ad another month will tell you that.

Just an aside... a mild flare left untreated can easily turn into a full blown flare.. 😏.. and you have got to 7.5mg very quickly.

[PMRpro Ambassador in reply to NCStateLine]

Sounds fair - at least a month more and be honest about it staying the same! All the best