Return of flare 4 weeks after following flare protocol, successfully, I thought!

[waltztherapy]

Five weeks into 5 mg prednisolone,after a very slow taper, I was in a happy place, but 4 weeks into 6 mg, after 2 weeks on 10 mg, flare protocol, and the horrid flare seems to be returning. Though not quite to the same intensity as last time, I feel I need to top up again to get through the day. Should I repeat the flare protocol? I am so grateful to have this forum to turn to and would appreciate any advice, guidance in how to handle these flares, which cause pain in most joints, also stiffness and a kind of tingling all over.

Thankyou for being there for us all.

[PMRpro Ambassador]

It suggests it wasn't "just" overshooting the dose you need which is what the flare protocol is designed to manage. Flares can also happen as a result of an increase in disease activity, particularly if you have been under stress of any kind. And then you need a bit more pred than you thought,

[waltztherapy in reply to PMRpro]

Ah, how wise you are. I have had a couple of stressy issues in the last few weeks, so that could explain increased disease activity. It's high time I learned how to handle stress.Thank you so much. X

[DorsetLady PMRGCAuk volunteer in reply to waltztherapy]

It’s high time I learned how to handle stress

That’s easier said than done - it sometimes comes like a bolt of the blue when you least expect it and you can do nothing about it.

You might need to try flare protocol again to get things back under control.. no shame in that. Or just accept you need a touch more Pred for now.

[waltztherapy in reply to DorsetLady]

How right you are! Thank you for your reassuring guidance. It's easy to feel lost in bad times, but you and your colleagues seem to manage to clarify the problems.

Thankyou so much. X

[waltztherapy in reply to waltztherapy]

Bad flare on 6mg sent me to the Flare protocol for the second time in a few weeks. So upped dose to 10mg pred again.Now on day 4 with 10 mg and I feel awful.

Pain and stiffness from head to toe.

Did I not increase the prednisolone enough? Should I go up more, if so by how much and for how how long please.

Sorry to be a pain, pain is the problem of course 😔. Will try phoning the GP and Rheumatology nurse tomorrow. I haven't bothered them much. Thanks do much for any advice etc. Kind wishes to all.

Xx

[DorsetLady PMRGCAuk volunteer in reply to waltztherapy]

Sounds as if you probably didn’t get the first flare fully under control - and only 4 days into 10mg is not really giving it time . Maybe add another 2 mg and stay for a total of 14days. If all okay then down to 7mg

But are you sure it’s a flare and not covid?

[waltztherapy in reply to DorsetLady]

I guess I should test for covid, though previously, covid has suppressed my PMR symptoms quite nicely. Your suggestion sounds good to me, thankyou dear DL.Will report feedback. So grateful not to be struggling alone, thankyou! Xx

[PMRpro Ambassador in reply to waltztherapy]

Well if you do - tell the rest of us!!! And just be prepared for needing the flare protocol AND maybe a tad more pred.

[waltztherapy in reply to PMRpro]

I'll do my best. x