No improvement whatsoever? And you are resting too? Is it the same all day?
Not everyone gets the instant relief spoken about and it can take a week or two. However, you did get fairly rapid relief on 15mg before didn’t you? Then you worked really hard. Was it physical work?
You are above the usual highest dose for PMR which is 25mg. Some docs do go for the hit it hard approach and lots of us with GCA have way more than that so don’t panic.
I don’t know what kind of movements you did but is there a possibility that you are dealing with the backlash from that as well? Did you also work extra hard because you were boosted by the Pred that can give you extra go juice and it seems, to turn off feedback that one is over doing it. I’m curious because you said 15mg did such a lot of good when you started, then suddenly 30mg isn’t good enough. Was your trauma in Sept purely emotional (not to downgrade it!) or was there a physical part that may be causing an issue too now?
Anyway, it is but day 4 so hang in there to see if, with rest, you start to see the benefit.
Hi Glads, my commiserations with the assault, I am not surprised it gave you stress. That alone could account for the extra Pred you need. I started, well after about three days on 15mg, at 30mg, I stayed there for a week, then dropped to 25mg for a week then 20mg for a week and started slow taper down from there. My doc was/is a big believer in hitting it hard to start with and then finding what you need to keep things under control. It worked well for me. I suspect you also need to cut back on the work side, ifpossible, as well. You can't take the Pred and also carry on as normal, you do need to adjust and take more rest than previously. Don't rush things, plenty of time to things under control and then start working your way downwards again.
Someone very close to me was badly assaulted by a couple of men to whom he had given a lift in his car. It took him some months to start to get his confidence back. It’s tough 😟
So between that and the PMR, I think you need to cut yourself some slack. Don’t fight your feelings or the PMR, acknowledge them and move on. You will come out on top, all in good time xx
Nasty. Sorry about that. As I said, 30mg is over the normal dose for PMR, so it should be working soon. Your doctors should know if it isn’t helping, don’t soldier on.
So sorry to hear that…. No wonder Rheumy saw need to increase Pred - unfortunately higher dose can cause sleep issues..which should improve as you lower, and hopefully you should notice a difference pain wise within a few more days, certainly within 2 weeks.
As Snazzy says, no need to panic . I was on 15mg for three weeks before it had much effect . Then a couple of months later was diagnosed with GCA and was on 40mg for about 6 weeks before reducing. So not to worry too much about your dose.
What I do wonder is whether you have been able to deal with your recent trauma. Stress can have a big impact on PMR as can physical work. Take care of yourself Glads 🤗
It sounds to me as if it is a mix of several reasons. BUT one reason for a higher dose not having the expected result can be that the PMR has progressed to a more serious level, possibly LVV or GCA (Large vessel vasculitis and giant cell arteritis) and that needs looking at.
Another reason might be this isn't PMR but something else appearing with a polymyalgic presentation as the first symptom.
But unfortunately I think you need to behave as a poorly person to get a better view of the illness. And yes, I realise the problems.
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