Travelling to USA

[VickySponge]

I am tapering at the moment - down to 8mg from yesterday and dropping 1mg every 4 weeks . All seems to be going well though it takes a few days to settle into the lower dose. I am travelling to the USA un early February for 2 weeks to stay with family in Florida. I am wondering how to handle taking steroids and the time difference. Any advice or experience of others with this situation out there would be welcome

[DorsetLady PMRGCAuk volunteer]

Have a look at this and my suggestion is no tapering just before, during or just after after travelling .

healthunlocked.com/pmrgcauk...

[VickySponge in reply to DorsetLady]

Thank you - that makes good sense to me

[PMRpro Ambassador]

Now you have posted you will see loads of Related Posts which are probably asking the same question! DL has just beaten me to it with the link - and the advice NOT to taper before you go and for a week or two after you get back! Make sure you have recovered from jetlag and the stress of travelling first.

[PMRnewbie2017]

Could I also add that when you return home and begin tapering again, consider extending the taper duration to six weeks? If your regimen over 4 weeks is working for you fair enough, but if you're not doing so already, perhaps stay at the new dose for 2 weeks before tapering again. You are entering the zone where the adrenal cortex will have to "wake up". Unfortunately at this point it can be hard to distinguish between PMR aches and lack of cortisol. Once you get to 4mg you may need to reduce by only 0.5mg. After several failed attempts over the past 7 years, I'm now on a 0.5mg reduction using a slow taper regimen every 8 weeks. Have a great trip!

[CZAE in reply to PMRnewbie2017]

How can you distinguish between adrenal cortex waking up and PMR not gone away? I would be really interested to know?

[PMRpro Ambassador in reply to CZAE]

PMR tends to show itself with similar symptoms to how it started. Adrenal insufficiency is generally predominantly fatigue which can be overwhelming. There are other symptoms which are listed here

niddk.nih.gov/health-inform...

[PMRnewbie2017]

That is a hard question to answer! Generally speaking, when you reduce your dose of Pred it isn't unusual to get some achiness. This may take a day or two to appear but goes fairly quickly as your body pushes out more cortisol to restore it's natural balance. The aches also respond to painkillers. If you have overshot your optimal Pred dose, that is the dose which counter balances the amount of inflammation being produced daily, you will start to feel "off" after around a week. As the level of inflammation slowly builds up you will get a return of your PMR aches and pains. In this case, painkillers will not give you relief. You have to increase the Pred dose again to clear out the accumulated inflammation, then go back to where you were OK. I have learned to differentiate between the two, but it's taken me a long time, and it's not an exact science. If you search the site for this topic, there is lots more information available.

PS. Do ensure you carry your Pred in your hand luggage with the necessary paperwork for immigration AND carry something on your person saying you are on Long Term Steroids, just in case anything un-toward happens to you.

[jls93]

Enjoy your holiday. I concur w previous post. I would only add that traveling does add a significant demand physiologically. My physiology also takes 3 days or so to adapt to prednisone dose changes. Have fun. I am in the states. Plenty to enjoy and experience on Florida , it's a pretty big state, no sense in spoiling your trip. Success breeds success. Be good to yourself.

[Crusty1949]

I have travel a lot and it normally takes one day for each hour of time change for jet lag.To settle out.

As far as taking your meds, I have always just adjusted my schedule based on where I am at any given time. It has always worked for but it may be different for you. Try it for a day and see what works. My rheumatologist has always said your body will give you signs on what’s works best.

I have been off prednisone for over two years but always carry a backup pack just in case PMR raises its ugly head.

Enjoy the Florida sunshine and time with your family. God bless.