how long does it take for the extra 5mg Pred to work for a flare.

[Sumojo]

I was taking 6mg Pred and doing reasonably well. I tentatively began to do an exercise class which is specifically designed for older people. This was the first exercise, other than a daily ten minutes on my stationary bike, since recovering from two major operations on both legs, for complete tears of the gluteal medius and minimus tendons. I was aware of my limitations and attempted not to aggravate my recovery. I managed three classes. At the same time my stress levels were sky high. My mentally sick daughter who always causes me stress at the best of times, became totally unstable and tried to take her own life. I woke up one day last week unable to move from pain and complete fatigue. I’ve increased my dose up to eleven mg Pred which is more than disappointing after six years! After two days I feel much improved but there’s not been a miracle. How long does it take to clear up the inflammation before I can safely drop back to 6mg?

[DorsetLady PMRGCAuk volunteer]

We always say at least a week -I usually recommend 7-10 days but you can stay on higher dose for 14 days without an issue dropping back to just above previous dose. So give it time.. but are you sure it’s all a flare and not also DOMS (delayed onset muscle soreness) from the increased activity.

Sorry to hear about stress caused by daughter - that certainly won’t have helped.

[Sumojo in reply to DorsetLady]

Thank you for your swift response. I wondered if it was DOMS, I half expected to be really sore but it was the extreme fatigue which made me think it was something else. I simply couldn’t stay awake. I slept for most of Saturday, got up for a couple of hours and went back to sleep for 12 hours with breaks for toilet and medication. I’ve managed today for the first time since last Friday to not have a nap. I went food shopping though and had to come home and have a cup of tea before even thinking of getting the bags from the car. Weak, wobbly legs. Hopefully the extra pred is helping and will continue to do so

[DorsetLady PMRGCAuk volunteer in reply to Sumojo]

Sounds like a combination of both to be honest…

[PMRpro Ambassador]

So sorry to hear all that - hugs for you both.

Sorting a flare can take more than just a few days. But as well as the possibility of DOMS- the distress your daugher's state is causing you will be on top of all that. Those are the hallmarks of adrenal insufficiency too and you didn't deal well physically with that stress, it is a not uncommon effect.

Be patient and put your recovery ahead of less pred. I too have a Long PMR version - and even with Actemra I just manage with 7mg pred. Higher stress - and NOT In the realm of yours - really knocks me for six.

[Sumojo in reply to PMRpro]

Thank you so much for your reply, kindness and understanding. I’ll try to be patient and get well and not be too concerned about the dosage at the moment. This site, you and the others who contribute so regularly are an absolute godsend.

[Cromboy in reply to PMRpro]

Hi Pmr pro, I've not heard of the long pmr version that you have...... I keep reading that pmr should last up to 2 years.... I'm 3 years in and just flared going from 5.5 to 5 mg. What constitutes long pmr ... is it just the length of time the disease stays active ? As a long term sufferer, and obviously very knowledgeable about all things related to pmr, could you give your thoughts and any advice on my only being able to reduce to 5.5mg from 15mg over 3 years. Thanks