flare protocol

[Lovesport]

Hi again. Reading avidly about flares but still anxious. I’ve been at 7 (I had gotten down to 2) for 8 days or so. I’ve thought I can reduce back to 2 mgs in a few days. But my pain spikes quite dramatically still and my weakness and exhaustion mean it’s hard to do much. Does this mesn I need to stay at 7 mgs longer or might it still settle down. I have quite a few engagements coming up and don’t know how I will manage.

[DorsetLady PMRGCAuk volunteer]

I’d stay on the increased dose for the full 14 days.. and then drop in 2 stages. Initially to 5mg for a week and then to 3mg not 2mg.

Sounds as if your adrenals as well your PMR are struggling.

As you have engagements on the horizon you do need to rest -and pace yourself to get through them… no other way! Are there any that aren’t essential and can be rescheduled?

[Lovesport in reply to DorsetLady]

And also so helpful to have a concrete idea of how to try and come down, I am busy cancelling what I don’t have to do. You have given me such a boost.

[PMRpro Ambassador]

The weakness and exhaustion won't respond dramatically to pred - and if it is partly due to the underlying cause of the PMR, it may not respond even slowly. Pred is an antiinflammatory so relieves the symptoms due to that which is mainly pain and stiffness. It doesn't any real effect on the autoimmune part which is possibly making you feel fluey.

What do you mean when you say the pain spikes dramatically? That doesn't sound like a typical PMR thing.

[Lovesport in reply to PMRpro]

Again- so many thanks for quick reply. So helpful to isolate Pred function- pain and stiffness from underlying cause. I really can understand difference and allow the rest easier. Spike in pain just means in morning before pref working and in evening before dose. I will keep going.

[PMRpro Ambassador in reply to Lovesport]

And do look at your lifestyle - because it really sounds to me as if you are overdoing it on a few fronts.

The fact your pred isn't lasting a full 12 hours also concerns me - and suggests you need a larger dose. How are you taking the pred - and I right in understanding you are splitting the dose?

[Lovesport in reply to PMRpro]

You are absolutely right about overdoing it. And I am now paying for it. I’m a restless soul but am trying very hard to listen to all your wise words. My worry is dose isn’t high enough. I take 5 mgs morning and 2 in evening.