missed dose, flare?

[Mstiles]

hello everyone,

I have PMR/GCA and am on 9 mg. Pred and missed my dose yesterday morning and didn’t notice until this morning. Then I took 10 mg.

Yesterday I had noticed increased joint pain and foggy thinking but didn’t realize I had missed a dose.

Last Thursday I had a cortisone shot in my ankle because of pain and swelling there. It helped the swelling but not the pain. X-rays had shown arthritis but no fractures.

I can’t find the sick day rules amidst everything. I’m not in bed just in pain. Should I take more pred?

I’m 81 with multiple issues.

Could the cortisone shot have affected anything?

I might have been having a flare before all this as I’ve had pain in that ankle before from a beginning flare.

I’m still foggy and misplacing things this morning.

Here in the US our medical system is a mess. No coordination and long wait times.

Thanks for your help.

[PMRpro Ambassador]

At this stage you probably don't need the Sick Day Rules - they are for illness and more severe injury, See how you get on with the 10mg this morning - that should be enough to sort the aches - but have you also tried Tylenol for the aches?

If anything the cortisone shot should help a bit but sometimes, although the shot appears to work immediately, the pain returns as the effect of the local anaesthetic in the injection wears off. Don't despair of its effect yet.

[Mstiles in reply to PMRpro]

Thank you Pro. I’ll try the Tylenol.

[DorsetLady PMRGCAuk volunteer]

Yesterday I had noticed increased joint pain and foggy thinking but didn’t realize I had missed a dose.

One of the reasons we always suggest having your tablets in a weekly/daily dosette box.. then if you have a day when you don’t feel right, you can check if you’ve taken pills. Plenty available online.

Not really sure what you mean -Could the cortisone shot have affected anything? It might have maybe a little difference [some think so] but as it’s localised not that much difference to your underlying illnesses as such.

Might be worth taking an extra mg or two today, but not sure you really need to introduce sick day rules… and as PMRpro asks have you tried ordinary painkillers.

You aren’t the first to miss a dose and you won’t be the last… but try not to do it again.😊

[Mstiles in reply to DorsetLady]

Thanks Dorset Lady.

I have the pred and a written weekly schedule where I check off the days next to my coffee. A pill box would probably be more noticeable.

What is an extra minor?

[DorsetLady PMRGCAuk volunteer in reply to Mstiles]

Sorry - typo should be been extra mg or two😊

[Mstiles in reply to DorsetLady]

😊👍addled brain couldn't figure it out!