Flare-up Question for PMR

[RaisinBran]

I'm back with another question. Assuming it is a flare-up that I'm having, I took everyones advice and raised my prednisone from 3mg to 5mg. Tomorrow will be the third day on 5mg. My symptoms aren't better at all. Usually, I can feel some relief after 1 day but for sure, I feel a bit better after the second day and it seems like it is worse. I have strong pain in both hips and shoulders but especially my hips. If I put pressure on my left leg when climbing the stairs, pain is so bad, I have to stop. So I thought I might get on my treadmill and walk for a bit because it seems worse when I just sit, but that didn't help . Can I increase to 10 mg for two weeks and then go back o 3.5 or 4? Does it sound like a flare-up, because I have never felt this much pain in my hips in the seven years that I have been on Prednisone. Should I wait and continue with 5mg for another 7-10 days to see if it gets better? My Reumy stated that it just may be something else, any comments? Yes, I do have a lot of stress in my life right now, but I seem to deal with that pretty well, just cant imagine stress would manifest itself in my hips. I'm caretaker for my wife who has just started to show signs of cognitive impairment, and my 90 year old sister whom I am just relocating to another independent living home. Thank you!

[DorsetLady PMRGCAuk volunteer]

Usual advice is to up by 5mg not to 5mg, so that may be why you aren’t seeing much improvement. See this for more details - and you can stay on the increased dose for up to 14 days - and then back to just above previous dose [would suggest 4mg as you have a lot of stress at moment]-

healthunlocked.com/pmrgcauk...

It does sound suspiciously like a flare with all that’s going on, but obviously if above procedure doesn’t help then you may need to discuss with your doctor.. but try this initially. If it does help, then don’t attempt to taper further for time being.

[RaisinBran in reply to DorsetLady]

My mistake--great news, thanks DL

[PMRpro Ambassador]

It isn't increase TO 5mg, it is increase BY 5mg - so yes, going up to 10mg would be OK, you shouldhave gone to 8mg anyway.

It does sound very like a flare and given the stress you are dealing with. not surprising. Stress can affect the immune system and when it is already deranged and causing an illness like PMR, that can make it flare up. It COULD be something else as you rheumy has suggested, but ruling out more inflammation from PMR is a good start. You wouldn't have lost anything.

[RaisinBran in reply to PMRpro]

Thank you PMR Pro! (tell it like it is). Just having a bit of fun, hope it doesn't offend you!! I know you would tell me if it did!

[PMRpro Ambassador in reply to RaisinBran]

It's a label I was given a LONG time ago by the wife of an America colleague! Takes a lot ot offend me ...

[Louisa1840]

Dear Raisin Bran, I think that stress is a "silent stalker". You may THINK you're dealing well with it but your body shows you're not. You have a LOT to deal ith and the emotional strain of having to care for elderly relatives is HUGE.. don't be in a hurry to reduce your pred. Take the wonderful advice you see on this forum and go well.......

[Leafsong66]

Heartily agree with Louisa1840! Sometimes our surface reaction to stress is deceptive but our bodies may tell a very different story! You have listed two major sources of possible big stress. It’s understandable if your body reacts accordingly even though your experience and persona might think “ I can deal!”

Isn’t it great that we have this forum for support and wise insights on every level. All the best and hope you see some good improvements on a more realistic dose for this current period. Hugs from Aussie land.

[RaisinBran in reply to Leafsong66]

Wow!!! Thank you so much for the kind words!

[RaisinBran in reply to Leafsong66]

Thank you Leafsong66

[jls93]

Good morning RaisinBran. Sorry i'm late to the chat. Sounds like you are recieving great insight from our fellows. Personally when I have changed my pregnisone dose ( up or down) 3 full days was the minimum before i noted any physiological changes to which I would then note what was going on. I also have a calender/jounal i record my data ( dose, function, achiness etc) consistently to mitigate either wishful thinking, aufululizing , expectation etc. I also would note weather my sx were joint v muscle or both. In my case this relieved me of the "burdon to have to remeber" or confuse / stress myself.

As for "stress" ; "good,bad or other", as previously stated our body doesn't label it, that is in our brain. Stress is summative and so it's tap on our finite energy ( spirtit , mind and body). I try not to discount or amplify events ,just note thier presence and influence. It is like "gravity" i would tend to notice mostly if i got on a scale or took a fall ;-)..lol.

All kidding aside, I wish well to you and yours. Hope this contibutes to your understanding and well being.

Sincerely

[Leafsong66 in reply to jls93]

I really appreciate your wise and measured approach. If you happened to have a template for your recording system I would love to have a peek at it. I’ve been trying to work something out like that for ages.

[jls93 in reply to Leafsong66]

Thank you Leafsong 66 for your kind words

Hmmm ,there is no template per se. That being said it is a compilation of, education, competitive gymnastics, reading, journaling, prayer, meditation, practicing as a healthcare provider x 30 yrs, multiple surgeries/ recoveries, reading , being a seeker, life long learning and more.

Spirit, Mind and Body and doing something in each area each day over decades

Journaling; simple and convenient, Audubon colander and pen on dresser. brief words and you will develop a short hand as you apply yourself to it consistently. It is for you and insight will be about yourself and more

Insights gained "4 Noble Truths", 8 fold path , noticing "attachments" etc

Reading eg, "4 Agreements" and their insights

Understanding what is personally restorative and healing.

I hope this helps. It is alot to mull over.

all my best

[RaisinBran in reply to jls93]

Thak you for your kind words.

[Carver63]

i survived Prednisone but paid a recovery price that took 2 yrs to detox. So it does reduce impacts but it is an ugly medicine. look at an anti-inflammatory lifestyle change if you can. Diet is important

[ZeusMom]

Yes, you do have so much going on that stress can't be ruled out as contributing to inflammation and a flare-up, in my opinion. While I can't comment on the pred, and I believe you have good advice here and from your dr, I would say that your inclination to move is probably a good one. Blood flow, muscles working, lymph system activating, all help endorphins kick in and can reduce stress. Also try deep breathing to stimulate the parasympathetic nervous system that tells your brain to relax. Meditation is a good one too, but start with just breathing and slowing down. Then call on your support system and community to give you a break so you can step away for a bit. And it's never too late to build a system of caring and supportive people to help. We all need them. Good luck and wishing the best for you.

[RaisinBran in reply to ZeusMom]

Thank you very much for your thoughts

[Murphysmummy]

You have to be careful reducing pred it's usually done gradually.id contact your team for advice