A bad flare at 7mg

[waltztherapy]

I am entering my fifth year of PMR treatmennt. After two flare protocols, I have been reasonably comfortable back at 7mg prednidolone for 8 weeks, after very slow tapering each time. A horrid flare is now causing me to struggle with all-over tingling muscle pains and a few joint pains thrown in.Do you think I need to do another flare protocol please?

I feel some nausea briefly at times, reminiscent of when I was arriving slowly, at 5 mg, before using the first flare protocol, almost a year ago I think.

From this forum I have learned that it's best to "take the prednisolone you need to live your life the way you want to" and as I wish to remain active with my hobbies, travel, etc that's what I've been doing. But, finding the right level of prednisolone seems to be the toughest part.

I'd be grateful, as always, for any advice and guidance please.

Thanks.

[PMRpro Ambassador]

Have you required the flare protocol at a similar dose each time or is it getting higher each time?

[waltztherapy in reply to PMRpro]

Slightly higher each time.

[PMRpro Ambassador in reply to waltztherapy]

That is sometimes a feature when you let a flare happen, it is harder to get it under control again and harder to reduce the dose. Don't know why, but it does happen. And dare I mention it - age DOES have a bit of a role to play.

[waltztherapy in reply to PMRpro]

Od dear, how do I not let a flare happen ?

[PMRpro Ambassador in reply to waltztherapy]

You taper in VERY small steps and have a good gap before trying the next step down. You also then need to react quickly as soon as you suspect it isn't enough. But even so, people do flare. It is the fact that you have had 3 such episodes that is concerning. How far apart have they been?

Have you been unwell, under stress, done a lot more than you usually do?

[waltztherapy in reply to PMRpro]

I did think I was tapering slowly, reducing by only 0 .5mg every every two months. I would guess, roughly 6 months between each episode, and yes stressful times occur, and there are times when i do a lot more thsn usual, which i temper eith perids of rest, but that's life.

[waltztherapy in reply to waltztherapy]

Sorry about the typos...

[PMRpro Ambassador in reply to waltztherapy]

It is life, but when you have PMR you have to put YOU first. Yes, fair enough, that is pretty slow and should be OK. Something there is out of kilter - you are not being able to match the dose to your needs. However slowly you taper, you have to stay above the lowest effective dose. Maybe they weren't FLARES as such but just overdoing things that led to DOMS (delayed onset muscle soreness) that can be easy to confuse with a flare, they can feel very similar. With DOMS, rest is the answer, not necessarily more pred. Or it is a mild muscle injury - I get that and targeted treatment is better than more oral pred.

[waltztherapy in reply to PMRpro]

Thankyou PMRpro, I really appreciate your input. It hadn't occurred to me that this pain might just be overdoing things.I also look at listed rosacea trigger foods.

Thank you for your kind advice to help me move forward.

Best wishes to you and everyone.

[DorsetLady PMRGCAuk volunteer]

From this forum I have learned that it's best to "take the prednisolone you need to live your life the way you want to"

Not exactly but enough Pred to give you good QOL - which maybe not precisely as you want to… with or without PMR/Pred and aging we all have to make minor concessions.

If you are flaring at roughly the level [as PMRpro’s question] maybe you aren’t making those minor adjustments. As we say very often, PMR doesn’t stop you living your life, but it very often curtails parts of it. 😊

[waltztherapy in reply to DorsetLady]

Thankyou both DL and PMR pro.Yes the age factor is there of course.

I recognise that I do need to rest more including breaks within my active times, and do I take frequent naps, accepting the not so minor adjustments. Levels are reducing all round. I'm never without pain and consider that's normal for my age. I guess it's trial and error to get the best pain management.

I am reminded that acceptance goes a long way too.

Thankyou both. X