missed doses of prednisolone

[ronniebee]

For the last three days i have had novovirus or something similar anyway.

Any attempt at eating led to the same result - let's not get too graphic here.

So no food since Tuesday morning and no prednisolone or indeed metformin either.

Today at least I am upright and have eaten some cereal and taken my pred.

I do have the usual GCA type headaches which are different and more severe than the novovirus ones.

I am waiting for a reply from the rheumatology dept, but I am thinking to increase my dose for a few days to get my system back in synch.

I am currently on 9mg having reduced from 10mg two weeks ago.

[Estellemac]

I'd have a look at this but I'm sure someone will be along shortly with more guidance.

endocrinology.org/media/414...

[ronniebee in reply to Estellemac]

Very useful advice. Thank you

[PMRpro Ambassador]

I think I would at least use the flare protocol if not the Sick Day Rules which to some extent amount to the same thing.

However - bit late now but if it happens again, you need to contact your GP to arrange of injected hydrocortisone to cover you for adrenal insufficiency - far from managing on less pred when that unwell, your poor body would normally produce a spike of cortisol to help deal with the stress of the illness. If you were to show any signs of an adrenal crisis - don't hesitate to call 999 and tell them an adrenal crisis is possibly looming. They should send a paramedic with the injection to avert the need for hospital - one little injection could save your life!

[ronniebee in reply to PMRpro]

Thank you. Good advice. It's difficult to think straight when you are vomiting all night.

I do feel a lot better today. The novovirus has run its course I will increase the dosage for a few days.

Still waiting to hear back from rheumatology department after I emailed them first thing this morning, but I now know what to do anyway. Next time, if there is a next time, I also now know what to do.

[PMRpro Ambassador in reply to ronniebee]

Is this part of the second surge of NV?

[ronniebee in reply to PMRpro]

Never had Novovirus before, I wouldn't recommend it. I thought it was only cruise ships got it {joke}. i did see the NHS saying they were overwhelmed with it.

I did hear back from the rheumatology dept, in line with my thoughts of increasing back to 15 mg for three days, and then return back to 9mg. I'll give it the weekend, and review then as to whether to continue at 15mg for a few days longer.

With all respect to the rheumatology dept, I'm here and know my symptoms, they're the other end of a computer.

I did get told off for stopping abruptly - fair enough. I'm told that it only takes 30 minutes for pred to get into my system. It would mean taking them on an empty stomach though. I assume this is okay under the circumstances?

[PMRpro Ambassador in reply to ronniebee]

There is a second surge of it this year - with a mutated virus which is sufficiently different that if you had the first, you are not protected from the second! Not just cruise ships - the worst local outbreak was in a hotel up the road from me where an Italian child threw up in the dining room. Virtually every other guest got it and they all headed for the hospital. Idiots, the ED only has one toilet inside it, They all had ensuite rooms at the hotel, far more comfortable ... But that is Italians for you.

Er - and if you were puking everything up, how were you supposed to NOT stop it abruptly? Put brain in gear before speaking. Plonkers!! 30 mins without food I'd think, not with. But a few days without the cushion of food should be OK.

[Oh-my]

I had Norovirus over Christmas. I’ve mentioned it before but incase anyone else is in the same position - I was told by my GP surgery to disperse the Pred in 100mls of water and sip it very slowly over 5 mins. It worked when nothing else was staying down.

[ronniebee]

I hope there isn't a next time, for any of us, but good advice, thank you

[ronniebee]

A follow-up:

Obviously, I shouldn't have stopped pred suddenly - I've been told that enough times over the last year - wasn't exactly top of my mind when I was spending most of the time never more than 3 feet from the toilet.

That aside, I went on to 20mg for a few days as my symptoms were quite bad. Then 15 mg for the last two days.

Today, I do feel a lot better. Occasional shooting pains across the temples and my eyes, but nowhere near as bad as at the weekend. I'll keep it at 15mg for a few more days and get back to 9mg by the weekend, if it feels right.

I am grateful for the advice here, and the support of my wife of course.

Hopefully, everything back in synch by next week.

Thanks

Only disappointment - I thought I was more cured than I obviously am.

[PMRpro Ambassador in reply to ronniebee]

Never cured - just in remission! Pred dures nothing - it is a management strategy. You are on less than you were - that's the positive.