week from hell - what to do with dosage

[tiredbutoptimistic]

I knew this last week was going to be a nightmare - finishing off of building work in our garden with workmen who I have discovered have to be watched like a hawk or they vanish - but then I got COVID (Monday 7th). And then my 90 year old mother for whom I am a carer also got COVID. I followed sick day rules as I had a high temperature and felt awful and added (to my usual morning 11mg) 10mg in the late afternoon for 2 days. I cut that to 5mg extra pm as I felt better and last Friday reverted to my normal 11mg dose alone and all seemed well. Today my mother who had recovered from COVID has been rushed into hospital for something else and I’m at her side (I need to be - awaiting surgeons) at 3am in v uncomfortable chair failing to sleep. All the usual PMR pain started to come back as I stood in a hospital corridor about 9pm tonight so I took an additional 5mg and felt better quite fast. I’d be v grateful for any advice on what I should do about dosage for the next few days. I’m no longer sure which way is up….sorry to dump

[DorsetLady PMRGCAuk volunteer]

Sorry to hear -no wonder you’re not sure if on head or heels.

I’d be inclined to stay on extra 5mg for at least a week [treating as a flare]. Hopefully that will let all things settle a little - and then you should be able to return to 11mg.

Best of luck to both you and your mother.

[PMRpro Ambassador]

Sorry to hear that tale of woe - and that you have the clicheed variety of builder ...

Like DL, I would stay at the extra 5mg for the duration and regard it as Sick Day Rules - they apply for stress too. But don't rule out the fact that this isn't a flare brought on by overshooting the dose you need during a taper - that is what the flare protocol is really aimed at sorting out. Illness and stress can both induce a flare in disease activity and that is a bit different. During my husband's illness I needed a higher dose longer term, the disease activity was higher again so needed more pred ongoing.

And don't forget, even if Covid is a relatively minor illness now, it still takes a fair bit out of you and it is barely a week since you had it.