Hi all, yesterday I stupidly trotted across a road, my leg gave way and I ended up sliding across on my face, hitting my cheek/nose on the kerb. Been to A&E, all sorted apart from sore shoulder which is a little better today. The pain feels very specific in that I feel it only in certain positions or when moving it in particular directions - it doesn’t feel like PMR pain at the moment. I am currently on 10mg Prednisolone am and 4 mg pm and didn’t increase it yesterday. What would your advice be re increasing, should I? To what dose? and for how long? I was intending to decrease to 3mg in the afternoon tomorrow, obviously I won’t do that. I have seen that the advice is generally to increase for a short period following illness, trauma etc but if I am already feeling better (although still sore) I’m not sure that I should do this. Any advice, opinions etc welcome and thank you in advance.
Advice please re steroid dose following fall, fac... - PMRGCAuk
Advice please re steroid dose following fall, facial lacerations, broken nose etc…
I should add that I’ve been tapering by 1 mg every 2-3 weeks with no problems.
I'd definitely slow that down, fall or no fall - or at least, not less than 3 weekly!
Ouch though!! What a silly-billy - there's a lot to be said for behaving our age you know!!! Hope it heals up well.
I suspect that actually you are probably on enough pred to cope if you were OK at the time (not OK of course, but you know what I mean). Should you feel unwell, dizzy, even more fatigue, confused etc, then the Sick Day Rules would dictate going up to 20mg for a short while (double the current dose up to a maximum of 20mg), But if you aren't so damaged as to need to stay in bed, you may not need to.
Thank you so much for this advice, it chimes with my instincts but they are definitely not always the best guide with this condition! I’m quite surprised at how ok-ish I’m feeling - I look as if I’ve gone 10 rounds with Mike Tyson…
I feel for you. Hubby did the same a few weeks ago, didn’t break his nose but very badly bruised face and lots of bleeding as he’s on blood thinners! It took quite a while for the bruising to go. He thought that was the only damage but the body aches started a couple of days later, so definitely take it easy for a few days.
It’s horrible, I suddenly feel a lot more vulnerable and more like a 74 year old! But on the bright side I didn’t break anything, it’s all soft tissue injuries and should heal, given time…is your husband ok now? It can really knock your confidence 🙁
He’s fine but really lost confidence in walking. He won’t go out on his own now.
Oh that’s a pity, it’s hard to regain confidence after a fall - but over time it will probably improve if nothing else happens 🤞🏻
Buy him a Rollator, they are brilliant for your balance and confidence whilst you are out and about. They also have a seat and storage for your shopping. Best wishes.x
Do you recommend going up after knee surgery? Presently on 2.5. May be 1.5 by surgery date.
Only if you need it. You need to wait and see if you are OK - but if you do start to flare it makes sense to stop that developing. But really - the lower the better post-op.
If it were me, I’d stay put as you are improving and it doesn’t feel like your PMR. You are on plenty of Pred so as not to be worried about unmedicated adrenal insufficiency. I’ve found that Pred doesn’t do an enormous amount for injuries either. Do expect all sorts of tweaks and niggles to show up and usually the first 48 hours are the worst. The next thing to wait for is to see if you’ve put anything out, but that’ll take a bit longer.
Thanks so much Snazzy, maybe it’s better it happened now rather that a few months down the line when I’m (hopefully) on a much lower dose…
Better if it hadn’t happened at all… but that’s life…😂🤣
Probably okay to stay at current dose..but as stated you do need to slow down the tapering.
Reducing every 2-3 weeks is too quick with or without the recent issues, so please adjust that asap…. needs to be 3-4 weeks.
Noted DL, I will take your advice and reduce 4 weekly, all being well…also I’m off to my daughter in the States in 2 weeks time for a 3 week stay - I was not going to reduce any further until I return so I’ll just stay on my 10/4 split till then at least. Many thanks 🙂
No, definitely no reduction before a trip… and give yourself a week or two on return before you attempt taper.
Enjoy…
What a horrible horrible thing to happen. I am a bit worried why your leg gave way. I had a similar experience for the first time standing in the kitchen. But could steady myself on the worksurface. My hip seemed to suddenly go weak. Have you had this before? Is it something to check up on? So scary.
Yes it is a bit worrying, I say my leg gave way but to be honest it’s all a bit of a blur, my arm didn’t seem capable of keeping my face off the road either - I’ve got a follow-up appointment next week though so hopefully can investigate further. I remember that awful feeling of ‘oh no what have I done?’ while lying in the road vividly though….
do make sure they answer the question of why it might have happened...the docs might not follow up...I find them great at dealing with one thing but fail to see the bigger picture. Hope you are feeling better.
You’re absolutely right about them just looking at the main event and ignoring anything else! It’s an ENT appointment so not sure there’ll be much investigation but they might refer me on…
Oh Tribie I do sympthathise! I try to do things in a measured way now after I fell on the road last, but these things always happen when least expected, don't they. All the best 🙂
Thank you, I’m just so cross with myself - I wasn’t even in a hurry, just wanted to get home for lunch! I ended up involuntarily fasting for over 24 hours though - hadn’t had breakfast (I never do) - but the porridge I had when I got home at 9.30pm tasted like nectar! Ah well, we live and learn….
I did similar last year, Tribie. No broken nose, but lots of facial cuts/grazes and a loose tooth that thankfully didn't fall out, but is still loose. You feel so stupid don't you? I tried hard to stop myself falling, but in doing that I think I made myself stumble more, and my face really hit the ground hard. My muscles have gone to nothing over the last few years and that doesn't help with stability does it? At least you're not feeling too bad after your 'experience'. Hope you don't need to up the pred.
You do feel stupid, it’s horrible, I’m usually absolutely fine and was coming back from the gym having done a hiit class, lots of walking etc but there I was, sprawled across the road! But such lovely people helping me, a woman with a car full of children and a handful of wet wipes, moping up the blood etc…calling an ambulance which we cancelled, my husband took me to A&E - and in spite of it being rammed and short staffed, I was in and out after a scan etc within about 4-5 hours. Did you have to go to hospital? I hate having a loose tooth, it feels so uncertain doesn’t it? I banged mine, put them through my lip but luckily no damage…how’s your confidence now? Do you feel ok with walking generally?
To be fair Tribie I had a fall a few years ago whilst closing a lock gate. I sprained my ankle so badly I had to have 2 weeks off work because I had a desk job and needed to elevate my leg. Since then I've been more deliberate where I'm putting my feet, but obviously not deliberate enough. I've also always had knock knees, so never terribly stable! I wouldn't say I'm less confident after the recent fall. No, I didn't go to hospital. I wear glasses and although that could have ended badly, they protected my face to some extent. Scratched beyond repair though! The only good thing that weekend was that we went out for a family meal. The football team that I support had just lost massively, and normally they would have ribbed me mercilessly about it. However, due (I think) to the state of my face, no-one mentioned it! Hope that you soon get back to normal.
ouch, you poor thing! Hope you feel better soon. X
Thanks Bramble, getting better slowly….
Sory to hear that Tribie
Trust better soon
Persevere
Good user name, Persevere’s definitely the name of the game…
unless your Dr advised a change in prednisone I do not think you should increase and should continue to follow your original intention. Sorry about your fall. rest and take care for a few days would be my advice.
Hi Tribie
Many years ago, unsure why, my CrP was slightly raised at 12 (<5)
So, not wanting to see the doc, who for sure would have prescribed steroids,
I looked it up and found Devil’s Claw, a natural anti inflammatory
Tried it at 3 a day and a test a month later the CrP was down to 2
I’ve taken 1 a day ever since
All the best
Persevere
Mmm worth looking at, thanks
Just make sure it doesn’t interact with any medication you are on…
Yes I am very cautious with any kind of supplement, will check it all out thanks.
Good... when anyone suggests a supplement they should also caveat with a comment to check it out.. they don't know your medical history..
True, we all need to check out for ourselves 🙂
"not wanting to see the doc, who for sure would have prescribed steroids"
Not necessarily at all. ESR and CRP are very general markers of inflammation and can be raised for a whole raft of reasons - not only PMR which would be treated with pred, but also chest infections, heart conditions, and a load of other things where steroids are not appropriate.
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