My prednisolone dosage has reached 7mg with the next step down to 6.5 now due. I have been more active than usual but my 89 year old husband has quite a severe bout of a flue type virus (temperature 102degrees F) which is causing me quite a lot of extra activity. My shoulders, arms, back and legs are unbearable - the only pain relief that I can take is paracetamol which is pretty ineffectiv e. Please has anyone a miracle suggestion of the best way to tackle the pain problem.
Increase your pred dose back to a level that mananges your symptoms.
When you reduce the pred dose in PMR you are NOT heading relentlessly for zero using a fixed scheme. You are looking for the lowest dose that controls the symptoms and everyone is different. That is why you should go slowly, it makes for a more accurate identification of the right dose as well as avoiding steroid withdrawal pain.
You don't say how long you have been on 7mg, but I would suggest you may have been OK at 7.5mg but that was the limit. The 7mg is slightly too low and is not quite dealing with each day's inflammation so it has built up until it has reached the level that you can notice.
In PMR the pred is the mode of pain relief for the inflammation - and the sooner you take a bit more each day, the less of a problem it will be to get it all under control again. Leave it too long and you may have to go back to even 10mg and start the reduction again, albeit probably a bit quicker than the first time.
PS, I should have added that if you need to do more then the chances are you will also need a bit more pred anyway. The same will apply if you too catch the flu - and you may struggle with the flu because of the pred. Do consult a doctor if you do succumb.
Thank-you Eileen, I think you have confirmed what I was afraid might be the case. The trouble is that the higher the PRED dosage the worse I seemed to feel. The pain was not there, but I spent a lot of time feeling tired and very forgetful. On he lower dose I am less tired and more mentally alive. Have made an appointment to see my GP next week, having taken the initiative and asked for a blood test, but am not sure that she will be able to help because I did not follow her instructions 3 or 4 months ago when I last saw her, which was to reduce by 1mg every 2 weeks. I though it was too drastic so used this site instead.
At that dose decreasing by 1mg every 2 weeks would have led to the state you are in much faster - and you wouldn't have known at what dose it all started.
Where do they get the idea that reducing like that is OK - the top people say not more than 1mg per month after 10mg and even that is too much for many patients! If she gets stroppy just tell her about the real aspects of life! You have to care for your husband and without the pred it wasn't on. And if she is still stroppy - try to see someone who will listen and be a bit more realistic.
Have now had flu for 4 days together with excrucuating pain in my left shoulder and all down my arm. Dr came 3 days ago and prescibed cocodamol and analgisic cream to rub in and said not to increase my PRED any more above 10mg. The cocodamol worked until today but the shoulder and arm pain has now reached 'tear-making' proportions and I just do not know where to put myself. My temperature is still 37.8C which is quite high for me so the virus is obviously still active. I can see no point in continuing with co-codamol if it is not effective (I have a bad reaction to codeine anyway)I may as well stay with paracetomol for the fever. I just do not know what is being caused by the PMR and what is not related. Please can anyone offer any suggestions.
Difficult to say but I'm with you on the cocodamol - why a couple of mgs pred is bad and cocodamol is good is beyond me. It doesn't work in PMR, makes you constipated and can be addictive. But other than that it is fine ;-)
It sounds as if the shoulder pain is something beyond the PMR, maybe inflammation in the shoulder itself, bursitis, or in the shoulder muscles (where a bra strap sits) such as myofascial pain syndrome that could cause referred pain into your arm. That would respond better to a local cortisone injection though.
But left arm - she is sure it isn't a heart attack isn't she? Women present totally atypically. Do get checked over again, this is 3 days further on from when you were last seen.
Thanks for your reply. I am pretty sure it is not a heart attack. I have coronary stent and the pain is not al all like angina pain. Also I had a check up angiogram just a few months ago. Will keep suffering for a bit an see if it improves when the flue subsides If not ,a vsit to the Doctor who gives cortisone injections(which will probably be a two week wait) might be the answer.Thanks again for being a 'sounding box'. .
Do hope you start to feel a lot better very soon. Flu is horrible enough - without added extras.