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How much pain to tolerate
I started with PMR in June - July and began with 20 mg prednisone and am 10 weeks into methotrexate. I do have hand pain, tight leg muscles that loosen during the day and shoulder pain. Question is how much pain is worth tolerating to keep reducing prednisone? Should I go back up to 5 mg or stick it out and hope the methotrexate eventually takes over and gets rid of these pains? Also if my Dr. thinks the methotrexate isn't performing well me wants to switch me over to Cimzia - any insights or comments would be helpful. THANKS
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Forgot to mention that I have not ever split the prednisone dose. There seem to be pros and cons about that.
From others…Splitting the dose seems to keep the pain down, but that might actually reduce the prompts to the adrenals to get back in the business of producing cortisol.
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2 Reactions"From others…Splitting the dose seems to keep the pain down, but that might actually reduce the prompts to the adrenals to get back in the business of producing cortisol."
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The prompts to the adrenals can be restored by taking the entire dose is the morning when your dose is 10 mg or less. At doses greater than 10 mg, it probably doesn't matter.
I only split my dose when the overriding 3 a.m pain was very severe. I absolutely had to split my dose if I expected to sleep the entire night and be ready for work at 7 a.m. After I retired and tapered down to 10 mg, it didn't seem like I needed to split my dose anymore.
At doses less than 10 mg is when the adrenals need to get going again. Getting back in the business of producing cortisol again is a good way to say it. If the adrenals don't go back to work, I wasn't working which is probably why I retired ... no energy for work!
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2 ReactionsI think it might depend on the person and the amount of the evening dose. I read that no more than 1/3 of the daily dose should be taken as a second dose, and only if morning pain wasn't managed with a single morning dose.
From my first and only flare so far at 6.5mg - 6mg, I know that 7mg was my lowest effective dose. So on this tapering, from 8mg on I've reduced my early evening split dose of 2mg down by .5mg for each of the last two reductions instead of lowering the morning dose. I wanted to experiment with reducing the second dose before getting to 7mg again. Been a week on 7mg with a 6mg morning and 1mg early evening split and so far so good. It wasn't enough of an evening dose to control morning pain earlier but it's good now.
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1 ReactionHello everyone again, my insurance won’t cover Kevzara in 2025. Seem to be allergic anyway but they will cover Actemra now. Say what?
Still waiting for possible biopsy for GCA. He’s an ophthalmologist, new in town, wants to set up his own practice but went on vacation. This is the kind of treatment here in Vegas, the referral was from my new rheumatologist. Still waiting for another name.
Do opthamologists do these biopsies, not surgeons?
Thank you for the help.
Karo89135
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