Was Actemra providing you with 24 hour pain relief? The only reason I ever spit my dose was because the pain relieving effects from Prednisone didn't always last for 24 hours. I woke up with pain in the middle of the night.

I couldn't tell how much inflammation I had when I was treating PMR. However, when I treated flares of uveitis, I could actually see the inflammation floating around inside my eye. It was like a dense white fog that was hard to see through. When the inflammation wasn't as bad the inflammation was more like dense white clouds with occasional breaks to the clouds. My ophthalmologist was impressed with the details I could see from the inside of my eye looking out. He could verify what I saw from the outside looking into my eye. I could describe floaters and details of things inside my eye. My ophthalmologist could identify what I saw based on my description of it.

My experience with uveitis allowed me to see how inflammation responded to Prednisone during a 24 hour period. The inflammation fog was heaviest in the morning but after I took prednisone the fog lifted somewhat in the afternoon so I could see better. By the time I went to bed, I was encouraged because the fog was better. After sleeping, the next morning, the fog was just as bad or worse than the previous morning.

That was when I started to split my dose. At first I took a double dose by splitting my dose in half. That worked but I didn't sleep well. That was when my doctor suggested that I take most of my dose in the morning and less at night. I experimented with the proportions and decided 2/3 of my dose in the morning and only 1/3 at night helped me to sleep better.

The more impressive thing was how the inflammation from uveitis responded. Whatever progress was made in clearing the inflammation fog during the day was sustained overnight.

It wasn't like a single prednisone dose in the morning cleared up all the inflammation during the day. It was a process over the course of many days for the fog to dissipate. The nice thing with a split dose was the progress made on one day carried forward to the next day.

I think the uveitis inflammation improved faster because I never allowed my blood level of Prednisone to drop. That wasn't so good for my adrenals but it was good for uveitis. I could go from 60 to 100 mg of prednisone and taper off in a month or two so my adrenals weren't suppressed too long.