I am afraid the pain will never end.

Posted by toryf @toryf, Sep 3 5:57pm

Hi.

I am a 61 year old female and woke up after surgery in January with what the rheumatologist (and I) think is PMR. My life is so diminished as the pain has not relented. I had 90-95% relief at 20 mg of Prednisone but was told (and understood) that it was unwise to stay there so got myself down to 8mg.

The pain was just too bad so I bumped back to 10 mg. And then back up to 12 mg. The last time I felt ok/functional was at 15 mg but don't want to go that high again of I can help it.

I started Kevzara 2.5 weeks ago. I am looking for some hope. Straight up. Thank u to all.

Interested in more discussions like this? Go to the Polymyalgia Rheumatica (PMR) Support Group.

Thank you again for sharing your experience. It sounds like tolerable is the operative word. I don't have a high pain threshold, but I guess I might need to grow one. Thank God u did not end up with secondary adrenal suppression!

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Profile picture for toryf @toryf

Again, thank you! Where I am getting confused, tho, is I thought that the pain was part of the adrenal glands getting fired up and in working order again. That pushing thought the pain is what it would take to jump start the adrenals, otherwise they would be chronic under performers, so to speak... I do apologize for taking up so much of your time and effort, but it is a life line.

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I am a believer in the biological Kevzara. I was stuck at 8-9 mg prednisone and this got me past the speed bump.

Medicare and my supplemental AARP coverall all of it except the first $2000.00 per year. (That’s my AARP deductible). Good news, I don’t pay for any other prescriptions for the year.

Also, prior to Kevzara, I found good relief with Tylenol for Arthritis as a supplement. My Rehumy recommended it.

Yes, I was a mess at times, had to be to,d many times, not to overdue it (I figured I could fight thru, no). At this point remind yourself, it’s ok to not be on top of your game.

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Profile picture for Mike @dadcue

Pushing through "increasing pain" while continuing a taper probably isn't a good idea.

I believe what happens more often is that people immediately increase their prednisone dose for any uptick in pain. Each new pain should be investigated because it might not be PMR. However, doing another investigation isn't always practical after PMR is diagnosed.

Much of my pain through the years wasn't anything like my original PMR symptoms. I would complain to my rheumatoloist that I thought PMR slipped out the back door and the treatment left me in a world of hurt. She seemed to understand but it still meant I needed to take prednisone.

I understand wanting to be "pain free" but perhaps that won't facilitate tapering off prednisone. It is more about accepting "tolerable pain" vs "no pain." The "fear of pain" sometimes controlled me more than the pain. Does that makes sense?

I'm not the best person to tell anyone how to taper off prednisone since I took it for 12 years for PMR. I'm in awe of people who are able to taper off prednisone sooner than I did. However, the experience with Prednisone I had before PMR was diagnosed was that I could routinely taper off prednisone going from 60 mg to zero in a month or two. My ophthalmologist who was treating uveitis said I was "skilled" at doing Prednisone tapers. I had a lot of practice treating flares of uveitis which can also cause vision loss. The only difference was "short term" vs "long term" prednisone use.

In spite of 12 years on prednisone ... I was able to taper off. In some ways it was harder for me to taper off prednisone after such a long time. The biologic I now take made it much easier for sure. The other thing that helped me was when I was told that I should NOT taper at all when I was at 3 mg. It was hard to resist the temptation to increase my prednisone dose but the endocrinologist said to only increase my dose when it was "absolutely necessary."

The difficulty was knowing if it was necessary or not because it wasn't like having "no pain." I had to stay on 3 mg for six months until my cortisol level improved. Six months wasn't a "predetermined" length of time. My endocrinologist actually said "as long as it takes" for my cortisol level to improve.

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Oy. Just got a message back from my endocrinologist saying to wait until
April of next year to see her as Prednisone dosage above 4 mg means that
the adrenal glands are not being activated which means that any and all
pain I am experiencing is due to PMR. Does that jive with what I have been
told?

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Profile picture for tweetypie13 @tweetypie13

I am a believer in the biological Kevzara. I was stuck at 8-9 mg prednisone and this got me past the speed bump.

Medicare and my supplemental AARP coverall all of it except the first $2000.00 per year. (That’s my AARP deductible). Good news, I don’t pay for any other prescriptions for the year.

Also, prior to Kevzara, I found good relief with Tylenol for Arthritis as a supplement. My Rehumy recommended it.

Yes, I was a mess at times, had to be to,d many times, not to overdue it (I figured I could fight thru, no). At this point remind yourself, it’s ok to not be on top of your game.

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I am excited and almost afraid to be hopeful about the Kevzara. I hope to have a game back one day. Being in top of it would be icing on the cake. Lol. I am only 2.5 weeks in to the Kevzara and am chomping at the bot to taper the prednisone. But, I am still in pain.l at 12 mg. Not agony. Pain. Don't know if I should.

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Profile picture for toryf @toryf

Oy. Just got a message back from my endocrinologist saying to wait until
April of next year to see her as Prednisone dosage above 4 mg means that
the adrenal glands are not being activated which means that any and all
pain I am experiencing is due to PMR. Does that jive with what I have been
told?

Jump to this post

Yes ... that might be true. I was referred to an endocrinologist when I was still on 10 mg of prednisone. The endocrinologist said there was nothing she could do if I still needed that much Prednisone to control PMR. She referred me back to my rheumatologist to see if there was "anything else" that rheumatology could do to decrease my prednisone dose.

The endocrinologist I saw thought 3 mg of Prednisone or less was a "low enough" dose for my adrenals to get the message to produce cortisol again. She said it was anyone's guess how long it would take but I needed to be on 3 mg or less.

The idea was that 3 mg or more of Prednisone was enough prednisone to replace the body's need for cortisol. About 5 mg is the replacement dose for people with Addison's and for people who have lost adrenal function.

People on long term Prednisone won't always lose adrenal function permanently but the longer we take Prednisone the risk increases.

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Thank you for even more clarification. U and the group r leading my over active mind onto the path of understanding and away from panic.

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Profile picture for toryf @toryf

I am excited and almost afraid to be hopeful about the Kevzara. I hope to have a game back one day. Being in top of it would be icing on the cake. Lol. I am only 2.5 weeks in to the Kevzara and am chomping at the bot to taper the prednisone. But, I am still in pain.l at 12 mg. Not agony. Pain. Don't know if I should.

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Please note: it takes a few to 13 weeks for the Kevzara to take effect. You need to give it time to work, so you may not be ready to taper the prednisone yet.

Yes, we all want off the prednisone, but don’t rush to taper until you have more Kevzara under you belt, so to speak. The more pain you are in, the more tension your body is in.
Let it have some peace, relax and heal.

Lastly, find a PT, trainer or massage therapist to help your body.

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Profile picture for toryf @toryf

Thank you for even more clarification. U and the group r leading my over active mind onto the path of understanding and away from panic.

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Don't panic ... I don't think "short term" Prednisone is that bad. On the other hand, I don't think your Prednisone dose should be increased for niggles of pain. I wasn't sure what a niggle was until I found a humorous video that explained it to me.

I never increased for niggles like some people might suggest that you do. I certainly increased my Prednisone dose for other reasons and for pain that wasn't PMR. It just gets easy to blame PMR for all the pain when the Prednisone side effect of adrenal insufficiency accounted for some of it.

There are other painful things which we acquire as we age which might account for the rest of the pain. The amazing thing to me is how many conditions respond to prednisone but those conditions aren't treated with Prednisone.

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That's lovely! Lol. No panic and no niggling.

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Profile picture for tweetypie13 @tweetypie13

Please note: it takes a few to 13 weeks for the Kevzara to take effect. You need to give it time to work, so you may not be ready to taper the prednisone yet.

Yes, we all want off the prednisone, but don’t rush to taper until you have more Kevzara under you belt, so to speak. The more pain you are in, the more tension your body is in.
Let it have some peace, relax and heal.

Lastly, find a PT, trainer or massage therapist to help your body.

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Thank you very much. I was actually going to start the taper next week, which would be one month in. I will wait.

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