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@saltyg

I was diagnosed in beginning of Dec 2022 after having experienced a few weeks of extreme fatigue and weakness. I was feeling like I had been doing pushups all night when waking up. During the night it was hard for me to even move my bedsheets. I also had pain in unusual places. I say that because I already had been suffering with chronic pain from Ankylosing Spondylitis for many years. Usually my pain was hip down, but now it was hips up - upper back, ribs, arms, shoulder, neck. Plus some headaches, not something I normally have.
My rheummy pretty much said after a few questions you probably have PMR, which I never heard of. I am I like to say ONLY 56 (lol). Anyway he said we try a course of steroids if I improve well that’s it. So I did a Medrol pack (which I have had many times over the years having Iritis connected to my AS) but I never wiped out all my symptoms like this one. I felt awesome. That lasted about a month and then I noticed PMR symptoms coming back so I took another Medrol pack hoping for at least another month. Well I took my last dose on a Thursday morning by Thursday night I could barely lift my arms. After a couple of days I couldn’t take it anymore. I called the rheumatologist back and he said well you’re gonna have to just be on steroids for a long time. Let’s start with a low dose and see if it has to work up higher. We started with 5 mg - it helped but not enough so then I had to go up to 7 1/2, which I pretty much have been on for about two months. I am due to go back and see him for the first time after being diagnosed, which is the purpose for this post.
Any helpful hints on questions I should ask now that I am going back. It seems pretty well under control at the 7 1/2 although I can tell it’s still there and if I overdo it, there’s definitely flares. Potentially I could do a little better by going higher, but reading all this tapering off stuff not sure if it’s worth it? Any thoughts are welcome. Thanks, wholeness and wellness to everybody.

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Replies to "I was diagnosed in beginning of Dec 2022 after having experienced a few weeks of extreme..."

I am in a similar situation in some ways, though I have been on prednisone longer, since August 2021. 8 mgs is the dose where I know I still have the disease but I can function. On my way down to that dose from 20 mg, 10 was the lowest dose where I had no symptoms but there were more side effects like insomnia and heart rhythm issues. I have tried going lower and had 4 major flare-ups (unable to raise my arms and barely able to walk due to hip pain in the morning). At this point I do not believe it is worth it to try going lower until I feel better at 8 mg. From what I have read here everyone has a different experience and my advise is listen to your body and work with your doctor to find the best dose. Since I have been "stuck" at 8 mg for quite a while my doctor recommends that I add methotrexate to the prednisone in order to get to a lower dose.

Interesting post as I also have been dealing with AS (since 1972, give or take). Over those decades I managed the pain with exercise and meds. AS has run its course and most pain gone as many joints are fused. Luckily I am not bent over but cannot paint a ceiling or catch a pop fly ball to save myself.

You did not mention your SED Rate and CRP readings. My rheumatologist uses those to help determine best Pred doses and timing of tapers. Not sure I always buy into that science as there are times i’m hurting and he is disinclined to raise my dosage. Currently at 4mg and will start 2 in day and 2 in middle of night, as mentioned in postings. Then down to 3.5 in a week or two. Wishing you and others all the best.