While I was thinking about medicines and long term therapy, I thought I’d ask another related question about prednisone. I started a prednisone burst just over three weeks ago. 20 mg made a quick difference in bringing up the energy level, dramatically. The pain was improved, at least for a few days. Then randomly (or so it seems), the pain kicked back in, but different in some ways. It was more the muscles, not just the joints. A switch to Ultram ER helped, and the week I was at 15 mg was the best I’ve had in so long. I even managed to be social over that weekend and stay up late(r)! But last week I went down to 10 mg, and within two days, the body was letting it be known that it didn’t like it. Major fatigue again and the pain just ratcheted back up, to where I was doing the Ultram and several doses of Relafen and still not feeling much relief. I talked to the rheum, who told me not to drop down to 5 mg this week and to stay at 10 mg until my Monday appt. So now I’m left wondering what next? What are other options for treatment if lower dosages of prednisone don’t seem to help? The other times I’ve done prednisone bursts, I didn’t have this problem at all, so that sort of worries me too, but it’s been probably close to 10 years since I’ve had to do a burst. It’s so frustrating (what isn’t with these things), but I was really starting to feel better, really feeling hopeful about things improving, and it sort of felt like the rug was pulled back out from under me.
Does this happen often with prednisone bursts, where you see improvements in your symptoms but then hit the halfway point or so and see it start to go the opposite direction?