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Re: techniques for cutting flares?
Gibbo #263330 01/13/14 10:33 PM
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Prednisone for the mega flare-ups that just won't go away. Heat (bath tub and microwavable pads), gentle stretching, and menthol back patches for thoracic spine and SI joints (Absorbine brand). Good luck finding your cocktail!


Amy

27 years old
AS diagnosis 2013; neck pain for seven or eight years, and spreading multiple-joint pain for about two years
Also: Fibromyalgia, Hashimoto's, hypoglycemia, Raynaud's phenomenon
Meds: Remicade, Norco (10-325 mg), Gabapentin, allergy shots, Prozac, Synthroid (25-50 mcg)
Re: techniques for cutting flares?
Gibbo #264048 02/05/14 09:49 AM
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I see a few of you on anti tnfs take prednisone when you have a flare. I was wondering - does it help stop the flare or just help you get through it?

I was also wondering what dose helps you? Before I was on humira or methotrexate I responded best to 40mg pred, and not quite so well to 20mg, but I'm thinking (hoping) I might get away with less than 40mg on top of the other treatments?

I'm struggling at the moment and my crp is up to 18. Humira always wears out during the second week of the fortnight, but at the moment even the first week is a problem. Apparently moving to embrel's the only other option here in NZ - increasing the frequency of humira's not an option here - and my rheumy's loath to move me off humira until it stops helping completely.


Shirley
Peripheral and axial AS diagnosed October 2011 aged 50, more than 15 years after the symptoms started. Also PCOS, GERD/oesophagitis/dysphagia, IBS, asthma,chronic rhinitis. Taking enbrel, methotrexate, folic acid, omeprazole, vitamin D, metformin, steroid inhaler and eating low starch/low GI.
Re: techniques for cutting flares?
Gibbo #264049 02/05/14 12:44 PM
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Shirley, when I am in a flare, I will often start a long term steroid taper. usually starting at 4 pills for a few weeks, then 3 for a few more, then 2, then 1, then 1/2 ect. its about a 4 month taper and when I am off the steroids, the flare is typically gone.


Carrie
Small business owner, 53 / mother of 5, Fort Worth, Texas
Remicade, Seroquel, Folic Acid, MTX, gabapentin
Undifferented spondylopathy HLA-B27+ (onset 2007- DXed 2008) with associated uveitis, psoriasis
EPI and IBS - gastritis due to NSAIDs
Right Hip replacement 2017 with subsequent 4" heterotopic ossification (removed 2019)
Re: techniques for cutting flares?
Gibbo #264068 02/06/14 12:56 AM
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Thanks Carrie.
I'm too scared of the side effects to try prednisone for more than 10 days or so at a time, but I'm glad that works for you.


Shirley
Peripheral and axial AS diagnosed October 2011 aged 50, more than 15 years after the symptoms started. Also PCOS, GERD/oesophagitis/dysphagia, IBS, asthma,chronic rhinitis. Taking enbrel, methotrexate, folic acid, omeprazole, vitamin D, metformin, steroid inhaler and eating low starch/low GI.
Re: techniques for cutting flares?
Gibbo #264074 02/06/14 05:31 AM
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Fasting plus high dosing of probiotics. finally broke a nasty Iritis flare for me

Last edited by drizzit; 02/06/14 05:31 AM.
Re: techniques for cutting flares?
Gibbo #264076 02/06/14 08:22 AM
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It seems like fasting does help alot of people. Unfortunately, fasting's not really an option for me as my stomach tries to digest itself...

Last edited by Shirley; 02/06/14 08:23 AM.

Shirley
Peripheral and axial AS diagnosed October 2011 aged 50, more than 15 years after the symptoms started. Also PCOS, GERD/oesophagitis/dysphagia, IBS, asthma,chronic rhinitis. Taking enbrel, methotrexate, folic acid, omeprazole, vitamin D, metformin, steroid inhaler and eating low starch/low GI.
Re: techniques for cutting flares?
Gibbo #264077 02/06/14 09:59 AM
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It would be much easier for me to count the weeks I've been off prednisolone than on over the last three years. I think the longest might have been something around three months. The last year has been tapering off a two-ish year stint on the stuff and going through several ~one month tapers to head off flares.

I wouldn't be too worried about using it for longer than a couple of weeks, but that's something worth talking with your GP and Rheumy about.

As to the rest of my strategy. I allow myself to ease into the day, loosening up slowly and dealing with any bothersome hotspots. I make sure to go for a walk or run an errand at some point, even if I need my walking stick. In the evenings, I'll vary my sitting position from the sofa, to the floor, on my back, side, etc and use the wheat bag on joints and frozen bottles on the feet.

In a nutshell, prednisolone tapers and as much movement as I can manage.

Re: techniques for cutting flares?
Gibbo #264078 02/06/14 12:33 PM
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Shirley, I can not tolerate pred, I take methylprednisolone (whats in a medrol dose pac) and get none of the side effects.


Carrie
Small business owner, 53 / mother of 5, Fort Worth, Texas
Remicade, Seroquel, Folic Acid, MTX, gabapentin
Undifferented spondylopathy HLA-B27+ (onset 2007- DXed 2008) with associated uveitis, psoriasis
EPI and IBS - gastritis due to NSAIDs
Right Hip replacement 2017 with subsequent 4" heterotopic ossification (removed 2019)
Re: techniques for cutting flares?
Gibbo #265021 03/16/14 08:36 PM
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I've tried various steroid tapers several times over the years. Unfortunately, they don't seem to help in my case.


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