Prednisone NOT working....??

Hello all. I went to the er this past friday night for pain upon breathing. It ended up being pleurisy again. They gave me a prescrip for Naprosyn & Prednisone(60mgs once a day for 5 days)...I emailed my rheumy since I hadnt heard from her since telling her about my original symptoms.(she was going to do a short term prednisone treatment anyway)..she said 60mgs was way too much & called in some 5mg tablets so I could start 20mgs for a week then taper off dropping 5mgs each week till I was done. I took 60mgs 2 days in a row before I heard back from her to hopefully get some relief. Well,the pleurisy is better but the aching/burning in my joints is not. Im also still getting rashes & its making me sleepy. I have heard prednisone can do the opposite. When I told my rheumy how Im feeling she said its probably because it`s not inflammatory that im experiencing?!...or that its still early in the prednisone treatment...I just feel like it hasnt done anything for me...am I expecting too much? Does it really not work for some people by itself?...please Id love to hear stories from everyone! Side effects,etc. Thanks so much. Hope I find you all well. *hugs* -Lupie Britt aka LadyBug

Note: I am taking only one dose of the recommended amount each day, not spreading it out over the course of a day..should I spread them out??

When i get infusions once a month when i am in a flare i get solumedrol shots usually 80 mg and it helps esp until the full affect of the infusion kicks in. I try to stay off prendisone because i don't notice it being beneficial enough, and it makes my sugar really high (diabetic) I would say at 60 mg you should be feeling no joint pain after a day or two, I would call my dr. and say I am just not feeling right.. I wouldn't spread them out.. My rheumy told me when i do medrol packs or stuff like that to take all at once in the am. because steriods usually make you awake . I would call your dr. leave a message with phone nurse say your breathing easier but you just are not feeling well your joints are killing you and your rashes are present and you just don't feel right, should you wait it out or come in?

hope you feel better soon.

Short term treatments usually do not work.  Effective treatment is usually very long term starting with a higher dose and slowly tapering to a maintenance dose.  A second drug that is not prednisone is usually added to provide a controlling med that is better tolerated than pred over the long term.  Treating lupus is not like treating an infection.  Treatment suppresses a misdirected immune system which will sometimes reset itself over a long period of time and go into remission but you cannot count on that happening.

I would seek a second opinion from an experienced rheumy about your treatment.  Never heard that short term treatments work except temporarily.  Many of us have been on pred for years.....6 years in my case but will be off soon.  Also had IVIG and imuran along the way.

Every patient responds differently to treatment and what works for one might not for another. 

Bill

Good luck.  The rheumatology dept. at JH is excellent and I know one of the docs and know others by reputation.  JH has the only Myositis (a class of muscle disease that I have) in the world and their docs are highly respected.

If you eventually go to Benlysta the approval process is not easy.  I have one friend on it and another trying to get approval.  

The short course treatments are common but I have yet to hear they work.  It was tried with me several times but did not suppress my immune system and went on a long course of pred which did not work either.  Early and aggressive treatment is usually best but I think some docs are reluctant to be that aggressive until the symptoms worsen.  All the drugs have down sides and a conservative treatment is usually prescribed unless it is a really bad case.  Mine started out slowly and steadily got worse and then got a lot worse in the course of a week. 

Bill