my appointment is coming up and I'm not sure if I'm ready to up my meds

Gosh. It sounds like your symptoms come and go. I think that is typical. Mine don't do that though. Mine are constantly bad. I don't have good days or even good moments in a day.

I haven't noticed any improvements either.

With all of the difficulties that you have been having, I would say hold off on raising your dosages. None of this is going to be smooth sailing for a bit, but you also don't want to completely overwhelm your body either!

Be sure to have a good, loooong talk with your doc about all of this, IHL. I'm concerned about you upping dosages considering how bad you can feel too much of the time. I surely wouldn't want to have you get a lot worse. Just be careful - and remember, you know your body better than any of us or your doc!!

When is your appt?

IHL - my days are up and down - all over the place...always have been. My symptoms change throughout the day...it's really hard to plan things living like this.
I typically flare in the evening hours...especially when I'm sitting down.

I am finding that my bad hours most days (not all) aren't as bad as they were several months ago.

If you're not finding that you have any improvements...then maybe it's wise to stay on the current dosage.
Improvements meaning - your bad times aren't as bad as before...or you're having more good hours in some of the days.

I know with me - it's really hard to tell sometimes because my changes are in micrometer amounts.
Also - if I have for example about 30 symptoms...and three are better - but they maybe aren't three of my worst symptoms - it's hard to recognize. My one worst symptom is still there...so I may not notice some other ones that are improving. Does that make sense?