Tapering already?

I went to the Dr. this morning for a follow-up - explainned that while there is no more blood - and I've gone from 10-15 D a day to 4-6 soft a day, still pain...dr. wants me to taper from 40 mg. pred to 20 mg.  I have another sigmod scheduled for next Wednesday (sedated this time), last time was not, and he said he could only go up so far, wants to go further to see what's there - and that maybe because of that treatment would be different.

Does this make sense to you, and is a 20 mg. drop normal?

A 20 mg drop is insane. Most recommend a 5 mg/week taper or maybe a 10 mg/week. If you've only been at 40 mg for one week maybe dropping to 20 will be ok. But if you've been on it for more than 7 days no way should you drop 20 mg off your dose suddenly.

Thank you all. I've been on for 9 days. I even asked him "are you sure you don't want to go to 30 mg"... :) he just smirked at me, he is a very good Dr., just concerned that I'm not even 75% better and he is tapering already. He did say if I got worse, or blood started again, to call immediately.

(I had blood work done Monday night, after I had a gatorade) he walked in today telling me my sugar level was 380...I explainned about the Gatorade, his nurse took a finger prick and it was 89, he said I was fine then, other than that (and a few tears yesterday) I'm fine.

So at this point what do I do? Should I do it on my own and take 30 mg? do what he says and see what happens or call him and disagree with him? I had to move heaven and earth to get an appointment and become his patient,

Spent 5 weeks with a GI that would not diagnose me because during the colonoscopy in December (and I was 100% better then than now) - she actually said "textbook UC is more then 3 inch of inflamation which is what you have, I'm not ready to call it that yet", she had me have 2 MRI, 2 ultrasounds, cat scan....my primary Dr. finally called my new Dr. and asked him to see me. He did a sigmod, at that point I'm bright red upto 5 inches...and blood all the time.

I'm afraid to tick him off or doubt his knowledge :)

And yes, you should call him and discuss your concerns. I would not go around him and take the pred without letting him know. I would listen to his arguments (assuming he will make any - my bet is he will just agree with you to get you off the call) and then decide whether to seek care elsewhere or work the taper directly with your GP. Since you are seeing him next week for another scope, what about suggesting that you hold at 40 mg until then?

In my opinion it is better to be aggressive and completely kill the flare instead of trying to manage the meds so carefully. I spent probably 5 years with smoldering disease until I developed joint pain everywhere and ended up on 60 mg/day for a month. That taper took 3 months.

that's a really fast taper. i stayed at 40 mg for one month and then dropped to 35 mg and continued with 5 mg drops until i reached 20 mg (then it was 2.5 mg drops). this took almost 4 months but i will say that prednisone didn't do anything for my UC so the slow dropping maybe wasn't necessary. i'm not sure. it seems you've reached your peak with how well the prednisone will help. i still wouldn't drop that fast though.

your excuse can always be "i tried to drop to 20 mg but noticed symptoms again the next day so i went back up to 30 or 35 mg."

My GI had me do this as well. I was not pleased with it. I was on 40 mg for 1 month then he drops me to 20 mg. I was too scared to argue. He hates giving prednisone at all. I felt if I disagreed with him he might not give it to me in the future if I need it.

Pred is famous for symptoms returning once you start to taper down...any good GI knows this and expects this to happen to their patients...it's used as a "booster" med until maintenance meds kick in or as a break from severe disease activity for those that don't get much or any relief from maintenance meds.

I did ok til about 10 mg. then I got stuck there a while. Started having this terrible pain. At first the sy shingles. Then the doctor says it is UC. Now he says he doesn't know. It really is practicing medicine.