What is a flare? What is a remission?

[drz]

My treating doctors have always used what I consider a very liberal definition of remission. If my symptoms are stable or decreasing and supported by same indications in lab work, then no additional or different treatment is required so that means I am in a drug induced remission and any symptoms of Wegs I still have are consider residual symptoms which may or may not improve further.

Then the converse I learned recently is that if i can get through a small flare without any new, different or more aggressive treatment, then it is not really a GPA flare, but an increase in GPA symptoms brought on by infection or some cause other than a GPA flare. They define flare as something that requires more aggressive treatment.

I find this a little confusing and disturbing cause when I get new nasal bleeding, increased pain in my joints, loss of appetite, extreme fatigue all of which remind me of my initial Wegs before my diagnosis and treatment it feels like a flare to me. My inflammation markers are increased just like they were when Wegs was active, I have always viewed that as a small flare or mini flare or mild flare, even if it could be managed just with some extra steroid sprays and antibiotics and lost of rest for a few weeks. These have usually happened when I have a concurrent infection but they never occurred before I had the Wegs. Now I am not sure what to call those episodes. So if they are not a "true flare" what should they be called--pseudo flare or increase in residual Weg symptoms brought on by infection?? Doctors have told me previously that they don't know if the "flare" brings on the infection or the other way around?

So how do you and your doctors define remission? Flare?

Do others have infections with their"flares" too?

[chrisTIn@]

So how do you and your doctors define remission? Flare?

Do others have infections with their"flares" too?

My Wegs-specialist said I was in (medicated) remisssion in 2011, when I still felt rather ill (joint pain, very tired, needed lots of rest...).
During early summer 2012 I had my first medicinefree remission. Still felt rather ill, but not that much as I felt when first diagnosed.

This winter I am medicinefree most of the time. I try to be 'pro-active', to remain flare- and medicinefree. (I rinse my nose, and so on...)
I think it is often not totally clear when a Wegs-patient is in flare, remission or just going through an infection with no further damage.
So I think it's good you started this topic, Drz.
I'm curious to read how the doctors and caretakers of other forum-members define remission.

[renidrag]

I too am in drug free remission, although I see My PCP every three months for bloods, etc. My Rheumy will see me as needed or if I call for any reason. He also gets results. My last battery was done 2/1 with slight increase in inflammation and SED rate. No alarms rang and no treatment was prescribed. That being said I still have fatigue, neuropathy in feet legs, SOB and other WG like symptoms. I guess even though in "remission" I still have this disease within me waiting for another trigger?
Dale

[Psyborg]

I'm always wondering this too. First two times I was "In Remission" I felt pretty lousy. The first time I actually got back to feeling anything approaching normal was this past December. I really have some trouble telling what is Pred Withdraw symptoms and what are GPA pains.

[annekat]

drz, from your doctor's viewpoint, I have been in drug induced remission during the last year or so. My doc never brings up the "R" word, and I don't ask him. But I think he thought I was pretty close to it and we were both surprised when this latest flare came along and he had to increase my meds.. (I'm feeling better, BTW.) I think I may have had one or two minor flares which I recovered from without additional meds; one of them was shortly after I switched from CTX to MTX, and the other was right after I'd caught a fairly minor cold. Throughout, I've had the residual symptoms that go along with permanently damaged sinuses. A good thing for me: if I'm on any amount of prednisone over 5mg., I will generally not have joint pain, though some did creep in very briefly during one of the "minor flares" I mentioned above.

So, I guess it is like life, not everything is black and white, and there is a lot of subjectivity involved. I'll be interested in what others and their docs have to say.