### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
I have Wegeners. Last Rituxan infusion Jan 2013 and Prednisone free since Nov 2013. I was taking Plaquenil and the occasional Diclofenac and have weaned off those completely as well. It has been about a month medication free and I am having a flare. My doctor is on vacation and I m not sure what to do. Severe joint aches in back, knee and elbow as well as increased inflammation in right ear. Prednisone? If so how much. Also do I start taking Plaquenil again...it will take a while to get back into my system. If I take prednisone without a maintenance drug in my system will my body be reliant upon it?

### output:

Hi, thank you for providing the brief history of you. As you being suffering with Wegener, and taken steroids as well, for which now you are again having pain and aches, so you want to restart the medication. Well, self-medication is never advised as if complications happen one can never be sure off. Also, steroids for longer run will not be a choice of any physician due to the future side effects and the troubles if taken in excess dosage. As you have the joint aches, pain, backache, knee pain, elbow pain, etc. I will advise you to undergo physical therapy. As per the pathology of the Wegener, one needs to make the control of the symptoms with little medication and more of the physical therapy like - exercises. In my clinical practice most patients with Wegener are misdiagnosed with RA and only on a later stage they come for a conclusion of Wegener. We recommend them to try physical therapy and the majority of them has a good outcome score. Since the pain can be controlled without more of the medication than it should be tried out. RegardsJay In Chat Doctor. 