For now he has increased pred to 20 mg per day (last week) and it seems to be helping more than the 10 mg per day. My next apointment is oct 18. The neuro indicated he will consider other options at that time if not getting enough relief from pred. He did not say plasmapherisis but said other options he would consider require hospitalization which may be due to other unique logistical issues i have - i have elected to have a treating neuro that is 250+ miles away so i fly there for the day(s).