Swollen artery around the temple area

[Old_Bedfordian]

Hi everyone. My physiotherapist, a lovely person and real help to me, has suggested that I take an image of the temple area, at different times of the day. This hopefully will show people any swelling. Now the temple pain is always worse at 2 to 4am, however, here is the first one taken during my rest period 2.41pm, laying on my back with my cervical supported. The pain at that time was in the lower quartile, taking 100% as the time when pain is at its greatest. My prolific amount of hair negates seeing the whole thing, so here we have just a section. The other side is normal. I am still not on prednisolone and awaiting response from GP and Rheumy who are both on hols. Not panicking, but monitoring everything I can. Dave

[Celtic PMRGCAuk volunteer]

Dave, if I had a swollen temple artery like that together with temple pain, I would be "panicking", and hot-footing it to A&E. I would certainly not be waiting for either rheumy or GP to return from holiday.

A CRP blood test should be carried out (a more specific marker of GCA than ESR), although a normal result doesn't rule out GCA.

You need to be on high dose steroids, at least 40mg. Hopefully, your pain will then improve within a few days or even within hours, and you will have confirmation of GCA.

Your photo can be compared to the following image of a swollen temporal artery from the Mayo Clinic:

mayoclinic.org/diseases-con....

[Old_Bedfordian in reply to Celtic]

Thanks Celtic. I have been to A&E recently, and the result is that the OOH GP makes this statement: 'I would do no more than your own GP'. SO that seems a waste of time to repeat, but after this morning's episode (1am to now), with the pain spreading across the whole front of the head, I was in no state to go anywhere. Also a large PMR type flare came on yesterday, spreading to pelvis, hips and upper legs. The cervical and shoulders being affected primarily.

Don't forget throughout my med notes, it talks of two short episodes, instead of then years of continuous suffering. Also I was in the Army for 1976! No one told me!! Getting my med records last Friday was an eye opener. My GP did try Pred at 40mg/d for five days. After three days my symptoms went. Sooooo, you see, the notes are clear to them all. Two short episodes, and no problems now. (The last time I saw the GP, a week ago, she said, quote:''come back when the pain is worse, and I will see what I can do'').

What I really need is not to live in Bedford, methinks.

I will go and see the stand in GP later, if I can move well enough. There is no appts at our clinic, we join the queue.

[Celtic PMRGCAuk volunteer in reply to Old_Bedfordian]

Dave, with the way you say you were feeling from 1am this morning to now, why ever didn't you just call an ambulance? After all, you mention that even the last GP you saw said "come back when the pain is worse, and I will see what I can do". The pain was worse but GP surgery closed....an ambulance to A&E would have ensured that you were seen when your pain was "worse". If this is GCA, then your eyesight is at risk. One too many trips to A&E is far better than that risk becoming a reality.

[Old_Bedfordian in reply to Celtic]

That is easy. My sister who is a nurse, and others have said that the average wait for an ambulance in Bedford is about four hours. Much the same as A&E (typically 5 hours). I believe the OOH GP is the best avenue, as she said. WHich is what I am to do this evening if I get nowhere with the locum.

Just uploading the other side (RHS) image of same artery on a new post, as I cannot find out how I do it otherwise. This picture may suggest that my arteries 'normally' look like this, although the LHS seems to be going up and down from large to medium, if that makes sense. Anyway, Have a look. I cannot go anywhere until 3pm, and there is a queue for the GP until 1730. (The way my surgery works). Thankyou Celtic, and all you lovely people who are trying to help a worried ole man!!! (Feeling sorry for meself!)

[greenlander]

I would echo that advice. Get some medical help NOW.

[Old_Bedfordian in reply to greenlander]

Thanks, Greenlander, please read Celtics reply. I know you are all correct in your instructions and appreciate the effor you all make.

[DorsetLady PMRGCAuk volunteer]

OB, further to our previous chats....do me a favour and get it seen to, pronto! Was I wasting my time talking to Daily Mail? May be not GCA but better safe than sorry! DL

[Old_Bedfordian in reply to DorsetLady]

If I was able to, Sue, I would put myself on the pred again, and if I responded, I would continue under the guidance of a med pro to taper over period of time. Much as you all have taught me.

However, I am not a medical person, and cannot prescribe. My really good physio, lady, says that it does look like GCA, but as it goes up and down, and is not constant, I should take a series of pics over time first. Presumably she means that when it is constantly swollen, It will be too late!

I'll let you all know what happens with the locum today. Thanks again

David

[PMRpro Ambassador]

If you're continuing the documentation - why not do both sides?

And I'm with the others - I wouldn't wait for holiday-makers to get back.

[Old_Bedfordian in reply to PMRpro]

Yes, I have thought of that. No pain that side as on the left side, though. However, I should do the work. Perhaps I should shave the area back to expose the rest of the area too.

Thanks for mentioning this, Dave B

[PMRpro Ambassador in reply to Old_Bedfordian]

As a comparison with normal it is important - otherwise someone may try to suggest it just something that happens from time to time.

Not sure I'd bother with the shaving though - unless you fancy a No 1 cut like my husband favours. Summer is acomin' in!

[Old_Bedfordian in reply to PMRpro]

Oops, the other side is worse, a lot worse. That is 11.50am. The side we saw yesterday seems to have gone down a little. But the RHS seems several times worse. Do you think the artery swelling can change like this or should it be constant?

I feel absolutley ill, and of course, might be a bug. How do I show you all the comparison of LHS and RHS. I can only upload one picture on a new post, is that correct?

Please keep in touch, if possible, cos naturally I am very concerned. I think the OOH GP ( or any other in Bedford will not prescribe pred, as I have tried four now over the weeks. My sight seems good, and I have a strong pulse LHS and a slightly weaker one RHS., but I reall am not trained in this.

Dave

PS: Might take a lift to Bristol and go A&E there!!!!!!!

[PMRpro Ambassador in reply to Old_Bedfordian]

Do what Celtic says - if you feel really ill as well it is obvious something is up and there is a relevant history.

[Old_Bedfordian in reply to PMRpro]

Yes, I really do feel ill. I will act, promise.

[Celtic PMRGCAuk volunteer]

Dave, have you seen my reply to your earlier post - please call an ambulance NOW, telling them how ill you are with suspected GCA/TA which puts you at risk of sudden, non-reversible sight loss. In the near future, there could well be a fast track referral system straight from GP to hospital where GCA is suspected (of course it needs an on-the-ball GP to even recognise it in the first place!). Meanwhile, we have to help ourselves.

[Old_Bedfordian in reply to Celtic]

left the GP a few minutes ago. She agrees, but reffered me back to the clinic.

As I say it would be quicker to go OOH service rather than ambulance. I am happy to monitor things, and have pred standing by. About 4 days worth. At the moment, I feel pretty rough, and over the weekend I expect to follow the procedure to OOH clinic. That should get me attended to pronto.

Sorry if I did not reply, I thought I did. Struggling a bit at the mo. Still see ok, and just pain seems everywhere, including feet, hands. Ne'e'r mind. I will sleep near to help and summon pronto.

[Hidden]

Old Bedfordian

You may not be wrong at all - If it takes four hours for the ambulance to get to the patients, that probably shows the service under immense strain. If you had a "stroke", it would probably be too late..(most Neurologists may agree)

May I ask roughly when you started to notice the symptoms pointing at "GCA"? I wondered if there were any studies as to how many years it has taken for patients before the diagnosis especially in "younger" (40s/50s) patients? It's completely odd to think 40s/50s are considered too "young" anyway? This doesn't make any kind of sense at all. Drs seem to be too fixated on these "small prints" (age, gender, race etc etc) without realising patients are ill, anyway (and something needs to be done)? Do you think you may be dismissed because you are not in your Eighties? What "excuses" were you given so far? How long has this been going on?

Thank you for sharing. Take care

[Old_Bedfordian]

Hi Ferntree, I have written a post on my latest. It was interesting that you could go back to see the rheumy, we have to wait 3 to 6 months to see one.

I have noted your words of experience here. Thanks OB

[Old_Bedfordian]

Hi there Elizcarroll,

Had a virus for three weeks, quite poorly and now all the kind emails to reply to...

Thanks for your experience, there seems so many of us out there.

I posted a new post to give update a little while ago, and I am managing well. They have convinced me it is spondylosis, and not GCA, so I will be monitroing everything very very closely. Not worried though.

Dave B