THREE MONTHS ON ...

[Polylinc]

Following a flu injection at the end of September 2015 ...

I began to feel unwell approx 10 days later with what I know now as the classic symptoms of PMR !

The first GP I saw unfortunately did not recognise the symptoms, so I suffered without any medication for a month until ... I requested a second GP opinion ...

She fortunately DID recognise the symptoms and her defining symptom was the fact that I could not raise my arms above shoulder height to wash my hair in the shower.

She put me on 15mg of Prednisolone and within a couple of days my symptoms had almost disappeared. Two months later, I am reducing and currently on 14mg Pred.

However ... I now have very high BP and on medication for that and am suffering from palpitations and dizziness too.

What I would like to ask is ...

Did anyone else on here start with PMR following a flu jab ? and ...

Is anyone else experiencing high BP, PALPITATIONS and dizziness ?

[Celtic PMRGCAuk volunteer]

Polylinc, did the palpitations and dizziness start before commencing the BP medication? I ask because some patients on medication for high BP can have palpitations and dizziness as a side effect of the BP meds.

You certainly aren't the first person we've come across to mention that their PMR diagnosis followed quickly on from having a flu jab, but equally many people mention having been prescribed statins just prior to their diagnosis. In the absence of a known cause, we are bound to blame certain events, but no clear infectious agent has to date been found as a trigger. Perhaps our immune systems are unknowingly low at certain times and certain interventions are the final straw.

[Polylinc in reply to Celtic]

Hi Celtic Charity

Thank you for your quick response to my queries X

Dizziness I have had on and off for over a year ... Strangely enough, following 2014 Flu and shingles jabs !!! but more noticeable since PMR diagnosis over last three months.

Palpitations and a strong pain in my chest, just yesterday, after a week on BP reducing meds. I am awaiting results of an ECG test just taken 2 days ago.

Due to yesterday's chest pain and more dizziness and palpitations today,

I have been given an emergency GP appt in just over an hour from now.

[Celtic PMRGCAuk volunteer in reply to Polylinc]

Wise move, Polylinc - good luck.

[Polylinc in reply to Celtic]

Hi -again Celtic Charity ...

Have left a reply below re the outcome of my late Friday GP appointment.

I would love to hear your comments on the outcome ... Thank you.

[Celtic PMRGCAuk volunteer in reply to Polylinc]

Polylinc, that turned out to be a much needed appointment, and well done to the GP for being so thorough. I ended up at A&E with my heartbeat all over the place just days after being diagnosed with PMR/GCA and a steroid starting dose of 40mg. They diagnosed an irregular heartbeat, something I had experienced years earlier but which had righted itself but was now stirred up by the steroids. Luckily, it has since righted itself again. I had been diagnosed with a heart murmur a few years previously which an echocardiagram revealed as being caused by a slightly leaky mitral valve. So far things have remained stable with no treatment necessary - hoping it stays that way, and that you, too, will find things improving as you reduce your steroid dose. I hope your cardiology appointment comes through soon - meanwhile do take things easy.

[Polylinc in reply to Celtic]

Can you tell me ... Is your name Celtic or Charity ... Or both

Thank you so much for your comforting words and for your support.

I am so pleased that I went to the appointment and I luckily had a GP who was thorough and saw the need for further investigation.

I trust that things will remain stable for you and that you will continue to need no treatment.

Fingers crossed, I may follow in your footsteps.

I have found since PMR in the last few months that taking things easy comes as second nature but ...

Not sure how I'll feel about that when the better weather and Spring/Summer return and I will feel like being more active and out and about .

I definitely feel a gardener/mower of grass may now be a requirement very soon ...

Very best wishes and thank you for your support and encouragement.

[Celtic PMRGCAuk volunteer in reply to Polylinc]

It's just Celtic. Charity appeared out-of- the-blue a few weeks ago in place of PMRGCAuk! But I'll answer to anything!

Good to hear that taking things easy is coming as second nature - at least it means that you won't get nagged by anyone here for overdoing things!

[PMRpro Ambassador in reply to Celtic]

You'll have noticed my "volunteer" label disappeared too at the same time. It's part of their "rebranding" I think. I won't discuss that any further.

[Celtic PMRGCAuk volunteer in reply to PMRpro]

Nor me!

[Polylinc in reply to PMRpro]

Hope your rebranding goes down well with you but ...

Hope you remain the same helpful, well informed person

[PMRpro Ambassador in reply to Polylinc]

I've already expressed my reservations - they rarely work in my experience! I opted out...

[PMRpro Ambassador]

Yes - there are several people whose PMR started soon after a flu jab - but also many who developed PMR without ever having had a flu jab, I'm one of the latter group. It is probably a case that the immune response to it was the final straw for your immune system that was already under strain. There are probably a whole range of cumulative factors that eventually tip you over into the realms of autoimmune disorders.

High BP can be a side effect of pred - though I'm surprised it has happened so quickly. However - since you mention palpitations and dizziness I'll tell you my experience. I started having both after my PMR started and asked the GP (who also couldn't recognise PMR - but it took 5 years to get the answer!) and since he couldn't hear anything wrong he suggested it was my age (!), and told me to call 999 if it went on too long and I was worried. There is sense in that - paramedics carry ECG machines and would be far more likely to get a tracing showing what is going on than if you were given an appointment for an ECG at the GP practice or hospital when it almost certainly wouldn't happen. I never did - the episodes that I noticed were rarely more than 10-15 mins.

Eventually I was put on pred for the PMR - and about 2 1/2 years after starting pred I had some back muscle problems which resulted in me being admitted to hospital for a fairly standard therapy here in italy - infusions of a pain killer plus pred as anti-inflammatory and, separately, valium as a muscle relaxant. The first night was fine - the second night I felt really peculiar after the i.v. valium. I had a 4 hour long episode of what turned out to be atrial fibrillation. The same happened the next night - so it was identified as being a rare but known reaction to the i.v. valium. But once it was fully diagnosed and treated I realised the previous episodes were a thing of the past! The cardiologist decided it was probably associated with the autoimmune part of the PMR which had done some damage to the electrical system in the heart.

In your place I would definitely ask the GP to check it out - though of course it isn't going to happen while you are with him! A 24-hour Holter ECG is the least you need if you can't get a paramedic on scene to catch it "in the act" so to speak. I assume the GP is dealing with the raised BP? I had always had a superb BP for my age, glued to 120/80, but the echocardiogram showed evidence that I had had high BP for some considerable time but it had never happened when it was being checked. It has been managed really well until the last few months - I'm back to having fluctuating BP levels again, anything from rather low to high normal. And the odd a/f flutter. So I'm off to the cardiologist again...

[Polylinc in reply to PMRpro]

PMRpro

Thanks again ... See my Saturday reply below about my GP visit late on Friday ...

I would love to know what your thoughts are PMRpro ... Thanks

[Polylinc]

PMRpro

Again, thank you so much for your interest in all that we post on here.

You are a star !!!

See my reply above to Celtic Charity too.

I have an appointment now to attend in just over an hour, so ...

Am armed with what you have both said !!!

Thank you so much X

[GreyOwl]

I hope Polylinc can find an early opportunity to let us know how her emergency appointment went.

[Polylinc in reply to GreyOwl]

Hello again to everyone who has been so kind with advice, comments and further information.

It appears that the emergency GP appointment WAS needed !!!

Thanks to Celtic Charity and PMRpro that I went AND armed with information too.

The GP checked BP which has reduced since meds taken for a week now but ...

After checking heartbeat diagnosed arrhythmia and heart murmur.

He added that "an appointment with a cardiologist was a matter of urgency,

hopefully weeks rather than months" and that whilst listening, had noticed 3 heart beats completely missed.

I was prescribed one aspirin daily and a spray for beneath the tongue should I experience palpitations/dizziness (I had just that day ... as several times before) and if I had a pain in the chest (I had a very strong one the day previously).

So once again ... Thank you so much for your concern and advice and like many others, I am so grateful for the comfort and friendship on this forum.

[GreyOwl in reply to Polylinc]

Take it easy Polylinc. Hope all goes well.

[PMRpro Ambassador in reply to Polylinc]

Result!!!!!!! And I'm impressed by your GP too!

This isn't to scare you but if you have pain - not just in your chest, up into your shoulders too, a sensation of tightness in your throat or feel sick when you are having an "episode" - and it isn't immediately relieved by the spray then call 999 and tell them. Calling them once too often is better than once not enough.

Looking forward to hearing the next installment.

[Polylinc in reply to PMRpro]

Thank you once again PMRpro X

I too was impressed by the GP who was on duty at my practice for the late afternoon emergency appointment on Friday.

I guess often it's the luck of the draw who we get on the day we phone for an appointment and what diagnosis they make and then ... what action they take ! I guess it was my lucky day !

I hope the next instalment is a good one ...

[joy-bells]

Hi Polylinc, yes my PMR started after a Flu injection. I also had a lot of stress at the time as well. One side effect from prednisone med., is high blood pressure. My B.P. went up so I am on medication for that.

There was an article in our local news paper saying

" A United States team analysed blood samples of young and older people who had received flu vaccines for several weeks after they had the flu jab. A week after the injection, younger people had higher levels of antibody--producing B cells- the cells that help your immune system to "remember" a particular bug. But the older group had higher levels of immune cells that produced inflammation. This level of inflammation aligned with a person's overall immunity after the injection. The researches said although the discovery was new, it would be worth seeing if suppressing inflammatory responses would make a vaccination more successful for older people.

This article was in our manawatustandard.co.nz. Monday December 28, 2015. Page 14.

Hope things settle down for you. Regards.

[Polylinc in reply to joy-bells]

Thanks so much Joy-bells X

See my reply above from yesterday's posts.

Hope that you are feeling better now.

[BonnyQuine]

Strangely enough, I've realised that I'd had a flu vaccination only a week or 2 before being diagnosed with GCA. Hadn't given it much thought. But had been having symptoms before that - just that they became more acute. Coincidence?

[Polylinc in reply to BonnyQuine]

Interesting BonnyQuine , but I guess if you had symptoms pre the flu jab ...

I do hope that you are ok now and coping well x