Hello
Although I have constant pain ranging from pretty awful to fairly manageable, I don't think it is as severe as those who are posting on here (thank heavens - I know I'm lucky). So... I'm wondering if it would be better to "tough it out" for the duration rather than accept steroid treatment. My thinking being - I have high blood pressure, normal tension glaucoma , work in a job that requires an even tempered diplomatic approach and I'm already overweight.
I would be cautious about that approach. The reason bring pmr is caused by inflammation, which is what the prednisolone is acting on. Uncontrolled inflammation can lead to GCA. I speak from experience, it took my Rheumatologist and GP 14 months to diagnose, as I was too young at 46. 3 months after starting steroids I developed GCA symptoms. Now only 1 in 5 progress to GCA, but when your sight is at risk, it is a big risk to take in my opinion. Good luck x
Thank you runrig01 - I'm at sixes and sevens at the moment, I already have optic nerve damage so trying to figure out which is more likely - damage by steroids or developing GCA. I must admit I'm a bit frightened by it all
Hi Wendy
I had a similar experience to Runrig, with PMR remaining undiagnosed for a year, and only being diagnosed when GCA arrived on the scene.
GCA requires a very much higher dose of steroids to get control of the inflammation and protect eyesight, so I'm really a believer in treating the PMR to reduce that 1 in 5 risk of succumbing to a potentially more serious illness which carries risks of other serious conditions, not least irreversible loss of eyesight.
I can so understand your fear about taking steroids when you already suffer from optic nerve damage, but surely that very condition could put you at risk of further damage if GCA arrived on the scene. In that case 40-60mg of steroids would be urgently needed to protect your eyesight, whereas 'just' 15mg is generally recommended for PMR alone.
I think you would be wise to take advice from a highly experienced ophthalmologist. As far as high blood pressure is concerned, that can be kept under control with appropriate medication, as can glaucoma with drops. I have both.
Meanwhile, a little time off from your job, especially if it involves stress, may help with your pain levels - sadly there is no cure and PMR has to run its course for up to two years at least.