Raised ESR CRP

[bowler]

I have been doing a slow taper and now on 13mgs.Pred.  also  having regular [ monthly ] b/test.

2  weeks ago I started a  cold    [ which is still lingering with headaches/sinus]    but I  still went ahead with my b/test  last week. I realise now that perhaps I should have cancelled the b/test and waited maybe another week or until I felt better,  but as it was pre booked I thought I'd keep the appointment.   I got a printout on Thurs, and the results are ......  ESR 25  CRP  36.  I really feel washed out and having headache/sinus pain with some bleeding [ spotting ]   from the sinus,   I feel so tired,  but better once the Pred kicks in.    I did have tests last year for WGP which were all negative, but the symptoms have returned again since having this cold, so not sure if it's my GCA ?  

I really don't want to up my pred again after getting this far on the slow taper,  BUT  wonder if I should to bring down the inflammation   or take more paracetamol,  ?  Like I said  I feel better once the pred kicks in but then I wake with the symptoms again,  which suggests I'm not taking enough?    

My surgery is closed till after Easter,    but I feel the Dr. [ who hasn't a clue ] will only tell me to up my Pred, anyway,   so I have probably answered my own question.  [ That is to up my dose ]   My next Rheumy  appointment s in 4 weeks.     

If it wasn't for this cold,  I was doing OK on the taper,  I seem to be going 1 step forward and 2 steps back.

 

[Celtic PMRGCAuk volunteer]

Oh, rotten timing to have a cold to upset the applecart, bowler, just when you were doing so well.  Of course, the ESR and CRP will, no doubt, have risen due to the cold virus, and don't you think that the head pain could be more to do with the sinus problem rather than the GCA?  If it were me, I think I would go back slightly to the dose just before the cold hit and rest there until you feel better before having the blood tests repeated and continuing with the slow taper.  Meanwhile lots of lemon and honey, chicken broth and some garlic if you like it, and get well soon.

[bowler in reply to Celtic]

Thank you celtic

yes lots of drink, and chicken broth, I'm one of those that always stews up my chicken carcass and makes soup/stew with it, and yes I love garlic, especially roasted. 

I think your right the headache is from the sinus'  if it was my GCA then I feel the  headache wouldn't respond to 14 mgs, pred.  looks like I will have to up my dose again,

[PMRpro Ambassador]

The cold is possibly enough to trigger a flare in itself. A raised ESR/CRP shouldn't really trigger a knee jerk reaction to increase the pred dose unless there are symptoms to support that. So really, you have to be honest in looking at how you are and decide if this looks like a return of the symptoms. 

I know how you feel - after a good 18 months on 5mg or less I was put back to 15mg where I felt pretty good. I've reduced a bit but after 3 days at 12mg I think my body is telling me that is a bit too far. So, I suppose, 15mg it is...

[bowler in reply to PMRpro]

I'm going to up my dose to 15mgs and if ok will stay on that for longer,  My next b/test is due just before my Rheumy appointment in 4 weeks time,  so I will see how it is then and take the results with me, plus my other printouts

  I'm thinking if it was my GCA  14mg wouldn't be enough for that kind of headache, so like celtic said "it could be my sinus'   

 I still have a gut feeling that I have some  of the symptoms of WG. 

     

[Parijm]

Yes. My doctor told me not to go for blood tests while unwell. From the beginning of my PMR the ESR and CRP were high but over the couple of years are on a downwards pattern which I suppose is good. I had quite a stressful weekend and have struggled with fatigue this week, so I am trying to be relaxed and sleep in an effort to maintain my current dose of Prednisolone. 

[bowler in reply to Parijm]

Catching this cold has really set me back, and like you say any stress mental or even physical can knock you back,  I  have tried to keep my currant dose of pred, but as my ESR and CRP are raised and with my symptoms I feel I will have to up my dose just a little to 15mg. and see how I get on with that, 

 I have been on Pred for 16 years, and I don't think I will ever be off it completely.    

[piglette in reply to bowler]

I had a cold and my ESR and CRP shot up. My GP panicked and wanted me to increase the pred, however by that time I felt fine, so just carried on at the current dose.

[bowler in reply to piglette]

Thanks for that piglette, 

I will see how I am tomorrow  before upping my dose,  as I really don't want to go up if I can help it, but if needs must I will just go up by 1mg.  to 15mg 

I may ask for another b/test in 2 weeks time instead of 4 and see how it is then. 

[piglette in reply to bowler]

Good idea, I often ask for extra blood tests in that case too.   Luckily my surgery are quite happy for me to book them whenever. The nurse and I then decide which ones we fancy doing!