I woke up on Monday morning with flu like symptoms and severe pain down the length of my esophagus ( centre of chest from throat to stomach, it also affected one side of my jaw intermittently ). I also vomited. My husband phoned the GP for advice and was told to phone an ambulance, I guess because it was chest pain and my age etc. the pain kind of blossomed at my sternum and went right through to the back. Heart checks were done in the ambulance and I was also sick again. They gave me some God awful spray that made me feel horribly sick and dizzy ( it was to dilate the blood vessels. All the heart tests were normal, as was blood pressure etc. to cut a long boring story about lying on a trolley in various parts of A&E with nothing to drink or any Prednisalone . I had a throat swab that confirmed flu. I was then told I had to wait for blood tests to see if I'd had a heart attack. By this time I was fairly sure I hadn't but was in the relentless system that doesn't look for any other explanation for my symptoms. Because the blood test results would take another 2 hours and I was feeling terrible I decided to go home. My own theory is that the steroids had caused some irritation to my esophagus ( it really hurt though, like a thump). I was 90% certain that it wasn't my heart. The pain eased off and I'm in bed with flu. I don't feel like eating anything but I know I've got to protect my stomach. Omeprazol didn't suit me and I no longer have anything to "protect" the digestive system. As I said the pain has eased off but the area feels significant but I have only had liquid for over 24 hours. Needless to say, nobody I came in contact with had heard of PMR and nobody was interested in steroid side effects. Heart attack only, which I don't think I've had. Sorry for the ramble. Does anyone recognise these symptoms or have any ideas? Thank you for your attention! I grieve for the fire fighting NHS, I really do.
Ambulance Drama: I woke up on Monday morning with... - PMRGCAuk
Ambulance Drama
Hi SheffieldJane,
Sorry to hear about your experiences, A&E is not the nicest place to be at any time - many a long hour spent there with my late hubby! But at least you got an ambulance, and the spray is GTN spray used for heart problems, hubby used to carry one around in case he had an angina attack, and he used to say it was horrible!
Can't help with the oesophagus pain, unless it's GORD, did anyone check for that or hiatus hernia?
Have you tried other PPIs - or do you have a bad reaction to all? If so, many people swear by yogurt, natural and/ or organic is best I think, but sure someone will advise. In the meanwhile best to steer clear of spicy foods in case it is something other that the Pred.
Totally agree with your last sentence.
Take care.
Thanks for your thoughtful response DorsetLady. If only A&E had the capacity to be as helpful as you are. It's comforting to know you're there.
I have no pain today and took Prednisalone with a live yogurt and had no adverse symptoms. I'm still in bed with what feels like a shortened version of flu, maybe due to the flu jab. Yesterday was shocking with a soaring temperature, today I'm just tired and a bit off. Hiatus Hernia might fit because of the sensation of having swallowed something that's stuck. Women's heart attack symptoms fit too though. When I'm well enough ( ha ha) I'll talk to the GP. I've had these symptoms, though of very short duration before. Thanks again. Roll on Spring!
Ditto to that!
Query esophageal spasm which is often related to GERD or hiatus hernia. Very much mimics a heart attack as it feels like your mid chest is in a vice and it radiates into the back between the shoulder blades. It's a very long muscle and man when it spasms it is very painful.
Yes, I've experienced esophageal spasms, even though on Ranitidine, and went to the ER with the first one.... I thought it was heart pain for sure...mid chest into back, up into jaw, ears, teeth......I and others in another group find drinking water (some prefer quite cold) often heads them off...never go anywhere without my little thermos now....touch wood it's been a while since I had one, they're quite terrifying....
Cheers.
As they see feed a cold starve a fever and flu is a fever.
Have you thought about coated pred? This is absorbed in the gut rather than the stomach and so does not cause the stomach upsets.
I do recognise your symptoms Sheffieldjane. I have had 6 such attacks in the last few months but only went to A & E with the 1st as I passed out in the street (probably due to having too many GTN sprays for the pain) so passers by called an ambulance. I was also told it wasn't a heart attack but they thought it might have been a spasm of an artery. I've since seen a cardiologist (I do have some heart disease) and he thinks it was gastritis but to make absolutely sure he is doing another angiogram (this Thursday) so at least I will know one way or the other. The funny thing is that 5 times out of the 6, the attack has occurred in the late morning! (A couple of hours after Pred!) I was diagnosed with pmr last August so I have wondered if the steroids were causing it but I do also take omeprazole to protect my stomach. The pain is similar to angina but I have never suffered such bad attacks until recently. I am also eating yogurt now on a daily basis to try and stave off any more episodes.
Like you, Carrot, I used to use the GTN spray. Apparently it is of some use with the oesophagus pain but I always have Gaviscon tablets with me and chew a couple on the spot. Does the trick for me.
I have no wisdom to offer but what a frightening episode for you. I too, as you know, have experienced A&E recently and although staff were brilliant A&E were just at bursting point. I do hope you recover quickly from the flu, take it easy,drink plenty and soup I found was quite good for meals when I was unwell. I too take plenty of yoghurt with my
Wishing you all the best
Jackie
Left out the word"pred!" I.e "plenty of yoghurt with my pred"
I am now taking yogurt with Manuka Honey before my Prednisalone and Atenolol and so far, so good. I will go to the doctor to discuss this symptom. Thank you Chloe, Carrot and Piglette. I think Hiatus Hernia too and didn't know about the spasms. Why do doctors stop looking for an explanation when they've discounted the life threatening one? We seem to have to make all the running with doctors these days. Unless I have a strategy for these attacks I will waste another ambulance and trolley in A& E. The pain is frightening. Over the hours I was in a corridor, then a cubicle, then a curtained cubicle, then when the flu swab results came back, I got a private room. A definite sense of moving down the order of priority. Being told bloods would be taken in one hour and results another 2 hours was just too much, I had a high fever, nobody was sorry to see me go. But you are left wondering - especially as I can't see what else I could do in future?
The weary kindness I overheard from staff all day made me feel so sad for them. My son in law is a GP and is going to work in Australia for a year, earning twice as much as here, in well equipped surgeries. Actually maybe my heart just broke because my grandson Theo and his expected brother and my daughter are going too. I already have my eldest daughter, partner and two grandchildren out there. 😪
So sorry to hear about your scary episode. It's hard to fight the doctors/system for the correct diagnosis while you are also fighting an illness. Just a thought, yogurt works great and I find kefir helps too. Besides, you get 300 mg of calcium in an 8 oz glass but I space them out because Pred does interferes with calcium absorption. I hope you feel better soon. 
Good excuse to get yourself out there then. Aim for a Christmas in the sunny Southern Hemisphere with family - that's my plan - give you a wave as I pass over on my way to NZ.
Thank you Jackoh and kulina your kind advice is much appreciated!
Three days in bed, fasting and I'm tottering out to see" Annie Get Your Gun" at the Crucible Theatre with husband and son. Hoping for some inspiration from a tough cookie. Life must go on!
Hi SheffieldJane, hope by now you are feeling better.
I suffer from gastric reflux and have been on lansoprazole for a long time. Before my PMR diagnosis and starting on pred it was enough for me to take 1 lansoprazole every 2-3 days, very low dose, and I used to take it late morning. Since being on pred I have suffered intermittent sharp pain like you describe - like being in a vice, or like I've swallowed something cow-sized and it's got stuck in the middle of my chest.
I increased the lansoprazole to 1-2 daily and rearranged the time of taking my meds, so lansoprazole first thing, then pred with breakfast about an hour and a half or two hours later. That helped a bit, but not completely. I added in ginger capsules, taking them at the same time as the pred, and since then I've had no problems. I've also been able to reduce the lansoprazole to just one a day, and suffer no ill-effects if I miss a day occasionally. There's a fair bit on research on the medicinal benefits of ginger - including soothing the digestive system and acting as an anti-oxidant. Might be worth a try?
I'm very new to all this - only (finally) diagnosed and given Pred in December - but even with Omeprazole I've realised fairly sharpish that I have to cut out spices. I was waking in the night anyway, par for the course I understand, but then started to be woken by the considerable pain of acid reflux. I'm now swigging 2 large spoonfuls of Gaviscon last thing before I go to bed and that seems to be holding the acid reflux at bay. No idea if this would help you, but thought it might be worth mentioning?
Thank you for your posts, Patience and Mai45 you describe the symptom I had perfectly Patience, I just knew it was Prednisalone related. Oddly I feel as if I tolerate meat and fibre less well now. I guess the sneeze/ cough and choke attacks are connected. Let's face it everything is connected. I wish doctors looked more at the whole person rather than isolated symptoms.
SheffieldJane
I too have had this experience at least 7 times and find just water turns it off but the first time was before I had a PMR flare. I was bicycling on a trail so an ambulance was not reachable. I do not know how I would recognize a spasm from a heart attack now. Thanks for talking about it.
I also have had this occur . The odd part , to me, was the jaw soreness occurring at the same time. I take Zantac when it happens and that seems to get it under control. I tell my children ...if the Zantac does not work...call 911 . My rationale is that my esphogas is just irritated either from food or medicine. I have had costrocondritis in the past and there might be some element of that also. We will all qualify for some sort of medical degree when this is finally in remission, 😁
Thank you for sharing your experiences Ronswife and 30048. It is reassuring to know that this symptom is quite common amongst us. I think "heart burn" doesn't describe the pain at all. For me it doesn't burn, it's more like the pain from a thump on the middle of the chest. I had heartburn with all three of my pregnancies, it was entirely different and manageable. I felt deathly sick and fatigued last night, going to the pre- booked theatre was overly ambitious unfortunately. You're right about the medical degree 30048, the para- medics told me to leave Google alone, but I don't agree. A 10 minute GP appointment does not get to the bottom of things.
Most of us ramble Sheffield Jane! My own situation is not far from yours. I suffered a severe angina attack in June 2015 with the usual ambulance saga. This was followed by several more angina attacks and short inpatient stays then angioplasty (stent) and all went quiet.. until Christmas Day 2015 ..sigh...when admitted with another attack.
Usual blood tests showed nothing untoward with the heart but consultant suggested oesophagus was the cause of the pain. Gastroscopy showed large hiatus hernia and reflux damage to oesophagus. The pain is almost identical to angina/heart but doesn't refer up to the jaw or along the arm. It also feels as if you have a stake through from under your shoulder blade through to just below the sternum as you describe. My 2016 was spent dealing with oesophagus tests etc. until GCA struck in June. Which is why I'm here!
I think you should request a gastroscopy and probably an oesophageal manometry test etc.
Because of my tender gullet I can't tolerate Alendronic acid (tried 3 times but needed pints of water to get them down - they're so porous). I couldn't tolerate Lansopra/omepra or any other zole either. Spectacular diarrhoea in my case. Ranitidine (coated) seems to do the gut protection trick for me with no side effects. I also have coated (gastro resistent) preds. Because of the preds (started on 60 mg in early June and down to 10 mg now) porous bones and Vit D deficiency are par for the course. Tests, including DEXA scan show this to be the case. Instead of weekly Alendronate I'm having a Zoledronate infusion this Friday. Only once a year!
It could well be that you've been struck down with one of the horrid viruses going the rounds but this is being confused with your gullet problem. Try to get that sorted would be my advice.
As for steroid side effects they're legion. My own were spectacular; two months of mania followed by a month of dangerous paranoia. Less said the better, but reducing the dose as as quickly as poss but safely is recommended and supervised by my consultant. I was also gaining a kilo a month and look like humpty dumpty with a moon face. Basically gained 2 1/2 stones in 6 months. Pleased to say the gaining has stopped since on 10 mg. One day I may even start to lose weight!
I do hope you soon get things sorted - and keep us informed. You'll get so much good advice and support here.
It is possible to lose weight while still on even higher dose pred - a lot of people on the PMR/GCA forums have avoided weight gain by cutting carbs drastically from the start. I started to lose weight (especially the mid-riff and face fat) by doing so while still at 15mg and lost 36lbs altogether while still at 10mg and above. Others on another forum on pred have lost a lot of weight using the Slimming World approach.
Thank you for your comprehensive, detailed and useful reply. I am sorry your Christmas Day was ruined by another attack. I dread the drama and embarrassment of it all more almost than the fear of where this pain will lead. Your steroid side effects sound horrendous. Given the initial high I experienced on a much lower starting does and the sudden irritation, I imagine that I would not have responded well to 3 x the dose either.
I had already come to the conclusion that my next GP visit would probably lead to a referral for the old camera down the throat test. I'm still low from the flu virus so am putting the inevitable off. How is it then treated? Can it be managed by careful diet? I am already avoiding certain foods and keeping portions small.
Thanks again Willowherb35. Let us know how you get on.
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