Appointment with rheumatologist : I was diagnosed... - PMRGCAuk

PMRGCAuk
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Appointment with rheumatologist

Janann25
Janann25

I was diagnosed with PMR about two months ago and my symptoms were relieved immediately. On the doctor's advice I started a reduction of 2.5mg with disastrous results so, following the advice of the lovely people on here, I reduced by only 1mg. Unfortunately this was still not enough so I went back up to my 15mg. Initially this helped but about 10 days ago, I started experiencing dizziness, really loud ringing in one ear and pressure head aches. Of course, having to start antibiotics for an infection under a crowned tooth hasn't helped!! Then, over this last weekend I also started to feel very tired so decided I should get investigated. I managed to see a doctor yesterday morning. I already had a bone scan scheduled for yesterday afternoon so at least I knew that that would be checked. The doctor immediately arranged blood tests - these were taken the same morning - and is make no an urgent referral to a rheumatologist. So, my question is, what is likely to happen at this appointment - is it just a chat, are more tests done, is new treatment suggested? I would be very grateful if someone who has experienced this could give me some advice. Thank you again.

Jan

5 Replies
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PMRpro
PMRproModerator

It sounds as if your doctor is suspecting that your PMR has turned out to be a forerunner of GCA. Unless they have access to ultrasound of the temporal artery there are unlikely to be more tests done at the time of your rheumy appointment - though they may take blood (again) and possibly do an x-ray though I doubt it unless they suspect anything other than GCA.

The normal approach with suspected GCA would be to increase your pred dose considerably. There is a new drug, tocilizumab, which has been found to work well in GCA but it is not yet approved in the UK although it is being used in individual cases I think. You still start on an appropriate dose of pred for GCA but the tcz allows a much faster reduction.

In the meantime, if you have ANY visual symptoms at all please get in contact with this doctor immediately - and if you can't, don't wait but go to A&E and tell them what is going on. Don't be fobbed off, if they aren't helpful ask to see the consultant and be insistent.

What sort of bone scan? A dexascan or another sort?

Janann25
Janann25
in reply to PMRpro

First of all, thank you once again for your very prompt reply. My scan was a Dexa Scan. I didn't know there were various types - what are the differences?

Jan

HeronNS
HeronNS
in reply to Janann25

A DXA scan checks for bone density only. Other scans would check for disease.

Janann25
Janann25
in reply to HeronNS

Thank you.

Jan

PMRpro
PMRproModerator
in reply to Janann25

You can also have bone scans where you are injected with a substance that shows up any areas of damage - some patients get them mixed up.

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