New and confused by GP, questions galore? - PMRGCAuk

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New and confused by GP, questions galore?

vnett profile image
38 Replies

I’m a newbie but I have been reading your posts with great interest. Does anyone take turmeric supplements and if so does it seem to help? I’m still waiting to get a final diagnosis for PMR/GCA. I have elevated ESR(51) and CRP(3.0). My ANA titre is 1:640. My GP still does not believe I have PMR but is sending me to a rheumatologist next week. He did put me on Prednisone for 5 days 20 mg twice a day and my bilateral shoulder,arms,hips,thighs, wrists and numb right hand pain was gone in one day. All of the pain came back approximately 30 hours after I stopped the Prednisone. He put me back on it at the lower dose of 10 mg twice a day and again the pain disappeared, although it took a little longer to get it under control again. And yet he still doesn’t believe it is PMR and wants to reduce to 5 mg twice a day. Help please!

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vnett
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38 Replies
SheffieldJane profile image
SheffieldJane

Hi vnett and welcome to the forum! I hope you find it as informative and supportive as I have over the past two years with PMR.

I am sorry that you are engaged in the “diagnostic dance” with your doctor. So many of us seem to go through this. Your symptoms sound very familiar as does your response to Prednisalone. I sincerely hope that you have a good Rheumatologist and you end up with a correct firm diagnosis on a steady dose of 20 mgs for about 4 weeks then a very gradual taper down to the lowest possible dose that controls the pain and stiffness.

Please let us know what happens next. There are very knowledgeable people on here who will help you all the way. Good luck!

vnett profile image
vnett in reply to SheffieldJane

Thank you so much for your response. This is a wonderful and very knowledgeable group and I so appreciate all the valuable info from the very people experiencing this nasty PMR. I will share my experiences too in hopes it helps another with the many questions!

DorsetLady profile image
DorsetLadyPMRGCAuk volunteer

Hi vnett

With your reaction to the trials with Pred why does the GP think it’s not PMR?

I would say the 20mg x2 was a bit OTT for PMR but about correct for GCA, although if GCA then should be given in one dose not two, and the second 10mg x 2 in the mid range for PMR.

I sounds to me as if he really doesn’t have an idea of how to treat either, so the sooner you see the Rheumy the better, in the meantime this may give you a better idea, and please let us know outcome of your appointment.

Suggest you try and persuade GP to leave you at 20mg until you see Rheumy.

healthunlocked.com/pmrgcauk...

vnett profile image
vnett in reply to DorsetLady

I’m afraid my GP is still hoping to find an underlying cause other than PMR. I’ve had several very stressful years as caregiver to my parents and have lost both of them in the past 15 months. And both my husband and I have fairly rare cancers. I fear he thinks it’s just a reaction to this stress. I’m hoping the rheumatologist will confirm PMR so we can get on with management and eventually ridding myself of it. I seem to have all the symptoms and the response to Prednisone. Thanks so for your response.

DorsetLady profile image
DorsetLadyPMRGCAuk volunteer in reply to vnett

Hi,

As most of us on this forum know, the onset of PMR or GCA is a very normal reaction to stress. To me, you sound an ideal candidate! Hopefully Rheumy will confirm whether that’s correct.

vnett profile image
vnett in reply to DorsetLady

Thank you again. I had that uneasy feeling that he thought it was “all in my head”. My hopes rest in the rheumatologist appointment.

PMRpro profile image
PMRproAmbassador in reply to vnett

To be fair - PMR is just the name given to a set of symptoms which are due to an underlying cause. That includes a few cancers as it happens but usually once that is treated, the PMR symptoms resolve too.

But if it were the cancer, and the treatment hasn't stopped the symptoms - what is the matter with using pred if it works? Quality of life is all - treat the patient...

vnett profile image
vnett in reply to PMRpro

I absolutely agree with the “treat the patient”. I do appreciate my GP being as thorough as possible in his desire to find the source but I also want him to appreciate the pain involved with this and the incredible relief when it’s finally gone. We will get there! I live in Chicago, IL and am quite surprised by how much farther the U.K. seems to be in treating PMR. We seem all too often to want to give a pain pill for it here. That was my GP’s first approach. He had me take a pain med and a muscle relaxant for a full two weeks before trying the Prednisone. Thanks to all of you for allowing me to vent about this.

Elaine-W profile image
Elaine-W in reply to vnett

Hi Vnette,

Goodness me you have a lot on your plate. The experts will sort you out on this forum and the rest of us will offer support as you go through your journey, best wishes xx🌸

vnett profile image
vnett in reply to Elaine-W

Thank you so much! This forum has already made me feel so much better and confident about getting this properly taken care of in the best possible ways! You all are indeed supportive of one and another and your knowledge is so extensive! I’m happy to have found all of you!!

PMRpro profile image
PMRproAmbassador

I could be very rude about your GP - I'll restrain myself! Why on earth can they not look up the recommendations? 20mg is the typical PMR starting dose, not double that and if he had used his head he would have had a clearer answer. Other things would respond to 40mg - but what happend to you would be typical of PMR. The ANA titre is the cut-off between low and high - so doesn't really signify a lot other than you have an autoimmune disorder. DUH!

Quite a lot of people use turmeric in cooking, garlic and ginger too and some feel it does make a difference. The trouble with supplements as capsules is they can cause gastric problems - but if they work for you, great. But everyone is different.

piglette profile image
piglette

Hi Vnett, I am sorry you seem to have a GP who does not know what he is doing.

Regarding turmeric, there was a programme on radio saying you are much better using fresh or powdered turmeric based on some research they had done.

vnett profile image
vnett

Thanks. I’ll look into the fresh turmeric.

Mahnahvu profile image
Mahnahvu

This article from a year ago casts some doubts on the value of turmeric as a super food.

time.com/4633558/turmeric-c...

PMRpro profile image
PMRproAmbassador in reply to Mahnahvu

Doesn't alter the fact some people perceive a benefit. Which is really all that matters!!! It tastes good in cooking anyway!

Sunnyd7 profile image
Sunnyd7

Hi Vnett, when I was going through the diagnosis process I thought I would handle whatever it was "naturally".

I bought tumeric capsules, and other supplements. Unfortunately for me I could not take as much Tumeric as was suggested because it upset my digestive system and I had bad acid reflux.

I learned, while stomping and kicking my feet, that Prednisone is the best help for PMR.

vnett profile image
vnett in reply to Sunnyd7

I do admire the natural way but have quickly started praising the Prednisone “god”. I had hoped a combination would assist in the process. I thought I’d try a combination of supplements and pure powder turmeric. However, I too suffer from GERD and find the Prednisone has intensified it for me. Is that a common side effect? Thanks for reply all this info is so helpful!

PMRpro profile image
PMRproAmbassador in reply to vnett

It can be - has never bothered me. Many patients are put on stomach protection meds (which have their own problems of course) but it is important to take pred with food, in the middle of a proper breakfast is best if you have severe problems, but many of us have found taking it with yoghurt is enough. Full fat, natural organic if possible - no flavours/sugar. Cutting carbs also helps with many cases of reflux.

vnett profile image
vnett in reply to PMRpro

Thanks PMRpro. Yogurt has become my go to breakfast and it does help. It’s the evening dose that seems troublesome in addition to the craving for the no no carbs. I’m trying to cut back on them with limited success.

Sunnyd7 profile image
Sunnyd7 in reply to vnett

Most of the people on this forum say they take something for their stomachs. Prednisone has side effects of stomach burning or pain amongst others.

PMRpro profile image
PMRproAmbassador in reply to Sunnyd7

A lot do yes - but an awful lot of us don't! Yoghurt rules amongst a lot of the long established members ;-)

vnett profile image
vnett in reply to Sunnyd7

I’m taking Pantaprazole for reflux but plan to ask GP about it’s effectiveness. Yogurt is more appealing and a change in eating habits. I see suggestions here on good diets for better control of blood sugar and reflux.

PMRpro profile image
PMRproAmbassador in reply to vnett

Some of the PPIs don't work for about 1 in 3 patients - but it is a little publicised fact!

vnett profile image
vnett in reply to PMRpro

That’s good to know. My reflux has been worse since starting the Prednisone.

daworm profile image
daworm

I use Turmeric, I think it helps...also a fish oil..Turmeric isn't absorbed easily so try to get one with Pepper added or take with a fatty meal...10mg is pretty low, wish I could get there, but I'm in no hurry...pred isn't so bad..there's worse drugs...(this coming from a guy who six months ago said no way was I going on that crap)...:)

vnett profile image
vnett in reply to daworm

I’ve ordered the turmeric with pepper and ginger and I will continue to cook with fresh. I’ve increased my fish oil, calcium and D3. Like you the Prednisone scared me and y husband said “no way are you taking that” at first. He’s come around after witnessing its rapid easing of pain. We adjust.

piglette profile image
piglette in reply to vnett

Sounds like you are eating all the right things. Beetroot is supposed to be good too. I prefer to go for the actual foods if I can rather than taking supplements, although I do take vit D and calcium.

vnett profile image
vnett in reply to piglette

Beetroot! I’ll try it. Thanks!

Kath567 profile image
Kath567

I tried turmeric supplements but gave up as it bothered my stomach. Check for interactions too, and possible bleeding risk. I do use the fresh turmeric occasionally.

It seems pretty common for some of us to be in diagnosis uncertainty for a long time. I have been waiting 5 months for a diagnosis that initially was PMR, but then I developed a jaw bone infection and abscessed teeth that went undiagnosed for 3 months. Since they couldn’t figure out why my CRP kept going up despite prednisone at high doses, they decided I had an inflammatory condition of unknown origin. The infection is gone now but I still have the PMR pain and stiffness every morning until prednisone kicks in, and still no official diagnosis for it. My rheumatologist was still checking out other things but I have switched rheumatologists so hope to get on the right path finally. Hope you find out your answers soon.

vnett profile image
vnett in reply to Kath567

Hello Kath567. I feel for you waiting so very long for your diagnosis uncertainty, the additional health issues and adjustment to a new rheumatologist. Hope you are indeed on the right path now.

daworm profile image
daworm in reply to Kath567

me too...I would really like for someone to say "this is what it is, PMR"...or "RA".....enough of this "I'm pretty sure"....leaves doubt in my mind about things....six months in now...never seen a rheumy yet though, DR. see's no point in it yet..??

PMRpro profile image
PMRproAmbassador in reply to daworm

"DR. see's no point in it yet"

How ignorant - rheumatic disease needs identifying earlier rather than later. And it is rarely a GP is good enough to do it.

vnett profile image
vnett in reply to PMRpro

Well said!

vnett profile image
vnett in reply to daworm

It’s the waiting and letting the condition, whatever it should be, continue to cause pain, a lesser quality of daily life and potential complications and rise to other medical issues that is so frustrating. Six months is such a long time. I’m only into third month and have been frustrated by my GP. I fortunately see a rheumatologist next week. I’d say maybe there’s no point keeping your current GP. Are you required to have a referral or can you simply reach out one on your own?

PMRpro profile image
PMRproAmbassador in reply to vnett

The GP I saw for the best part of 5 years was useless - but when I finally told him what I thought I had and he sent me to a rheumy it was to meet one of the sort who thinks PMR is beneath them and wanted it to be ANYTHING that needed another drug - despite a miracle in under 6 hours with 15mg pred. When I saw a different GP in the practice it all changed.

vnett profile image
vnett in reply to PMRpro

I’m seeing a pattern here. It is so important to find a the right doctor! If it’s not a good fit the patient suffers. I have an arsenal of good information to help me quickly evaluate my rheumatologist! Thank you!

daworm profile image
daworm

I can get my own...I may, soon...although not everyone is happy with the "rheumy's" here on this forum....still..gotta do something soon..before summer..

vnett profile image
vnett

Good luck to you! I do hope you get your rheumatologist soon! I’m hoping my rheumatologist appointment next week gets me closer to some definitive and a solid and consistent treatment plan. I wish the same for you!

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