Hello all - I was diagnosed last nov - my gp started me on 10mgs prednisolone- within days I felt fine pain in shoulders and arms gone but still had pain in my hip - as I am type 2 diabetic he wanted me on a short burst steroid to stop my blood sugar spiking- my dose was cut to 5mg within 3 weeks and the pain in my hip was worse than ever however after xmas he cut me to 3mg for two weeks then stop- I kept telling him about the pain in my hip which even stopped me walking at times but he said it was buritis and it had nothing to do with PMR - two weeks later I was in so much pain I contacted NHS24 and was told to take paracetamol and see my gp on Monday - I can’t begin to tell you how I felt - saw a gp on mon who basically thought it was all in my head and said they would do an ESR test but in the meantime take cocodamols for the pain even though I insisted they did no good - 24 hours later was sick due to codiene- blood test was not till following week but I insisted that someone took my blood - no luck the nurse said I would just have to wait till next week for blood test - I honestly don’t know what came over me but I refused to move until someone gave me something to take this pain away , the nurse said “you must be in pain “ she saw duty doctor who immediately started me on 20mgs prednisolone- since then it took 24 hours for pain in shoulders and arms to go and just over a week for my hip to be pain free- I have been living a normal life for 4 weeks but have to see my gp on Thursday- really worried he cuts my dose quickly like last time and pain returns - my bloods came back just slightly raised - please can you give me advice regarding my appointment - sorry it’s long winded but thank you for reading
The next step....: Hello all - I was diagnosed last... - PMRGCAuk
The next step....
Auldco, so sorry you have such a difficult gp who seems to be do I'll informed re PMR. I understand that he might be worried about Pred and diabetes, but there are members of this community with diabetes who have managed on Pred with diabetes. I'm sure you will get lots of replies within a few hours.
I'm the meantime, you might want to look at some of the pinned topics or search for topics that are relevant to you at this point in your PMR.
Hi Auldcoo
Sorry to hear your problems with GP, but having looked at your previous posts I think many of us expected it to be like that.
Unfortunately he doesn’t seem to understand the nature of PMR and the treatment of it. I know he was worried about your diabetes and the Pred’s affect on it, but there has to be a sensible solution, and his gung ho approach to reductions isn’t.
The fact that you have been good for four weeks is brilliant, but now you need to reduce in a timely manner, and I think that means on a monthly basis (provided you have no return of symptoms) and the following is a “recommended” plan -
17.5mg - 15mg - 12.5mg -10mg. After that in 1mg tapers.
However, not every body manages this. So I would suggest you agree with GP you put this plan into action, but if along the way you need to amend it you do.
Have monthly blood tests for inflammation and blood sugars (although I guess you do them on a daily basis anyway).
Have a look at the attached
healthunlocked.com/pmrgcauk...
Good luck
"as I am type 2 diabetic he wanted me on a short burst steroid to stop my blood sugar spiking"
All very well for a lazy doctor - but that will NEVER work in PMR in a million years. It does sound as if the last one knows what he is doing because the first one blatantly obviously is a very lazy person who won't even look up the illness for which he is treating. Hip and/or shoulder bursitis is an integral part of PMR for many patients. Can you stick with that second guy?
If the GP is so worried about your BS then he should refer you to specialist care asap. And if you don't already, the advice to cut carbs drastically should have been part of the original discussion.
It is a sad day when a patient has to go through the trauma of being difficult in order to get adequate care. Happens too often.
My question to him would be, why did he treat a long term condition (average 2 years) like a short term acute illness? By that I mean a quick reduction over weeks.
Regarding diabetes - strict attention to carbs should stop the spikes, but there are a few who have problems with diabetes whatever. I would have thought yo yo dosing wouldn’t help stability either.
Not an average of 2 years Snazzy, pretty much minimum of 2 years, a median duration of 5.9 years.
medpagetoday.com/rheumatolo...
I would shout this from the rooftops given the slightest opportunity so I may get boring 
Here's your lesson:
Once you insisted, and I'm sure with great dignity and class, you got the treatment you needed and deserved.
These folks work for you. You don't work for them. You're an adult, not a child to be ordered around.
You know what to do. You've already done it.
Stand your ground.
They may be "authorities" on what they've studied and learned, but you're the authority on your body.
If you're not getting the treatment you need and deserve from the professional staff you're consulting, find someone else.
I am so glad that someone saw the light and gave you 20mg of pred per day. Your GP ought to be shot. He is doing an appalling job in my opinion. Diabetes can be managed with pred, and he should do this for you. Don’t let him cut the pred down like that again!
Oh poor you, Auldcoo, but thank goodness you fought your corner and came across a more aware Dr. Stick to him in future rather than the first one, who really must have lost the plot, treating you with a short course of fast-reducing steroids as though he was treating someone with either asthma or a chest infection! Your response to the second doctor’s intervention more or less confirms PMR. It’s great that you are now well enough to be able to say that you have lead a “normal” life for the past week but do be aware that although the steroids appear to have got control of the inflammation, they have not cured PMR. Sadly, there is no cure at present but the steroids at the dose needed at any one time should keep on top of the inflammation whilst the disease runs its course and that ca take anything from 2 years upwards. I have come across a handful of people who have recovered in a year to 18 months, but it is rarely so. In the meantime, although you feel so much better, please have plenty of rest to allow the steroids to do their job. The more you do at this stage, the more steroids you will need. Do try and change the Doctor’s appointment to the more knowledgeable one next week. Good luck!
Well done for standing your ground!
Hi, I am also Type 2 diabetic which was diagnosed a couple of months after the PMR. I was put on gliclazide and 6 months after my diabetes is so well controlled that I have been taken off my diabetic medication. My hba1c at diagnosis was 99 and when taken off gliclazide was 37. This was done by LCHF diet, exercise and weight loss.
My doctor is very good and at start would not reduce my prednisolone if ESR was high. She now leaves me to reduce myself and after a year I am now on 7.5 mg reducing to 7.
Good luck with your doctor but type 2 and prednisolone can go together.
Also as an aside don't be fobbed off if you blood results are ok. 1in 20 don't have raised ESR or CRP levels and so it is symptoms you are looking at not necessarily blood results. I have PMR and GCA but don't have raised blood results.
My doctor has always said to treat the symptoms and not the numbers. Thank you Heron - I think that's what I meant but had Pred head on!!!
Good morning- thank you for your reply’s- my update is very frustrating - saw my gp on Thursday he is not convinced I have PMR as my bloods are fine but I show all the classical signs (!)and has cut my steroids in half from 20mgs to 10mgs as when first ?diagnosed I was fine on that dose I have to go back in a month I have no option but to take each day as it comes but if pain returns I shall be on the phone just feeling very frustrated and anxious
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