Latest rheumatologist visit

[Dejon73]

Saw doc last week. Told him I decided against the biopsy. He ordered a CTA scam of my chest, which came back negative. So no GCA? He increased my prednisone to 60mg for 2 weeks, at which time I go back to see him. I am feeling somewhat better as far as the muscle aches go. Experiencing shortness of breath and still have headaches, but not as bad. But, he says he’s still not sure about the PMR diagnosis. I am very confused. HELP!!!!

[SheffieldJane]

I a not clear why finding thing on a chest scan would point to no GCA. I had one for Aortic Stenosis another kind of Vasculitis that was clear. I still worry about headaches, eye symptoms and jaw claudication though. My diagnosis is only PMR.60 mgs is a common start dose to get the dangerous GCA inflammation down. The you should expect a gentle taper down, maybe 5 mgs a month until 20% the no more than 10%. If you are taken off Pred to fast it will all come back.

[PMRpro Ambassador]

I'm somewhat confused - if it isn;t GCa, why give you 60mg? Not that I think a CTA would show GCA. But 60mg is really OTT for PMR.

[Dejon73 in reply to PMRpro]

That’s what I thought. I’m very confused as well. My symptoms of muscle aches, and headaches are better. What really bothers me the most is the fatigue and lack of energy. I went to pick up some groceries earlier today About halfway through I was so dizzy and tired I didn’t know if I was going to get to my car or not. Came home and took an hour nap.

[PMRpro Ambassador in reply to Dejon73]

The pred won't change the fatigue of autoimmune disease - you have a serious systemic illness. That you have to manage by behaving like a poorly person.

[Dejon73]

The reason he did the CTA was because I didn’t want the biopsy and with the chest pains I was having he thought maybe inflammation would show in the arteries of my chest. That pain is better now too.

[Hidden]

Was that a scan to check aorta? I wonder how many people turned out to to be positive in GCA and PMR When the scan was negative? Mine always seems to stay above my chest/neck. Am I right to think that Tbiopsy will always come back negative once you started your treatment? I often feel scans may show false neg results in certain patients, contrary to what is being said in medical papers.

[PMRpro Ambassador in reply to Hidden]

It's thought that some signs remain for the first 2-3 weeks of steroid treatment. But they are not evenly spread anyway so it is chance when they do find them in the bit of artery they look at. The bigger the piece the better - but if it hasn't got to the temporal artery, they won't find anything at any point.

[Dejon73]

Yes it was

[Hidden]

The Bigger piece sounds like a key... Thank you, PMRPro.