Flu and flare

[Purplecrow]

Last week, I felt a cold coming on. Sore throat, coughing, etc, I blamed it on my allergy to heavy seasonal pollen. I used inhalers and just plodded through....then 3 days ago, I woke in the night with teeth chattering chills, elevated temp, and all over body aches.

A trip to the GP, who did an xray to rule out pneumonia. So no abx ordered. She did a swab to test for flu. Yes I did have a flu shot.

*****She said my overall pain was probably an exacerbation of PMR. ***** i was delighted to find someone who knows about PMR, and I learned something new...that PMR could flare as a result of common illnesses!! Guess I just never thought about that.

The remedy was 5 days of 40 mg prednisone!

My first 40 mg dose of pred eased the body ache, and turned on waterworks!! I perspired so heavily that my pillows got soaked and I changed shirts several times today.

My current dose of Pred was 10 mg, so I bumped up to 40 mg for 5 days, the back to 10.

Do any of you wise ones have further suggestions?

Thanks, Jerri

PMR diagnosed 2013

[Hidden]

You will to make do with me for the moment 😁

To have a Dr willing to understand the importance of dosing to requirements is great. 40mg a big whack! Having a severe pollen allergy/asthma usually lead to my father having to do a blast of pred so I can understand Dr raising it to cover that and the flu. I melted at 15mg so not surprised you sweated.

Having had a dose of flu whilst on pred and a dmard I would say just take it easy, still fluids. As Rheumy said we can be prone to post viral issues so no marathons. You were lucky, no one told me to stop dmard during colds and flu so it was 4 to 6 weeks before I started to recover from flu symptoms and 3 to 4 months to feel any better. Hopefully with a whack to 40mg any inflammation from infection might be avoided. 🌻

[Purplecrow in reply to Hidden]

Thank tou for the reassurances, and your opinion is valued!❣️

[SnazzyD]

Hello, that sounds a bit rough! Quite a number on this forum have reported exacerbation of PMR after minor illnesses. I’m glad your doc was aware of the possible need to increase Pred in illness but I have misgivings about the level of increase and readiness to blame PMR. One of the accompanying features of a rapid rise in temp and/or a high temp is pain in joints and muscles. It can be really quite severe if my own experience is anything to go by. So unless there’s something I don’t know, it seems to be a bit of heavy handed response taking you to real immunosuppressive levels . It was good that they tried to rule out a bacterial cause because a high dose of steroid with no antibiotic cover could have made the situation worse, but they still couldn’t be sure. A sudden increase in temp after a few days of illness can sometimes signify a secondary bacterial infection too. Pred is a good painkiller for general aches and would have caused sweating at 40mg but that could also have been your temp coming down. I’m not a doc but if it was me I would either have held fire a bit longer to get a bit more clarity or increased to 15 or max 20mg. I hope you’re on the mend. Anyway, be sure, more opinion to come!

[Purplecrow in reply to SnazzyD]

🙏🏽

[PMRpro Ambassador]

I think pretty much anything can exacerbate the PMR pain! Mine has been awful since the pacemaker was put it. Today is a bit better!! But the weather had also changed for the better - not as damp and less chilly. The weather in February was better!

How are you feeling now back on 10mg? A short course of high dose pred seems to be "in" for chest problems these days - daughter gets it quite often and it does seem to reduce the need for abx.

[Purplecrow in reply to PMRpro]

Increasing my normal dose of pred to 10 settled down the flare. I intended to hang there for a bit before trying another taper. Then this new virus. Mostly I fear another run in with pneumonia, having had two events in 2017.

This time, Xray clear👏🏽, and nasal swab will confirm or not, the flu.

No matter which, i still have some serious pain in back/chest area. Probably from coughing?

Amusing tidbit, this monstrous dose of pred does not seem to alleviate the pain. Therefore...not all that hurts is PMR...🤓 (heard that before)

Hope your pm eases your problem, Be Well, J

[Oxford8]

I had a chest infection recently which caused a PMR flare. My GP said that the link was entirely possible. I also had a fall, which caused movement in my herniated lumbar disks. The area round the discs were inflamed and that, too, triggered a PMR flare. The double whammy was absolute agony.

I was told that any 'inflammatory' event like that could cause our PMR ultra sensitive immune systems to over-react and flare.

Makes sense to me but I'd love to know iwhat others think.

[Purplecrow in reply to Oxford8]

You have described my situation exactly, mostly🥴

My lumbar area has been causing lots of grief, and the orthopedic dude said surgery would carry a huge risk of failure. Better to continue to manage that issue with acupuncture, steroid injections, massage, and pain mgmt. be well, Jerri

[Whittlesey in reply to Oxford8]

Hi Oxford, I have PMR (GCA also). During this last year, diagnosed with scoliosis - left back, disc problems and spondyliosis. Past three weeks, back is very inflamed, to the point where walking is difficult.

PMR pretty severly flared. Have been using diclofenac cream for my shoulders and neck and taking valium for extreme pain. I mg of medrol daily. I don't want to increase medrol yet -- 7 years of it for GCA - 100 mgs daily slow tapered to 1 mg. Cushings from pred diagnosed. Some weight gain when on pred. Going for phy therapy.

All of this. But now, some days of very very limited walking.

Divorced professional, living in New York City. The limited mobility -- not liking it. Going for another back MRI, soon. The 1 mg of medrol is enough for now. Am also trying massage of neck w grapeseed oil mixed w lemongrass oil, so far so good.

Much luck.

Am in agreement w lower reductions in pred --40mg seems very high.

I like the idea of treating the cold/flu -- THEN any PMR flares w a lower dose. Pos thoughts -- for Feeling Better

Best, Whittlesey

[Oxford8]

PS. 20mg of pred for 10 days for the PMR got things back to normal (now back to 9) and Naproxen and pregabalin for the nerve pain on my spine has worked wonders.

[Purplecrow in reply to Oxford8]

🙏🏽

[Soraya_PMR]

10 to 40? Wow! Big hit!

I recently had a cough-cold and refused to up my pred to counteract it, I just basically slept for a week. Hubby had the same cold a week later, and he’s hanging on to it longer than I did, but he’s working.

I’m not averse to increasing if there’s no alternative, but 400% seems excessive to me.

[Purplecrow in reply to Soraya_PMR]

Agreed, tis why I come to the forum for collective wisdom. Thank you, J

[PMRpro Ambassador in reply to Soraya_PMR]

Except a burst of 40mg seems standard for chest problems - and really it was only 30mg for that ...

[Soraya_PMR in reply to PMRpro]

True.

[piglette]

How rotten you might have got flu. Apparently the flu jab only reduces our chances of getting flu by around 60% although it varies from year to year. Hope you are feeling better now.

[Purplecrow in reply to piglette]

🙏🏽🦠🦠🦠🤧 little bugger germs are lurking everywhere!

[piglette in reply to Purplecrow]

Behind every gooseberry bush!