So tired.

[SRIXON]

Hi. As per previous notes had PMR for 28 months now, this along with type 2 for 16 years, I am struggling with my BP which at present averages around 158/95, My doctor is reveiwing at the moment, last visit this week.

Im on 10mg pred which is just making things bearable i.e. slightly stiff shoulder and arms in the morning but my main concern the last 2 weeks I feel so damn tired in the afternoon. I play golf badly I might add but the last 2 games I have felt so tired especially my legs I have had to finish the game.

Any thoughts. Col

[PMRpro Ambassador]

Do you ever feel you have palpitations? Or a racing heart rate? And a BP like that - he should be doing a bit more than reviewing.

[SRIXON in reply to PMRpro]

In regards to BP what do you think he should be doing.

[SRIXON in reply to SRIXON]

Yes I do feel I have palpertations at the top of my chest, especially after eating.

[PMRpro Ambassador in reply to SRIXON]

Getting it under control, with medication if necessary. And if you haven't had any yet you need some tests - at the very least a 24 hour Holter monitor for both BP and for ECG. They will tell you it is the pred. It isn't always and they should make sure there isn't anything else going on. Like atrial fibrillation as was the case for me and it was caused by the autoimmune part of PMR.

[SRIXON in reply to PMRpro]

Thanks for reply. Im on 3 meds for BP, at moment . Ramaphil 10mg, Doxazoson up from 4 to 6mg this week and Felodipine 5MG.

I do feel uneasy with just increasing tablets and did wander what tests are available to see what is causing my high BP.

[PMRpro Ambassador in reply to SRIXON]

Is that from a GP or a cardiologist?

[SRIXON in reply to PMRpro]

My GP.

[PMRpro Ambassador in reply to SRIXON]

My GP refuses to have anything to do with dose changes!! She writes the scripts and sometimes checks BP (I have my own sphygmomanometer) - no more than that. I have yet to be convinced that GPs have enough knowledge to decide which drugs are most suitable.

[SRIXON in reply to PMRpro]

Thanks, as I say Im uneasy how this gas been going now for last 3 -4 months

[PMRpro Ambassador in reply to SRIXON]

It was your comment about fatigue that I registered - and a/f does leave one very tired. So does PMR and it is possible that the pred dose is a tad low - on a higher dose of pred I was much better. But I am so aware how much better I feel since the pacemaker being put in - not coincidence I'm sure - although I would have said that my heart was OK if you had asked me, never really felt much in the way of symptoms until recently.

[SRIXON in reply to PMRpro]

a/f!

[PMRpro Ambassador in reply to SRIXON]

Well, not necessarily atrial fibrillation - any arrythmia, tachycardia/bradycardia.

Over the years I've heard a lot of people saying they have palpitations on pred and it is put down to the pred. I know quite a few of them who have been diagnosed with a/f. I had 5 years of no pred when I had a lot of the effects that are claimed to be due to pred - but due to PMR. It was only after the a/f was sorted out that I realised these episodes I'd had for the entire PMR journey had almost disappeared.