Hi .guys. Cannot believe that just days before Christmas I went flying and dislocated my shoulder with a small fracture to the head of humerus. Talk about pain..
Since then my temperature has gone up slightly by 1 degree and I do feel off - colour . I will consult medics again but wondering about raising steroids .. Help, especially PMRPro and Dorset Lady .. Thank you
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Cinka
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I think this is a case where I would increase my dose for about 2 weeks, maybe by 5 mgs and then return to your usual dose. I know that pain, having done the same thing myself falling over a suitcase arm outstretched. The pain was unbelievable. I think this injury was a factor in my subsequent PMR diagnosis. It is such a shock to the system.
I am sure our star advisors will be along shortly.
I wonder if the healing process around the fracture leads to a slight increase in body temperature? If it rises more I'd seek medical help right away, but probably just a sign the body is doing what it's supposed to if it doesn't go up any more and is back to normal in a day or so. I remember when my leg was broken, the bone wasn't displaced at all. Nevertheless within a few hours my leg had swollen to twice its normal size, and I read later that this is a natural mechanism to help stabilize the fractured area - a kind of natural cast if you will. I didn't take my temperature at the time but I would be surprised if it hadn't gone up.
Reading more about this. I think the inflammatory response to an injury is actually beneficial so if there is no particular increase in PMR symptoms probably best just to leave the pred at current level, for now at any rate. Time to reassess in a few days, or if you notice PMR is actually flaring. Rest, rest, rest, and drink plenty of fluids and eat protein-rich foods!
If your sling is just thin off white fabric type it will slip and slide. I was given arm immobiliser as pictured in first example on link PMRpro has posted. This was much better, though strap needed adjustment on occasions as it affected my neck and shoulder blades. I think hospital increased my pred for a few days, but I was having it intravenously so unaware of dosage before op. Post op went back to normal dose tablet form.
If you still have temperature on Monday I would advise you try to get emergency appointment to check it out in case of infection.
It has been found that a fall can actually trigger a flare so keep a close eye out and don't ignore any signs of a flare.
What sort of sling have you got? It is essential that it fits properly and supports the damaged area in the right way. Most hospitals these days use the sort labeled Arm Immobiliser here:
I do have the arm immobiser but it doesn't adequately function as such..
The A&E nurse said I might have to adjust my arm into the sling if slips which is not ideal. I did wonder whether the trauma of it all could affect my temperature .. Will increase pred if things don't settle in a day or two.
In my experience they should work well if the right size and adjusted correctly - I know it is a pain (pun NOT intended) but it may be worth going back and asking if there is something not right with it.
I would stick to paracetamol first for the pain from the fracture (and the temperature) - Pred is not a painkiller per se, but a small increase might help with the inflammation caused.
But do be aware that the whole episode could cause a flare so be prepared to up Pred if PMR aches & symptoms occur.
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