i was diagnosed with PMR on May 26, 2019 and started in prednisone. Currently at 7.5mg/day. I had left TKR on January 24, 2020. I’ve developed pretty severe headaches the last few days, along with blurred vision. Headaches started early AM while sleeping, and resolved once up and around, (as up and around as you get 10 days after knee replacement!). Last night I developed a Headache centered on my right eye/temple that will just not resolve.
Any thoughts of GCA? Is there a test that I can have to confirm? I do see a rheumatologist on a regular basis, but not scheduled for a follow up for another month. Thanks for any advise.
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Pmrat60
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Any visual disturbances should always be investigated asap. It may be something all together different causing the headache but you need to protect your vision. Please let us know how you get on. YBB
GCA pains are usually bilateral, but as stated any new headache or sight issues should be investigated.
You may well find that your inflammation markers are higher which may be an indication of flaring PMR or the onset of GCA.
However they may also be raised following the TKR - a common occurrence following that replacement in particular - as I can confirm! Mine went v. high following mine - certainly not GCA as I’m in remission - but it had the doctor throwing a fit at the time!
I agree with this. Go to A&E at the hospital where you see the rheumatologist, give your hospital number and ask to see somebody from rheumatology. If the receptionist hears 'headache' and tells you to go home and take paracetamol, explain you have PMR which means you are susceptible to GCA which can cause blindness if untreated.
PMRat60 has been on pred for some months and is in the USA where the system is different. The TAB may be the gold standard but it still gives false negatives and especially in patients who have been on pred for any length of time.
I'm not convinced - if it is positive then that is wonderful and no-one should be able to argue (but they still do on occasions) but once a patient has been on pred for any length of time the likelhood of that happening is reduced - and a negative result does not mean you don't have GCA. It means they didn't find what they were looking for and the diagnosis must be based on the clinical signs alone.
I think you need to see your doctor as an emergency - and if in the meantime you develop any more visual symptoms don't wait for an appointment but go to A&E/the ED.
I know DorsetLady has said the GCA pain is usually bilateral but there is considerable medical literature saying unilateral pain is also possible, especially in the early days.
It sounds to me as if the pain may be developing when the morning dose of inflammatory substances is shed in the body and then easing as the dose of pred you are taking starts to take effect. It isn't enough to protect your sight if it is GCA and it progesses so please do get it checked out.
If you need an emergency appointment at the GP then say so - they MUST make sure someone sees you promptly. 2 weeks may be fine for a routine matter - but NOT for emergencies. And potential GCA is a medical emergency - just like a heart attack or stroke. Would you be prepared to wait for 2 weeks if you had central chest pain?????
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