Hi, I am wondering if someone could help with advice for my mum, she is 80 years old and has been diagnosed with PMR and GCA. She as had these conditions sometimes,and her meds are reduced to 2mg a day od predisonal,(steroids) but every now and then she gets severe headaches from her GCA.the doctors do not want to increase her steroids as it affects her mental health, does anyone have any recommended pain killers that would work for her headaches, they keep her awake at night.
Thank you
If she has headaches caused by the GCA then she needs the correct amount of Pred - no point being below - never mind what doctors might think! If her symptoms are not controlled then her eyesight is at risk.
Presumably she has tried painkillers in case the headaches aren’t GCA related - so if they don’t help - it’s more than likely GCA.
Can you give more details of her reduction plan and start date/dose. That might help us to give a better answer.
The buzzing could be tinnitus- which may or may not be related to GCA - not sure there’s much that can be done about that - apart from distraction therapy.
Thank you for your reply,not sure what she started on,but she is now only on 2mg a day,Which seems to have brought on the headaches,but she seems to think the buzzing is related,but my main concern is the severe head aches,which she gets every now and then and she can not sleep or do anything.Because she ended up with a phycotic episode from the steriods they do not want to increase the dose,but her headaches are unbearable for her.I am thinking we could ask for the doc to slowly increase the steriods and keep monitoring her mental health. she is only on 2mg its a very low dose.
My main concern, if she is suffering as you say, is sight loss - which can happen if her GCA is not controlled.
My GCA was misdiagnosed for quite a long time - and I ended up losing sight in right eye - and I wouldn’t want that to happen to your mum.
I appreciate higher doses cause her mental issues, but losing her sight wouldn’t do a lot for that either.
I don’t wish to scare you, or be pessimistic, but she really does need some sensible thinking from her medical people at the moment....and certainly a considerable increase in medication (for the short term at least) to get control of her symptoms.
If it is GCA then painkillers are not likely to work.
I do appreciate the mental health problems, especially if she also has dementia - but without an adequate dose of pred for active GCA her sight is at risk. And there is medication for psychotic episodes - have the doctors included a psychiatrist in their considerations?
yes,she has medication to keep the mental health issues under control,I think I will ask the doctors to slowly increase her dose,until her headaches stop,and just keep monitoring her.thank you for your help and advice,much appreciated.
lots of water (like 10 glasses a day if possible), and a mini aspirin (preferably something like Asterix with the enteric coating to prevent gord, and some caffeine ..like a couple of cups a tea at least a day..and maybe 3 or 4. The aspirin+ caffeine help the blood vessels in the brain as does the water..also the pred does too (or at least seems to for me). other than that..I cant think of anything and I had that buzzing after a car accident for about 5 years at least..gradually diminishing (I also had loud screeching tinnitus too before it settled to a buzzing These may all help, but will not be any sudden help ). thay all help the blood circulation in the brain..at least they seem to do so for me , and are known to help the blood get around partially blocked blood vessels easier (thin the blood). I've just started trially 5mg per week of methotrexate too, and so far it does seem to help the blood in the brain circulation as well... though It's really too early to tell. I have read it does get into the brain... I would be looking at increasing the pred though. I do not function well on just 2mg but 3 to 5mg is way better!
All I have read says that MTX does indeed cross the BBB but ONLY at very high doses administered intraarterially. Have you any other references?
My First Rheumy Visit
Doctors appointment today (update) 
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ESR
