Red cheeks?

[Lyndalou62]

I was diagnosed with PMR very recently and started on 20mg for 2 weeks. The pred took a good few days to get on top of the pains but I felt much better. I had a phone consultation as a follow up after the two weeks on 20mg pred and the dr told me to drop to 15mg for 4 days and then start on 10mg today- 1st of the month and reduce by 1mg per month. I have been ok but I have had a return of arm pains in the evening on the 15mg.

Not as bad as before but they are there. Particularly my right arm but thats probably due to the fact that my 5 month old puppy pulls a bit on the lead. Should I persevere or ring the gp about going back up to 20mg? Dont want to appear as though ive not give it a shot.

Another question- does anyone get random red cheeks and nose- one minute its normal and then from nowhere bright red band across both cheeks and nose. Sometimes just the rght cheek- it feels warm and tight. I did mention it to the gp but she said its nothing to do with PMR. I had it before i started the pred so i know its not related to that. I just wondered if anyone else had something similar? Thanks.

[DorsetLady PMRGCAuk volunteer]

Much too quick a reduction...need at least 4 weeks on initial dose (preferably 6)......then reduce monthly not as you have...

20-17.5-15-12.5-10mg is recognised taper -

certainly not 20-15-10mg - no wonder you have issues.

You might find another week or so on Pred resolves the issue - 15mg is a normal starting dose, so give it go. Obviously if it doesn’t then you may need to increase.

But definitely slow up on the taper after that.

You might like to have a read of this for a bit more info before you discuss with doctor - healthunlocked.com/pmrgcauk...

[Lyndalou62 in reply to DorsetLady]

Thanks so much for your reply- i did think that it was a steep drop- the GP said that she usually drops straight to 10 from 20. It feels a bit awkward telling them their job and I dont want to come across as a though I know more than her at this early stage in the proceedings. Its difficult isnt it? But I am going take your advice and go back to 15 which means I will have to ring and tell her as Ive only got a prescription that will last me if I am on 10mg. I have read your attachment very thoroughly. Thanks again😊

[PMRpro Ambassador in reply to Lyndalou62]

The next question is - how many poor patients does she actually have? Glad she isn't my doctor!

[DorsetLady PMRGCAuk volunteer in reply to PMRpro]

Mmmm!

[Lyndalou62 in reply to PMRpro]

Shes a locum- drs only seeing face to face if you are practically dying! Shes a really nice lady to be honest- just obviously not much idea about PMR! 🙊

[PMRpro Ambassador in reply to Lyndalou62]

Doesn't alter a basic rule: if you aren't sure of the latest guidelines on something, LOOK THEM UP! That's what that computer in front of you is for ...

[DorsetLady PMRGCAuk volunteer in reply to Lyndalou62]

PMRpro has given you link - I was going to attach same...so won’t add anything.

[PMRpro Ambassador]

She obviously knows nothing about managing PMR. A month at 15mg would have been the correct approach and then 12.5 on the way to 10mg.

rcpe.ac.uk/sites/default/fi...

might be valuable bedtime reading for her.

Pred can often cause rosy farmer's wife cheeks but they do tend to be more consistent. But I see no reason why it can't be flushing as a result of either PMR or pred.

[Lyndalou62 in reply to PMRpro]

Thanks- i am going to go back to 15 then 12.5 then 10 as you say .

[MrsNails]

I have the Red Cheeks, sometimes one sometimes both, they can feel bumpy as well as tight then return to normal.

I’ve discussed it with various Rheumatologist’s but the usual “it’s nothing to do with PMR” but l also used to get similar red patches on my arms where the muscle would be incredibly painful.....

MrsN

[Lyndalou62 in reply to MrsNails]

Thank goodness its not just me then! ☺️

[Rokerman in reply to Lyndalou62]

The one good thing above all others on this forum is that you get an idea what might be relatively common symptoms of a disease you probably never heard of before! I’d bet that your doctor hasn’t had PMR before - everybody here has..... Your suggested taper sounds way too fast; not sure how long you’ve been told this will last - it’s very likely to be a lot more than 2yrs so don’t be in a hurry to try and get to zero. DL and PMRPRO are spot on with their advice.

[Lyndalou62 in reply to Rokerman]

Thanks Rokerman x

[piglette]

What is she trying to do to you? I wonder how she would feel if she got PMR and someone told her to do that sort of reduction. Some doctors make me mad!! If you have any problems STOP, don’t try and sweat it out. If necessary go back to the last dose where you felt comfortable. Then when everything is OK try again, perhaps at a reduction of 2.5mg rather than 5mg at a time.

[Lyndalou62 in reply to piglette]

Thanks piglette- sound advice!

[Coffeebeans]

I mentioned my facial flushing to rheumatology on my last call - I'm fair and the flushing is very noticeable. It's also very random as you describe and he said it's almost certainly the prednisolone dose.

It's more likely to happen after eating or on a temperature change and it can be quite uncomfortable! Hopefully it will reduce as the pred reduces.

[Lyndalou62 in reply to Coffeebeans]

Thanks for your reply. Its odd isnt it?

[herdysheep]

To add to the joy, when others see your heightened colour the response is often ' you do look well'. Difficult for them to realise you feel rubbish!! It will go in time

[Lyndalou62 in reply to herdysheep]

Thanks- I hope so! X

[Parami]

I know that if I have flushed cheeks and nose that I'm not feeling too good, but others think I'm fine, annoyingly.

[Lyndalou62 in reply to Parami]

Mine usually happens after Ive been to the loo for some weird reason 🤷‍♂️

[Parami in reply to Lyndalou62]

Lol, we're a funny lot, aren't we?

[Lyndalou62 in reply to Parami]

We certainly are!!!🤷‍♀️

[Lyndalou62]

I thought it had started before I went on pred- before diagnosis but i coukd be mistaken🙂

[S4ndy]

Head sweats and facial flushing is normal for me these days. Have always had red cheeks and used to break out quite regularly. This had been diagnosed as Acne Rosacea many years ago and I have had treatment from time to time for bad breakouts. The redness and flushing I get now is different, no breakouts and linked to the head sweats which my GP says is likely to be the prednisolone. Interestingly, I haven't had a breakout in the 4 years I have been taking Pred! On the upside I've never needed to use blusher which is immaterial at the moment as putting makeup on is a complete waste if time as it just melts off when I flush!

[Lyndalou62 in reply to S4ndy]

Thanks Sandy- sounds like you are having a miserable time! I wake up with a sweaty forehead too! Strange creatures arent we? X

[CSMM]

I was always as pale in face never flushed etc now I’m like a tomato one min then gone it’s horrible definitely the pred . Your reduction is crazy your doctor sounds like mines .

[Lyndalou62 in reply to CSMM]

Thanks for your reply- at least we have a glow- on and off !!!

[CSMM in reply to Lyndalou62]

😩🤦‍♀️😂

[Linny3]

I have had a skin problem called rosacea for years. The last 3-4 years it had disappeared and all was well. About 5 months ago my cheeks started getting rosie once again, just as you describe. There is such a thing as steroid induced rosacea and I just figure that is what it is. It acts a little differently than before because now it comes and goes. Before it stayed for years. Good Luck

[Lyndalou62 in reply to Linny3]

This is a very strange illness- you never know whats going to happen next!!!