I’m writing this for my mother and apologies in advance for the lengthy explanation.
My mother was diagnosed with PMR in November. We think she probably had it for sometime but as my father was receiving full time palliative care at home we were not as aware of her health issues as my dad was so poorly. She was put on Pred 15mgs and it worked initially like a dream. However within a couple of weeks she had severe headaches, blurry vision and pain in her right temple and thanks to a well informed out of hours GP she was immediately increased to to 60mgs and admitted to hospital for tests. As they couldn’t find a pulse in her temple as well as her other symptoms she was diagnosed with GCA. To cut a long story short my dad passed away at home just before Christmas and mum just made it home in time. They had been happily married for 62 years and it has hit her very hard. He was increasingly ill with heart failure and dementia for several years and mum soldiered on caring for him but I think this must have caused the GCA. She is also taking alendronic acid.
She has been having dental problems throughout with infection which occasionally clears up as well as oral thrush. She now has a severe sore throat. Amongst many questions I have is, could the sore throat be caused by the thrush? Or is it a GCA symptom? Or both? She’s being prescribed Nystin for this. I feel so sorry for her. We have all suffered as a family with dads ill health during this difficult time of Covid, but mum has borne the brunt of it and this sore throat has just knocked her. She is 82 years old and now lives alone with my sister and supporting her as much as possible.
Again apologies for the length of this and also if I don’t respond at length. Many thanks
Written by
Tillydog1
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I am so sorry that you are all going through a hard time. I think you should contact either your GP or 111. Describe all you have told us, just as you have written it down about your Mother's current problem. Does not matter if it is the w/e just call.
As your Mam has been having problems with her teeth as well...........AA is not a good idea as some dentists won't deal with someone taking AA.
BTW. Does your Mother have Osteporosis?
Don't worry about a quick response just deal with it all and then let us know the outcome when you have the time.
So sorry to hear of your loss - you will have had a very hard year.
Do call the doctor - the high dose pred will suppress her immune system to some extent and she is more likley to catch infections and not be able to fight them off. She will be frail in a lot of ways still and prone to infections.
Is she able to swallow OK with the AA? I'd also want the tooth infections sorted oout before taking AA - very good oral hygiene is essential with AA.
They have finally admitted that a sore throat can be an early symptom of Covid - is there any chance of that? Has she had/when did she have her first vaccine?
Well done the OOH doctor - hopefully you will get another one as on the ball as he was.
Thank you for your speedy response. I actually spoke to a doctor yesterday and he has prescribed the Nystatin. We also have a GP phone call on Monday morning. Generally I would say she’s getting good treatment and support, but obviously there’s not ever enough time to ask everything I want to know, which is why this forum is so helpful. She’s down to 35mgs of Pred now and seems to be coping well with the tapering with just occasional hints of pain on the right side of jaw/temple which has been hard to know if it’s the GCA or her dental problems which are also on the right hand side. I think it very unlikely to be Covid. She hasn’t seen anyone except me and I’m avoiding contact with people. She had her first jab three weeks ago
Hi Tillydog. I had a sore throat along with jaw pain, scalp tenderness, etc., two months prior to being diagnosed with GCA last October. The sore throat's listed as one of the rare symptoms here : arthritis.org/diseases/gian... put it down to the rough nurse who gave me a Covid swab test before going for my colonoscopy, but it had nothing to do with that.
The sore throat eased when I started the Pred treatment, but then returned a couple of months later, but I've also had acid reflux for 3 months, which hasn't helped. Like your mum, I've also got some thrush inside the mouth which tends to happen to me when my immune system is knocked off balance with an infection, or just after an operation - any sort of stress on the body at all really, and of course during Pred treatment, which can't be avoided if you have GCA/PMr.
Also, like your mum, I cared for my severely autistic son until last July when he went into care home because the stress was too much. I'm a firm believer that stress plays a significant role in auto immune diseases, and the ironic thing is that just at the point when you are starting to see the stress ease a little - planning to live your own independent life, etc., you're hit by an illness that prevents you from doing just that. Life can be cruel like that, and it's so unfair. I hope you get something sorted for your mum soon. Don't be fobbed off - my own GP did that to me several times until I presented myself at A&E a few weeks later. Good luck!
Many thanks strawclutching. Simply knowing someone understands how difficult this is helps, and I’m convinced stress was the main factor in bringing on Mums GCA. We spent years clinging to the notion that she might have a life left to live once Dad had passed away and it’s been so hard to accept this situation. But hey, life can be hard and they had it good for many years. Thank you again
No problem. Just wanted to add that if the sore throat turned out to be acid reflux related, Nystatin sometimes contains hydrochloric acid or citric acid which could make the throat worse. I find a tea tree toothpaste can work over a longer period of time, and is more gentle. You can get this from Holland and Barrett if you are in the UK - but if reflux is not the problem, the Nystatin will sort it quicker.
A constant sore throat was one of my symptoms when I was diagnosed with PMR and suspected GCA by an ED doc. There were no other causes e.g. stomach or sinus problems. It continued for months with mild discomfort while I was reducing from 40 mg, then disappeared. GCA was never confirmed because I had been on prednisone too long before I could get an appt with a rheumatologist. I agree that being overwhelmed with stress can bring on PMR. Mine started a few days before back surgery.
An update on my post from yesterday. So, the sore throat may well have been oral thrush as nystatin seems to have settled it down. The out of hours dentist she saw today said she should have been referred to an oral surgeon already by her own dentist. So, the moral of this story is keep pushing for the help you need and don’t suffer when help is out there. It’s such a relief to know that I’m not having to work out what needs to be done and that it is in the hands of a professional (for the time being). Sometimes this can all feel a bit like DIY healthcare 😕. Many thanks for your responses and suggestions
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