Symptoms abate when the immune system has something else to deal with ?

[Buttonshutton]

Hi. I’ve broken my ankle and was expecting that with the PMR too, using crutches was going to be very painful with my shoulders and also shuffling upstairs on my bum using good leg and arms for leverage.

In fact. I’ve not felt a twinge from PMR since doing it two weeks ago today. I’ve stayed on my usual dose. The hospital gave me extra via cannula after both ops and am on codeine, paracetamol and a bit of morphine if needed which I’ve not had for a week.

I’m doing the crutches to the loo and the bum shuffle once a day and no strain or pain in the PMR areas. Now i know the pain killers could help but they don’t usually touch PMR pain as we know.

I read somewhere ages ago but can’t find it, not sure if was on here, where someone had an infection I think and the PMR seemed to do one whilst the body dealt.

I just wondered if anyone had experienced similar. Does the immune system go to deal with a new upset for want of a better word and forget to attack itself PMR wise whilst it deals with it ? I’m not complaining. But it’s interesting !

[SheffieldJane]

Yes I have noted this phenomenon over the years. I am sure that it is a massive, relevant clue to the workings of the immune system. The problem remains that PMR comes rushing back with a vengeance when the stressful event recedes. If only doctors could interrupt this process. It is then that it should be clobbered with sick day rules 5 mgs extra Pred for a week to 10 days for the shock and injury. Perhaps PMRPro knows the science? Who would have thought that a broken ankle could provide you with a welcome holiday from PMR?

[Buttonshutton in reply to SheffieldJane]

It’s weird isn’t it. Oh dear so I’ll expect it coming back grand style shortly then! Yes if only they could grab whatever this process is and bottle it !! I was due to taper next week. Only by 1.25mg. Do you think I shouldn’t bother? I know broken ankle or PMR. What’s my life become 😂

[SheffieldJane in reply to Buttonshutton]

I wouldn’t. A broken bone is a significant trauma. Take some Homoepathic Arnica to soften the shock and injury.

[Buttonshutton in reply to SheffieldJane]

Thank you loads Jane

[Koalajane]

I developed sciatica a few weeks ago and for the first 2 weeks my PMR didn’t give any pain, it has come back this week so PMR and sciatica together!

I thought it was because the pain of the sciatica was stronger than the pain from PMR which I only tend to get before the pred kicks in

[Buttonshutton in reply to Koalajane]

Oh no !!!! Oh I’m sorry. That’s rubbish. But the disappearance of it is crackers

[MrsNails]

Hi BS

Yes - l think there’s something in that but in my case l think it was more about the adrenals.

I was on 7.5mg Pred Daily & 20mg MTX weekly when l was told l had breast cancer & l went into ‘Angela Mode’; as the diagnosis/prognosis become more serious from initial diagnosis to Surgery & Pathology, l never missed a beat…..

I took it all in my stride no matter what the next step, change of plan or prognosis was but l don’t know how l did it? Wether the Adrenal Glands were woken up abruptly or not l’ll never know & then Chemo just about wiped out everything so there’s no differentiating one set of pains to another.

All l can say for sure is - as l recovered there was a very gradual re-emergence of My PMR & 9months after Chemo l was back on increased Pred & MTX

So take it easy & l hope your ankle improves soon.

Best Wishes

MrsN 🌸

[Buttonshutton in reply to MrsNails]

Hi. Thank you. Never ceases to amaze the knowledge on here. That all sounds horrific. Glad you are recovered from the cancer now. Would love a look inside our bodies to see what goes on. Or perhaps maybe not !

[autumnlass]

Very interesting post from you! From June 2021 had renal problems which lasted 6 months resulting in 2 hospital admissions and surgeries. PMR thought it better shut up and had no symptoms at all from it!! However last month it decided to stalk me again, but it’s a bit better now!

Hope your ankle heals up quickly. 🌈🌸❤️ Take it easy.

I broke same right ankle twice in 1995 and 2003, and had DXA scan which revealed osteopenia. Sheffield Jane so right in her analogy. xx

[Buttonshutton in reply to autumnlass]

Oh no. Twice !! I had a bone scan in august and was fine but I’d only been on pred a month. I don’t know if it’s connected now. Can’t understand how broke It so badly dancing serves me right thinking I’m 21 not 51!! But it is interesting isn’t it how it goes when something else appears. ThNk you. Hope you ok now !!

[autumnlass in reply to Buttonshutton]

Yes it’s fine now Buttonshutton thank you! Good for you doing the dancing - mine was nothing so romantic! I’m glad the bone scan good too! As you say it is interesting how it goes when something else appears! Take good care of the ankle and enjoy the sunshine which I hope is with you today as it is here in Suffolk. 💐

[Buttonshutton in reply to autumnlass]

Thank you. Oh it wasn’t romantic. It was following a bottomless brunch. Who knew would be so literal later on !! Yes lovely here in Sheffield. Once the other half is Back from taking mum shopping (my job usually I feel so guilty he’s run ragged)! I’m going to request a seat outside !!

[autumnlass in reply to Buttonshutton]

Oh Ouch 😣 - it sounded horrific reading one of the earlier messages. Poor girl I hope you are not in too much pain. Lots o love 💕 for an uneventful recovery.

[Buttonshutton in reply to autumnlass]

I’ve never done things by halves ! Thank you so much x

[autumnlass in reply to Buttonshutton]

Me neither!! Wish you so well! 🌈❤️

[PMRpro Ambassador]

What dose of pred are you on? And DON'T taper next week!

Not sure about the science - will have to look it up later - but even as teenagers we used to talk about the "transference of pain" principle which is probably psychological and all that comes up with a quick google but it is a very real phenomenon in the ED where a patient may be brought in with a very obvious surface injury but actually the most serious problem is internal and therefore invisible. The obvious injury is called a distracting injury - and a systematic examination is carried out to look for other indicators of internal bleeding for example.

[Buttonshutton in reply to PMRpro]

I was just coming down from 20mg after the pet scan etc proves PMR and went back to the dose that worked after the zero for the scan we’ve discussed before etc. so was on 18.75. Crackers i know but worked. Was planning 17.5 next week for a month. So I’ll stay on the 18.75. That’s all interesting and makes sense. Thank you for the advice not to taper

[PMRpro Ambassador in reply to Buttonshutton]

Just make sure the injury is going the right way - to some extent you are fulfilling Sick Day Rules as normally the body would have far more cortisol to deal with the injury and pain.

Ankles aren't difficult to break - at any age. Do you know exactly what you have done?

[Buttonshutton in reply to PMRpro]

Tibula and fibia. External fixater op last week to allow swelling to go. This week plate in one side screw in other. Pot 2 weeks. Boot for 6. No weight bearing then review. It was dislocated too. I wondered if the sick day rules applied. They kept me in 24 hrs after both to administer extra cortisol. Ok. I’ll definitely not taper. Thank you.

[PMRpro Ambassador in reply to Buttonshutton]

Very impressive. Must have been some brunch ...

[Buttonshutton in reply to PMRpro]

Hmmmmmmm. Celebrating friends new job. She was ill couldn’t make it. If she had we wouldn’t have been in the place where it happened as she can’t go anywhere busy. In future nor shall I !

[PMRpro Ambassador in reply to Buttonshutton]

Aversion therapy!

[PMRCanada]

Yes, I’ve experienced this when I had a chest infection. Weird, but welcome!

[kulina]

Yes, it's happened to me when I get a sinus infections. The first time it happened I thought it was all in my head but this phenomenon repeated itself. It's almost like my body forgets the PMR while I have the sinus infection. This is something the medical establishment should look at but when I mentioned it to my doctor, who is affiliated with doing studies on RA and PMR, he gave me an incredulous look.

[Buttonshutton in reply to kulina]

Oh i know. They like to make you feel like who are you to suggest things to moi !! I said it to my rheumatologist. She said but can go the other way too and pred make things worse. You’d think they’d like a positive spin but nothing detracts from BIG BAD PRED rhetoric

[PMRpro Ambassador in reply to Buttonshutton]

I'm so lucky having a rheumy who understands the need for pred, that being on pred isn't the end of the world whatever the dose and that we need QOL or there isn't any point at all. If I hadn't been on the dose of pred I have been for the last 6 years I'd have topped myself by now!

[Buttonshutton in reply to PMRpro]

Absobloodylutely. The psychological impact on not being able to move is akin to the pain itself. This they don’t get in the main. I don’t think mine believes how bad the pain is when it’s in full throttle and when on correct pred dose I can almost forget it exists.

[PMRpro Ambassador in reply to Buttonshutton]

Even the good ones like Sarah Mackie struggle to understand the difference - or lack of it - with the pain and stiffness. As I flare I could point to specific places that hurt but I realised the other week that the worst effect, especially at the start of a flare, is the feeling of being in a whole body pair of non-stretch jeans that fitted when you put them on but in the meantime have shrunk a couple of sizes. You can't bend, your legs and arms won't do what you want them to and stairs are a nightmare because you tend to catch your toes. Just for starters ...

[Buttonshutton in reply to PMRpro]

I’m nicking that analogy !!

[PMRpro Ambassador in reply to Buttonshutton]

You're welcome