Possible GCA.

[pomeranion]

I had cataracts surgery March 15 the left eye, March 29th right eye. Within a few days of the second surgery my headaches started. Never prone to any headaches. I have PMR. Started on prednisolone 15mls. 45mg. about a year ago. High dose because of gastric bypass. Only got relief at high dose. Been tapering. Down to 3mls 9mgs. then had flare and increased to 5mls.15mgs. some relief. Then the headaches started. Went to urgent care and then saw GP. Both diagnosed tension headaches. Prescribed Tylenol. No relief. So many other symptoms as described on this forum. Gum pain, fever, fatigue and scalp tenderness. Pain behind eyes and watering. I'm on antibiotic and prednisolone eye drops 4 times a day. I am so scared. I started self-medicating with increased pred to 20mls.60mgs. Relief at last but still weary, feverish, some gum pain and fatigue. I am worried about my eyes having just had the cataract surgery. It was a total success. GP suggested seeing Ophthalmologist again. Any help appreciated. Is the pred increase indicated or am I overreacting? Thank you.

[herdysheep]

I understand your concern. You have had the 2 ops very close together and your headaches may be your brain trying to adjust to new conditions. I had similar symptoms after my second op and went through an extremely thorough investigation for possible GCA. It all settled eventually but did take a while. I would suggest you take up the appt with opthalmologist and go from there. If there is an issue, it needs dealing with. If not, it should help to put your mind to rest. I have never been on such high of pred but that may affect headaches too?

[pomeranion in reply to herdysheep]

Thank you for your reply. My follow-up Ophthalmologist appt. is May 5th. I don't drive. I have to depend on family for transportation. Have really been stretching this with all the recent Drs. visits. I hate being so unwell. I had finally gotten some relief with the PMR, hypothyroidism and cataract surgery. I feel like a really bad hypochondriac and a burden. I am going to be 72 in August. I have had RA since 2018 and all the immune system problems I believe started then. My PMR started in 2020. My fraternal grandmother and my mother had severe arthritis. My brother had rhematic fever as a child, my sister has PMR so I believe these immune factors are probably hereditary. Sorry for the long reply but I think my family and Drs. are sick of all my complaints. Thanks for this forum. Everyone is so knowledgeable and compassionate. It is a great comfort to me.

[SnazzyD]

My father-in-law developed headaches after his second cataract op. He had developed an infection in the second one, plus his brain was grappling with changes in vision. I would agree with Herdysheep, definitely see an ophthalmologist. It is possible that there may be some inflammation not connected to GCA and taking 60mg Pred will have reduced it, giving a relief of symptoms. Without the cataract op, it would be a bit easier to see what’s going on. Is the GP aware you are on 60mg?

[pomeranion in reply to SnazzyD]

Thank you for your reply. Everyone is so kind and informative. It is very interesting about your father-in-law. My follow-up Ophthalmologist appt. is May 5th. No, I haven't informed my GP about the increase in pred because of the weekend. I will Email him tomorrow. But the higher dose and the Tylenol have been lifesavers. I've been able to get some rest but when I elevate my head it just throbs. I hope to get some answers soon.

[PMRpro Ambassador]

If you are taking 60mg pred then you need medical advice immediately. Apart from anything else, if it is GCA you are reducing the inflammation that provides the symptoms for them to make a diagnosis. That is a very high dose and needs medical supervision.

[pomeranion in reply to PMRpro]

Thank you for your quick response. I really appreciate your extensive knowledge and compassion. I was so happy and proud of myself for my reduction on the pred. Now back to ground zero and worse. I hate being so dependent and ill. I feel like a hypochondriac. My follow-up appt. with the Ophthalmologist is May 5th. Because of the weekend I haven't been able to inform my GP about the increase in pred. I intend to Email him tomorrow. It will probably be impossible to see my Rheumatologist and I really don't want to go to the emergency room because of Covid. Just struggling now.

[PMRpro Ambassador in reply to pomeranion]

I do understand your aversion to the ER - but you do need medical input NOW, not on May 5th or from a GP by email. It is your sight that is at risk.

[Orpheus82]

Following cataract surgery in the U.K. we suggest that patients see their optometrist six weeks after the second op as their glasses will not be correct for their current refractive state as the implants often correct any long or short sight. Your current glasses won’t be correct and it is not uncommon to experience headaches which should settle. However, one should always keep an open mind as it could be that your headaches are totally unrelated to the cataract surgery.

[pomeranion in reply to Orpheus82]

Thanks for all the replies. My symptoms have really elevated above the headaches. Scalp pain, fever, fatigue, sore throat and the gum sensitivity prompts the back of the neck and head pain radiating up the left temple. I've been able to nap after the pred dose which helps until I elevate my head. I have added 500mg. Tylenol per the Drs. recommendation. My ophthalmologist appt. is scheduled for May 5th.

I don't drive, use a walker, so I am dependent on family who aren't always available. What are the possible complications of the 60mgs. pred? At wits end.

[Orpheus82]

I’m sorry to hear that your symptoms have escalated and agree with PMRPro that you need to seek medical assessment and advice. We all have a tendency to self diagnose but we’re not always right and it’s best to seek professional advice. I’m guessing you have done a test for Covid?