Post Exercise…flare?

[51Highland]

This year I shall be 70. I was diagnosed in March 2020 and started on 15mg which was miraculous and I’ve very carefully tapered down ever since. I saw no rush. After much preparation I embarked on a cycle ride from London to Rome 2-25 June (1450 miles, 90,000 ft climbing) in aid of Prostate Cancer Uk (another affliction). By now I was on 2.5 mg. Pred and very comfortable (PMR-wise) the whole way through the ride.

I returned to Uk on 27th and reduced to 2mg confident that life was now less of an effort and I could taper down a notch. Since then I have started to experience a painful tightness across the chest and upper arms at the end of the day and slight difficulty getting out of the bath. How weird is that? I shall monitor and, if necessary, go back up. Any views?

[DorsetLady PMRGCAuk volunteer]

In hindsight probably would have been better not to reduce just after your trip…but it is what it is. Well done on that by the way, hope you raised a lot of money.

You do need to get chest checked out, it could just be a reaction from the long bike ride, but chest pains should always be taken seriously and anything untoward ruled out.

In the meantime, it won’t do any harm to up your Pred - you probably don’t need to increase by much but it may help a little.

Please keep us informed.

[51Highland in reply to DorsetLady]

Thank you for the swift response. I will do what you suggest.

[PMRpro Ambassador]

It is felt that excessive exercise can trigger a flare - so bear that in mind!

Well done though - which way did you go through the Alps?

[51Highland in reply to PMRpro]

Thanks. Went Albertville-Valloire-Col du Galibier-Col du Lautaret-Briancon-Claviere-SestriereQuite a lot of climbing!

[PMRpro Ambassador in reply to 51Highland]

A Francophile - I like this end better - not that I ride a bike!!!!

[MiloCollie]

I couldn’t cycle to the end of our road!!! Well done 🤗

[51Highland in reply to MiloCollie]

Thank you Milo. Nor could I 3 years ago!

[pmr_nikola]

You made me laugh. You biked 1450 miles in 23 days averaging 60+mile/day which means probably 4-5 hours of biking each day in bent over position leaning over the steering bar and you have "started to experience a painful tightness across the chest and upper arms"!? Who wouldn't have muscle pain after such a long ride? It will probably go away in a week or so.

Fantastic job BTW. Perhaps some massage and/or stretching would speed up recovery, but I would not blame PMR for it or change dosage... I think it is just natural reaction to extremely high effort. Don't know how much biking have you done to train before this trip, but couldn't be as high volume as in those 3 weeks.

[51Highland in reply to pmr_nikola]

Ha! Looking at it like that I see what you mean. I suppose my point is that throughout the ride I felt great and although leg muscles ached a bit at the end of the day (obviously) there was no trace of PmR discomfort on the current, low, dose. Now it’s a week on all is well and I shall continue to taper with caution.

[pmr_nikola in reply to 51Highland]

Glad everything is fine...