Too late for Sick Day Rules?

[PMRZ]

My partner (PMR for 2 years) started what we thought was a cold on 3rd Nov. We were due to go abroad for 5 days in the sunshine, which we thought would do him good. Covid test was negative. He was quite poorly while we were away so he did a LFT Covid test on the first day, which was negative.

Soon after we returned, I developed the same symptoms - did a Covid test on Saturday and it was negative. We both did another test on Sunday (13th Nov) - he was negative and I was positive. So I think it’s more than likely he had it, it just didn’t show up.

Although he feels better than he did last week (comparatively!) he is still very fatigued and achey, so I wondered if it was too late to out Sick Day Rules into place? He’s currently on 8mg which is the absolute minimum that he can go at the moment, so I wondered about adding 5mg for a week and then dropping back to 8 again.

I’d be grateful for your experienced advice if you’ve been in this situation.

[SnazzyD]

Covid testing can be a minefield. I think I’ve had it three times this year and the first two times I was negative it couldn’t have been anything else due to the circumstances. Two of the people at the time took 5 days to test positive. I’ve read that sometimes the virus is carried more in one place than another and the ZOE study said nose swabs can give a false negative if the person’s viral load is higher in their tonsils or even bowel. My fourth time with Covid hit my gut and the docs on the Covid ward said it seems some people can test negative up top but positive from the stool.

Anyway, from my own observations of people young and old that I’ve met in the community even a mild dose of it can make you feel fluey and fatigued for a month. Both my daughters, after the short lived acute bit at the beginning, felt washed out and achey for a few weeks. This is a rambling way of asking if he is actually needing more Pred or is this Covid leftovers that he feels shouldn’t be there because ity about time it went. Personally I wouldn’t take it to pep myself up from illness unless I had had a hard look for true signs of adrenal insufficiency or PMR, while I was still on 8mg. Is he resting properly or trying to get back to life? So, some would go straight to sick day rules without question. Having struggled with my adrenals under 10mg I’d say, pause for a second and ask him if he really isn’t coping in other ways than post viral leftovers like general aches and no energy. Sit tight for more replies.

[PMRpro Ambassador]

My daughter tested everyday and had 3 negative tests despite being 100% sure it was Covid. Then she opened a different batch of her NHS issued tests - the old batch was negative, the new positive! The LFTs are very unreliable for Omicron.

The other daughter recently also had Covid and was pretty unwell for a week but thought she was OK to return to work. She got to the ED door and had a massive asthma attack - the ED was full so a paramedic colleague outside rescued her and provided a nebuliser. Two nebs, an x-ray and thorough exam later she was sent home for another 2 weeks at least with lots of steroids. A week before she caught it she had cycled from Whitby to Scarborough - not on an e-bike! That must be over 6 weeks ago - she is only just getting back to the bike. It hangs on.

I think he probably should have had more pred at the time - not sure how much it would achieve now although he is still recovering, it might speed things up.

[PMRZ in reply to PMRpro]

Thank you. The I nteresting thing is that my positive test and his negative test were from the same batch. However, I suspect it also depends on how thoroughly you do the swabbing, although we both did it with throat and nose.

[PMRpro Ambassador in reply to PMRZ]

As a nurse, my daughter's technique is vicious - even on herself!!

[SnazzyD in reply to PMRZ]

It also depends on your viral load.

[Purple-Owl]

I have a batch of covid testers I bought a few months ago. Tried one the other day but the head of the swab seemed to have dried up even though in a sealed pack, and it collected no moisture from my nose. Nothing squeezed out into the tube, so I couldn't do a test. Must I discard the rest of the batch? Q Tips are illegal now I believe or I could use one as a swab.. Maybe I could use a twist of cotton wool???

[Exflex]

‘Covid’ (Cv-19) got me during the last week of June this year, but it was a full wk later until I tested +ve by throat and nasal swab. I had been coughing quite a bit and then the second wk I felt really unwell. On day 2, measured from LFT +ve, I felt I was going to collapse and took extra 5mg Pred. An hour later I felt much better. (At the time I was on 3mg from recollection.) Day 3: I returned to 3mg, which in hindsight was premature. I recognise now, based on previous diagnosis by my GP for a chest infection, I probably had a cytokine storm causing much coughing. I don’t know what other than bloody mindedness stopped me following SDR, the reluctance for extra Pred I guess.

[nuigini]

I had covid in the early days, long before vaccines, confirmed with a positive lab test. For a month after covid symptoms disappeared, I had ongoing deadly fatigue and body aches. Initially thought it might be long covid. Decided to go back to sick day rules, which got me back on track.

In retrospect, what I thought was long covid may have been a PMR flare and going to 20 mg might have been overkill and a 5 mg increase may have been sufficient.

We make the best decisions we can in the circumstances.

Wishing your hubby well, whatever route he decides to take.

[PMRZ in reply to nuigini]

Thank you, I thought an increase of 5mg for a week might be a good compromise.