Bruises, Ankles Swelling, ETC.

[Missus835]

Never a dull moment. Diagnosed with PMR since Jan '22 and now at 32 mg. Pred after that GCA scare in Jan. 2

3. I am 73, but the bruising has just begun. Nasty ones and I don't remember bumping the areas where they are (like the joint of my big toe at the side), so it doesn't take much. Presuming thinning skin.My ankles and feet are swelling slightly with a lot of purple veining in tops of feet, ankles and progressing up the calf. Shoes and slippers are leaving a fairly deep impression in the skin. The only salt intake is that which is already in the food. I drink almost a gallon of water per day. The bottoms of my feet get extremely dark red (not purple). There is no associated pain with this. My feet and ankles are extremely pale on tops.

Moon face is so full and ring around neck, which is also large, turns red. I've had this pressure in my head (almost like a huge sinus issue). It presses out on my ears to where I go deaf in one ear or the other and you can hear the pressure "move" when you move your head back or sideways and it sounds like I'm under water. Tinnitus screams. Cheeks are pressing up on eyes and so they look practically closed, which affects my vision actually. Eye bags pressing down. Also pressing down on mouth, so difficult to talk coherently with all the saliva. When I tap on my head it feels hollow (not surprised. LOL. Now wearing a biteplane 24-7 for TMJ/TMD, which is not helping very much with the pressure, but dentist thought it would. Biteplane for approx. a month now. Jaws still cracking and "crumbling".

Rashes under breasts (from sweating I presume) and also between buttocks at top (which I can't see). I've been using Lotriderm cream and it is helping the breast rash, but not the buttock rash to far.

I have a phone consult with the unreachable rheumy on Tuesday next, but wish it was an IP appointment so she could have a look at my ankles. Had fasting bloods done just past Friday morning and hopefully it will indicate something (or nothing), if she's actually got the results. Had I been able to reach her prior, I would have apprised her of all of this and I'm sorry to flood the group. I feel it's a fluid issue and perhaps a diuretic might help. Not sure what BP is at this time.

Also, is it possible to go through a flare at 32 mg. Pred? Pain in left shoulder, back of neck, migraines on waking and thighes have resurfaced over the last few days since dropping to 32 mg. from 35, but I really don't want to increase as trying to taper from 60 mg.

Loaded post. If you'd prefer I address one issue at a time, please advise. Thanks so much.

[piglette]

A lot of the symptoms you mention are caused by steroids. The downsides of a wonder drug. At least you can talk to your theumy this coming week about the symptoms.

[Missus835 in reply to piglette]

You are right unless she rushes me off the phone after 10 mins. Lol.

[piglette in reply to Missus835]

Hope she doesn’t! Good luck.

[PMRpro Ambassador]

If you really are drinking a Canadian gallon of water you are drinking far too much and that could well be the cause of your swollen ankles. That would be 4.5 litres which is double the amount of fluid anyone recommends per day. Are you drinking that in addition to other drinks like coffee and the food you are eating?

The amount of fluid we should drink includes ALL fluids AND foods, most of which contain a fair bit of water. If you drink too much water, you flush sodium out of the body and that can lead to fluid retention. Even including food, the correct recommendation is about 2 litres, which really means 1 to 1,5 litres as actual liquids. You possibly need MORE salt, not less.

[Missus835 in reply to PMRpro]

It's an Imperial gallon Pro. I use it for coffee (1 in the morning) and for tea (in the afternoon). All the rest is just drinking it. In addition, I also drink low sodium soda water with a meal. I'm going to cut it in half. I do share a fresh bowlful with my cat.

Thank you so much for this information. I refill my water jugs at the grocery store. That is how I know how much I'm going through. Just thought we were supposed to drink as much as possible, so I keep a glass next to me all the time. My kidneys are probably working on overload as well. The salt gods will love this. Probably didn't need the biteplane. Just my hind teeth floating. Once again, thank you.

[PMRpro Ambassador in reply to Missus835]

I remember my sister in law having a fit about the usual recommendations about how much to drink - like me, she had a physiology degree! I have no idea where the volumes come from that some so-called health sites say we should drink! It applies to quite a few things, including nutrients such as vitamins - just because an amount is good for us, it doesn't mean double the amount is better for us! And water is one of those things. About 20% of your fluid intake comes from food - soups are obvious but all food has some liquid in it and some fruits and veggies are almost 100% water.

You need more if you are exercising hard or if it is very hot and you are sweating more. And you see claims that tea or coffee don't count - yes they do, they may make make you pee it out faster but they don't make you pee too much out!

[Missus835 in reply to PMRpro]

It does make perfect sense. Liquid is liquid. I've been drinking a lot of water for years and even more when I started with Pred. Sweating is a thing though. I do sweat a lot through the night because I take my Pred at bedtime.

I'm going to cut back by 1/2 to see if the ankles go down and also peeing 3 or 4 times throughout the night, so this will help. Thanks!