UPDATE: PMR Symptoms Reoccuring @ 30 mg. Pred or is it GCA?

[Missus835]

Seems like I'm on here often lately, but so many issues ongoing. Last night I awoke with what I thought was a fever and turned out to be low body temp at 35.8C. I've had an ulcer/lesion at the top of my buttock (sacral area), top of crack and to my right, for about 5 weeks. Tried to keep it dry, etc. When I had my last rheumy appt. 2 weeks ago, the nurse looked at it and said it could go "either way". Rheumy prescribed Fusidin. I've been using it for 2 weeks and the sore is feeling like it's burning through my skin. I cannot see it due to where it's located, even with a mirror. I'm going into ER this morning so they can have a look and ensure it's not sepsis. My body temp was 36.2C this morning. Praying this has not decided to "go the wrong way". I thought it was a rash due to the sweat and moisture in that area.

Also, PMR symptoms have reared their ugly head. Shoulders, neck, headache, mid back, tops of legs. All in addition to the low back/hip muscle spasms in back.

I'm now at 30 mg. of Pred as I upped it when the "new" pain started up. Was at 27 mg and trying so hard to taper. The 30 mg. barely touches the PMR part. I'm not understanding how they would at this high dose of Pred.

And they wonder why we would need something for anxiety.....

Update: ER did more bloodwork and urine. White cell count was up (that could be Pred). They also did an ultrasound on the ulcer and see no infection behind it or he would have drained it. I now have a new prescription for whatever infection is causing the PMR symptoms to flare. It's a Rx for resistant infections, so may actually work. Therefore, if it's diverticulitis, it would take care of that as well.

CRP was down to 3 again from 16, so maybe the extra 2 mg. Pred helped that. Feeling better about things in general. Low back has eased off a bit and walking is improving. Thanks everyone for your responses and concern. xx

[SheffieldJane]

Good luck Missus! I will be thinking of you. 🍀

[Missus835 in reply to SheffieldJane]

Thanks SJ. Quite worried otherwise I def would not be going to ER. xx

[SnazzyD]

I think you are definitely doing the right thing. A persistent sore needs proper assessment for depth, tissue viability, possible need for biopsy, organisms (swab), possible cause (eg pressure sore, in-grown hair etc) and possible need for a specialist dressing. With the level of Pred you’ve been on, this should not have been left without proper care because of the risk of infection.

Good luck!

[Missus835 in reply to SnazzyD]

Totally agree. It feels like it's burning a hole through my skin. Thank you SD for your input. Always appreciated.

[PMRpro Ambassador]

I suspect it isn't "just" PMR that is causing the pain. And that is why the pred isn't touching it, Hopefully the ER will look closely and identfy something ...

[Missus835 in reply to PMRpro]

At this point Pro, I'm concerned about the lesion being sepsis and of course "just the PMR". This trip to is get them to look at it. 4 weeks ago I told the doctor who was giving me a rectal exam that I had a sore on my buttock, but he just laughed. Now here we are. Thanks for your response. I believe there is some kind of infection ongoing in this body, but what I do not know is causing a flare and inflammation.

[PMRpro Ambassador in reply to Missus835]

If it got infected then it was a risk - especially since you are on a high dose of pred. Might be worth a complaint about the doctor ...

[Missus835 in reply to PMRpro]

It was the rheumy who prescribed Fucidin. Used it fir 2 weeks and the lesion, ulcer or whatever it is is still persisting and very sore.

[Koalajane]

I think you are doing the right thing by going to ER as it may need immediate treatment. Hope it improves for you and very quickly

[PMRCanada]

Hope your prescription helps the lesion and your diverticulitis.

I’ve been prescribed two types of ABX each time I’ve had diverticulitis and was told by the surgeon and GP that these two types of ABX specifically work together to help treat diverticulitis (Metronidazole and Ciprofloxacin). Bit of a challenge with timing of calcium supplements/dairy and ABX but worked like a charm.

[Missus835]

Hi...this is amoxi-clav. He had a number of choices. LOL. I thought well good old amoxicillan and clavulen. Let's try that. I'll keep ABX in mind for future and hopefully won't need it.