Arteries in the head

[prunus]

If having GCA means the arteries in the head have "furred up", when one stops taking predisolone does it mean they are completely back to what they were before we became ill?

[DorsetLady PMRGCAuk volunteer]

The arteries don’t get “furred” up in the way that they may do in coronary disease - with GCA it‘s the rogue giant cells that grow within the cell walls that make them narrow.

Once these cells are either controlled by the Pred whilst your GCA is still active or your GCA goes into remission the blood vessel walls return to normal.

when one stops taking predisolone does it mean they are completely back to what they were before we became ill?

It’s not governed by the fact you stop Pred, it’s the fact that GCA is in remission. Not quite the same thing.

See picture

GCA

[prunus in reply to DorsetLady]

Many thanks for clearing the matter up for me. I've had three relapses and at the moment am taking predisolone.

[SnazzyD]

My very simplistic view is the insides of the artery get thicker with inflammation so the path for the blood becomes narrower. A bit like a leaf stuck in your watering can spout. As a result the bits being supplied with blood by that artery become damaged and in the end irreversibly such as going blind.

That inflammation will be made less by the Pred and you have to keep taking the Pred until your body stops attacking the arteries with its own immune system. Pred keeps the arteries open and you reduce the Pred really slowly to find the lowest possible dose that will do that for you. Go too fast and the arteries begin to block off again. Ideally you reduce at the same speed your inflammation is being made which hopefully is less over time. The idea is when you get to zero you have also stopped attacking your own blood vessels.

[Gimme in reply to SnazzyD]

As a gardener, I love the watering can spout analogy. 🤣

[prunus in reply to SnazzyD]

Many thanks for the explanation. Being on a low dose of predisolone and with three relapses over almost eleven years I'm wondering what my best course of action is from here.

[PMRpro Ambassador in reply to prunus]

Have you flared at a similar dose each time? It is unusual for GCA to last this long - have the flares been GCA symptoms or PMR-type ones?

[prunus in reply to PMRpro]

The last time I had twenty six migraine with aura over fifty three days and it was put down to my GCA. So I was back on predisolone which has controlled it and the migraines with aura have stopped. I only see the Consultant once a year. The Dr reckons he knows all about GCA but I am not convinced. So I feel very much left to my own devices with the help of all you people.

[SnazzyD in reply to prunus]

Is there a pattern or trigger you can identify? Do relapses take the same form and what do they look like? What do you have to do?

[prunus in reply to SnazzyD]

As I've said to PMRpro the last time I relapsed I just felt like I had just fallen off a cliff. I felt awful and it was put down to a relapse of my GCA. Now I'm wondering do I try to get off again or stick with a low dose.

[PMRpro Ambassador in reply to prunus]

Is that put down to the GCA by an expert or the GP? He will be a very unusual GP if he knows "all about GCA" since a lot of rheumies don't either.

[prunus in reply to PMRpro]

I have a GP who is not easy. I have relied on help from members of PMRGCA and when I found this forum as a result of an article written in the newspaper it was a big relief. In particular Chris Young helped me and I shall always owe her a debt.

[PMRpro Ambassador]

Two really good explanations - I can't improve on them!

[prunus in reply to PMRpro]

Many thanks for looking at it.