er scare

[Twopies]

yesterday I had my worst “episode” ever—after an uneventful start to my day, I suddenly felt like I was going to collapse. Couldn’t breathe, could barely talk, weak, too weak to stand. My husband took me to er where my bp was very high (of course); spent the day. Long story short: not one thing wrong, all blood tests perfect; they ran the cardiac tests and ekgs twice just to be sure; cortisol fine. (I’m a 5 1/2 mg pred). I was sent home. As I told them, Ive been to er before whenever I was exposed to something I am intolerant of, such as sulfites, salicylates, many different foods, etc., where it felt like I was having a stroke; however, this time was different—I felt sickest ever. My conclusion: I’ve taken ibuprofen the last few days for pain, it helps but is a salicylate (Tylenol burns my bladder). Also I’ve been using a lot of lidoderm pain patches, more frequently than usual, for myofascial migraines. Maybe it’s Pepcid tablets. Er’s recommendation: if it happens again, see my doc. (They were very kind and understanding though).

im a little better today—so far. I took 2 extra prednisone yesterday; what do you think I should do today? Still pretty sick and weak; if it is some kind of intolerance to something, it will take a few days to clear out. In the meantime, I’m sitting down resting all day. Thanks.

[PMRpro Ambassador]

No, ibuprofen isn't a salicylate - but they are both NSAIDs, NonSteroidal AntiRheumatic Drugs. Possibly one of the fillers?

[Twopies in reply to PMRpro]

Probably. What about extra pred? This reaction will take a few days to wear off.

[PMRpro Ambassador in reply to Twopies]

I find it strange they aren't more interested, Do you think more pred helps?

[Miserere in reply to PMRpro]

Just a question - I thought ibuprofen shouldn't be taken with Pred?

[PMRpro Ambassador in reply to Miserere]

It isn't recommended to take ibuprofen or any NSAIDs with pred long term since each can cause stomach irritation and potentially bleeding and together the risk is higher, but many rheumies allow it when it is necessary. I take 600mg ibuprofen and 1g paracetamol a day as the only way to manage back pain - approved by both my rheumy and the pain clinic doctor. Best taken with food and possibly a PPI or other stomach protection.

[Miserere in reply to PMRpro]

Thanks, Pro. I ask because I have replacement knee surgery coming up and have been wondering what I can use for pain relief initially.

[PMRpro Ambassador in reply to Miserere]

I imagine they will start with opiods, which includes cocodamol - make sure you don't get constipated! Start some form of laxative BEFORE the problem arises. Maybe post and ask what others have been given in such a situation - few will see the question here.

[Miserere in reply to PMRpro]

Many thanks - I shall ask - I already tend to suffer with IBS-C so not a good start and allergic to paracetamol. Blast!

[PMRpro Ambassador in reply to Miserere]

Paracetamol is pretty useless anyway!!

[Pameliza in reply to PMRpro]

Having also been salicylate intolerant, I know that ibuprofen has the same effect on COX enzymes. Taking ibuprofen when salicylate intolerant has caused me problems too.

[Twopies in reply to Pameliza]

Oh thank you! Your reply makes me feel less whacko! I knew I reacted but never knew why.

[Leafsong66]

That sounds super scary! Hoping that you can establish whats going on. This is a very confusing and complicated medical problem! I also had a similar but not as scary situation where i had no choice but to present to the ED in a distressed state. I tested out perfectly on paper but the sensation of going to collapse was horrendous. They kept me in overnight for occasional monitoring and apart from low blood pressure at times, I was fine. I was having really heavy periods of palpitations but in my muddled state only mentioned that late in the piece, so wasn't monitored for that. Sitting quietly and resting seems our new work!

[Twopies in reply to Leafsong66]

I’m a tad better today, thank you; all I can think is that it had to be some reaction to something…I’ve read that as we get older, the reactions get more severe so I’m going with that, I guess. In the hospital er my oxygen level was 100%, it is always 99-100. Yesterday I did up my pred by 2 mg, can’t say it helped, who knows? Today I’m back at 5 1/2, and will ditch the tapering program again, at least for a month? Still weak and sedentary for now. Sure wish they could figure out what’s wrong with us! Love your name, by the way!

[HeronNS]

Ibuprofen is often recommended over aspirin but it does come with its own set of side effects, including more likelihood of stroke than aspirin (although allegedly somewhat safer regarding the stomach). Naproxen (Aleve) like aspirin is more prone to causing stomach problems, but lower risk of heart attack or stroke than ibuprofen. Choose your devil! They all make low dose pred look rather benign.

In any event, make sure you always have food with whatever painkiller you choose. I've found the yoghurt which protects us with pred is also helpful with my headache pill of choice, aspirin, and always force myself to have the full glass of water recommended also.

[PMRpro Ambassador in reply to HeronNS]

It does all depend on dose - and up to 1200mg/day of ibuprofen there is no increased risk of cardiovascular events.

[HeronNS in reply to PMRpro]

I did take it when I had my dental surgery because of not wanting to increase risk of bleeding, but a few days later when using it for headache it seemed less effective than I usually find aspirin, although both are light years ahead of acetaminophen!

[moonieboy9358]

Ibuprofen is not a salicylate. It is proprionic acid. Although both drugs have many of the same benefits. The chemical structures are different. I hope you feel better soon

[RT18]

can they accurately test the cortisol when ur on 5.5mg? I’m more clued up now following my mums adrenal crisis. If u double up to say 10mg for 2 days and that gets rid of ur symptoms u know low cortisol is the culprit.

[Twopies in reply to RT18]

I don’t know—they said they tested. (Bloodwork). I felt so bad by dinner time the last 2 days that I did go up by 2 mg which seemed to help…eventually.

[Moonriver65 in reply to RT18]

I am awaiting results of a cortisol test - am on 3mg pred after reducing to 2mg. Am praying this is the cause of my stomach problems over the last 6 weeks - unable to eat properly and have had dramatic weight loss plus general anxiety. I have had a ct scan on my pancreas, stomach and pelvis, so I’m very worried.

[Leafsong66]

How are you today?

[Twopies in reply to Leafsong66]

Thank you! Still wobbly and off center, looks like it’s gonna take awhile, whatever it is. Still plugging away though!