RSV and Flare

[MegfromOz]

hi everyone, I seem to be in the wars a bit at the moment and need some advice:

- diagnosed PMR and RA April 23

- dosage of 30mg pred and 20 mg methotrexate

- gradually reduced pred to 10.5 as per Rhumetologist instructions

- had a flare in calf muscles, increased pred to 12.5

- travelled to NYC , flare was very painful, I increased pred to 15

- tested positive for COVID increased pred dose to 17

- cruised from LA to Sydney and flare in calf gradually subsided

- tested positive for RSV and Rhino upon arrival in Adelaide

- very unwell with RSV for nearly 3 weeks

- Dr increased pred dose to 50 mg for 3 days to try knock the RSV- no reall difference

- went back to 17 mg pred and skipped methotrexate injections for 3 weeks

- during all the RSV I was coughing violently

- thought I had strained muscles in both sides of my back and sometimes stomach

- side back pain getting worse over last few days even though RSV slowly improving

- upped my pred to 20mg today as I finally figured out it’s a flare as it’s on both sides

- the side back pain is a new symptom for me and is extremely painful, painkillers and anti inflammatory cream don’t help

- heat packs help somewhat

- I see my rheumatologist on Friday

My question:

Should I increase the pred further or wait to speak to rheumatologist on Friday?

How long should I stay on increased dose of pred?

Thank you in anticipation for your responses. I find this site extremely helpful.

[DorsetLady PMRGCAuk volunteer]

hi

You have been in the wars haven’t you - and although I’ll link the usual info dealing with a flare- not totally convinced it is that - the calves might have been, but think the back & sides are more likely to be related to the coughing.

healthunlocked.com/pmrgcauk...

Perhaps stay at 20mg until you have seen the rheumy on Friday - and then if it’s not a flare you can reduce back to 17mg without an issue.

Between now and Friday any change of getting appointment with GP to discuss the back/ribs/chest issue?

[MegfromOz in reply to DorsetLady]

Thanks so much for the prompt reply. I’ll go see the GP and stay on 20 pred until I see the Rhumetologist on Friday

[DorsetLady PMRGCAuk volunteer in reply to MegfromOz]

Good let’s us know how things go please..

[PMRpro Ambassador]

Was the calf pain in both legs? It is unusual for PMR to just flare in calves alone. And have you had a chest x-ray?

[MegfromOz in reply to PMRpro]

Yes the calf pain was in both legs although more painful in the right leg. Yes I have had two chest X-rays and they’re clear . I also had ultrasound of the legs while in New York. And they were clear. The first symptoms back in Feb for PMR were painful swollen knee bilateral but worse on right side and I went to emergency and hospitalised for a week with all sorts of tests.there was also bilateral hip pain and upper arm pain. . The PMR seems to always be more painful on my right side even though it is bilateral. The back pain feels very familiar to both the original knee pain and calf pain.

Thanks

[PMRpro Ambassador in reply to MegfromOz]

That's good - but you have my sympathy with the "all over pain"! And ribs really hurt.

[Merryfield]

Dear Meg. You have been through it! No medical advice but you are on it. And you have DL and Pro. In the meantime, call someone who makes you laugh, even if it hurts your ribs. A hysterical distraction: Nathan Lane and Robin Williams in Birdcage.

[MegfromOz in reply to Merryfield]

Thanks, I always try to think of others who are worse off so I keep perspective and each day I think of three things I’m grateful for. As they keep saying ‘ this is just for now’ things will get better. Cheers

[perceptual63]

From what I understand about prednisone is that it can deplete magnesium levels which I think would explain why your calf muscles hurt.