PMR or not?

[pastamaid]

I had stiffness and muscle pain, so went to docs. He took blood tests all of which came back great apart from ESR and CRP. They were 53 and 44. Doc said he would take more bloods in 28 days. By the 28 days still stiffness and aches but bloods were going down, 44 and 33.

He had spoken to Rheumi specialist who said put her on PRED for PMR. He didnt see me. When i went back to GP symptoms had got 80% better. I was taking 4 paracetamol a day and that seemed to do the job.

GP said no we still have to do PRED. I asked for another blood test. It came back with 56 and 34, but most symptoms are so much better as long as i take the paracetamol.

What should I do, take the PRED or see how it goes?

Does anyones PMR symptoms get better in a few weeks without PRED and just paracetamol?

Will bloods eventually come down?

I do have irritable bowel which has been made worse in last 6 weeks by starting Sertraline for anxiety.

Any help gratefully received

[Bluey-1]

Take the Pred. I have GCA, you really don’t want to risk that.

[Bluey-1 in reply to Bluey-1]

Your inflammatory markers are high. If you improve quickly after taking Pred, you have the answer that it is PMR.

[pastamaid in reply to Bluey-1]

Should i ask doc to keep taking blood tests as i havent got any bad symptoms now to improve

[Bluey-1 in reply to pastamaid]

DL’s advice is spot on. You could take Pred for up to 10 days as she says to see if there is an immediate improvement. Subsequent blood tests would show reduced inflammation and indicate it is PMR.

[Koalajane]

I would say if paracetamol helps it is not PMR. CRP and ESR can be raised for a number of things

[DorsetLady PMRGCAuk volunteer]

Your inflammation marker are high, and the reason why needs to be addressed - whether that’s PMR or not is not clear if the paracetamol is helping stiffness and aches.

Some bowel issues can cause raised inflammation - what do you have?

Irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD) are two distinct gastrointestinal disorders, though the differences between the two can be confusing for many people.

While they have some similar symptoms, IBS and IBD are not the same condition and they require very different treatments. It is essential to get an accurate diagnosis so that you can properly manage your condition

[pastamaid]

35 years ago i had a hemicolectomy because crohns disease was diagnosed. I havent had anything since i had the op and there were doubts that i actually ever had it as the biopsy they took was lost. Since then i have controlled the fallout from losing part of my bowel by diet, so never really been ill. The sertraline has really played with my system and i have been going a lot. Im scared of starting on Pred if i dont really have to. Does that make sense or am i just being an idiot. The doctor i first saw was adamant that if specialist said take the PRED i had to, new doctor said its totally up to me and is not giving much guidance

[DorsetLady PMRGCAuk volunteer in reply to pastamaid]

Well your symptoms do sound very PMR ish…. so I see why Rheumy is suggesting. nah insisting on Pred.

I suppose you could take it for a week to 10 days to see if it significantly reduces CRP/ESR and makes a big difference to your pains/stiffness.

After that, you can the decide whether to continue with it or not. So long as you don’t take it for more than 14 days there’s not a problem stopping it.

[pastamaid in reply to DorsetLady]

when should i ask for repeat blood test after taking pred so it will show its taking it down

[DorsetLady PMRGCAuk volunteer in reply to pastamaid]

Yes….

[pastamaid in reply to DorsetLady]

thank you

[Bramble2000 in reply to pastamaid]

It’s always up to you, it’s your body. If it’sPMR, the pain will return soon after stopping the Pred. I don’t know anyone who has taken Paracetamol and had any benefit from it with PMR. Regarding risking GCA if you don’t take the Pred, my Consultant told me it wouldn’t make any difference. If GCA is going to rear itself, it will.

[ncfaaeos]

Definitely take the Pred. Re your bowel problems, I found it very important to read up on the best way to eat while on this medication (e.g., ucsfhealth.org/education/il..., but there is a lot of literature on this) - It makes an enormous difference (in my opinion). I wish you all the best.

[pastamaid in reply to ncfaaeos]

Thank you zxx

[oaktree5]

I saw no significant benefit from Tylenol in first three years of PMR, mild pain relief after 3 yrs

[Mfaepink1973]

Take the prednisolone and see if your inflammation markers come down within 2 weeks, if it does chances are you’ve got PMR

[pastamaid in reply to Mfaepink1973]

Im so worried about the side effects. Ive spent a long time losing weight and still trying, so the weight gain really worries me

[Mfaepink1973 in reply to pastamaid]

I’ve actually lost half a stone which I didn’t want to lose! I had to cut my carb intake but already ate quite healthily. Why not try it and see. I’m still waiting for the moon face side effect to appear and fill out my wrinkles! Not everyone gets all the side effects, if we believed we would get all the side effects listed on medication information leaflets we wouldn’t take any of them! They are only POSSIBLE SIDE EFFECTS.

[pastamaid in reply to Mfaepink1973]

Thank you. I am a worry wart and never take tablets. Had to force myself to take the paracetamol to keep shoulder pain in check, so your post makes me feel a bit happier. Thank you again

[MiniSpec in reply to pastamaid]

We all have different responses to taking Pred, so there's no guarantee you'll put on weight at all. There are some people who post on here who've actually LOST weight through taking Pred, so I wouldn't worry about weight gain. Although, it would be wise to try and cut down on carbs whether you take the Pred or not. There are many people who take Pred and have no side effects at all. You never know, you could be one of the lucky ones, but you won't find out till you try it.

The only side effect I've had from taking Pred is Tinnitus, and I don't know of many others on Pred who get that as a side effect. Anyway, I can live with the Tinnitus as I now have a QOL that I wouldn't have had without the Pred, because I'd be bed ridden and in constant pain if I didn't take my Pred each morning.

[pastamaid in reply to MiniSpec]

That's very reassuring thank you. I'm sorry I'm a worry wart! Xx

[DorsetLady PMRGCAuk volunteer in reply to pastamaid]

Weight gain versus sight loss? Although upsetting at least the first can be rectified, second cannot..

[pastamaid in reply to DorsetLady]

Im sorry if i upset you, just looking for reassurance thats all

[DorsetLady PMRGCAuk volunteer in reply to pastamaid]

You didn't upset me at all... I was just trying to impress upon you that at times you don't have any option but to take the Pred.. and for some that isn't always obvious at the outset.

Sorry if it came across harsher than I meant 🌸