PMR question with up coming MRI

[Ford29]

My journey with PMR. In August 2023 the doctor thought I had a muscle issue so they prescribed ibuprofen 800 mg every eight hours and Zanaflex for 4 mg every eight hours. I was on this for two weeks and there was no improvement Went back to the doctor on 9/23/ 23 and had blood work done and my SED rate was 43 and my CRP was 6.6. I was then diagnosed with PMR and started on 20 mg of prednisone on 9 /28/23. I tapered to 17 mg on 10/26/23, to 15 mg on 12/1/23, to 10 mg on 1/12/24. On 1/17, 2024 I was scheduled to have an MRI done at the Mayo Clinic in Rochester Minnesota. I have had other MRIs prior to being diagnosed with PMR and the nurse asked if I had ever had an allergic reaction to the procedure. I explained to them that I had PMR and I was on 10 mg of prednisone. The nurse then put dye into my right arm and gave me a shot in my left shoulder. I had the MRI and everything was fine at first, however while waiting for my consultation I started to have leg and hand cramps.I tried walking the cramps off and as I was walking my legs locked up and I almost went down. I assumed I was having a reaction to the MRI procedure. Called my primary doctor and she was gone so I talked to her nurse. I told her that I was having a major PMR attack and would it be all right to take a 5 mg prednisone? She was very noncommittal and told me that maybe somebody at Mayo could help me. Not wanting to lose my 2:45 consultation I told my wife to give me a 5 mg prednisone, and I would see what would happen. By the time of my consultation I was at least able to shuffle into his office. I explained what was going on and asked him what the shot in my left arm was. He explained to me that it was glucagon, which is a hormone used to increase blood sugar levels, it took me another three hours to where I felt at least a little better. I am scheduled for another MRI for this coming July and they need glucagon to help show any progress of cancer. My question is do I just realize that I’m going to be very uncomfortable and will have to up my prednisone after the MRI procedure? Will I have to start all over? Not sure what to do.

[Merryfield]

You’d think that docs at Mayo, of all places, might ask about existing conditions and meds😔

[SheffieldJane]

I would want a clear explanation of why this happened and how it can be avoided or treated should it happen again. I would want this explanation to come from the right specialist who knows. Possibly a Pharmacist could shed some light on the matter as well. It is really not good enough that you were left like that. I take Magnesium for cramps - is that allowed?

[Ford29 in reply to SheffieldJane]

I have a call in with my primary doctor. I did talk to her nurse and she said I should bring it up at the May 5 appointment. As slow as everything moves in the medical field, I was hoping to find this out well in advance of my MRI. I did make a call to Mayo and they said I should talk to my primary doctor.

[SheffieldJane in reply to Ford29]

Yes I like to be well prepared too. Blank looks do not fill you with confidence. Can you contact your lead doctor by letter or email?

[SnazzyD in reply to Ford29]

The department that administers substances for scans should know. It sounds quite niche to expect a general doctor to know so unless they have heard of it before, I wouldn’t use the general doc as your last hope for information.

Saying that, people here have noted that their symptoms are worsened if they have a sugar blowout as a treat, only to regret it later with increase in symptoms.

[Ford29]

So far everyone I’ve talked to has been noncommittal. I’m just going to have to continue to knock on doors until someone’s willing to at least give me some advice. I am sure it is the glucagon because it is made to increase blood sugar levels. I have flare ups when eating donuts and sugary foods. I am new to all this.

[Koalajane]

I really think that this is a medical question and I don’t think there are many on here who will have much knowledge about it, sorry

[PMRpro Ambassador]

Well the first thing to do is discuss it with your own doctor and also with the staff at the MRI unit. I am rather surprised (that is being kind) that you didn't have it explained to you pre-procedure - that is hardly informed consent!! I'm even less impressed with the care you received - or rather, didn't.

The glucagon slows peristalsis in the gut to improve the images they get by reducing motion artefacts from the gut - the high blood sugar is another effect and not WHY they do it.

healthonline.washington.edu...

Click on English to open the document in another window, explains it all. Well, nearly ...

DIfficult to say if it was a blood sugar effect that caused your experiences but they should have been checked at the time which would have answered that question.

If you are a person whose PMR worsens with a sugar blowout, that could be the reason. Has that ever happened before?

[Ford29]

When I had the MRI consultation with the doctor and explained what was going on, he surmised that it was the Glucagon that caused my flareup. He told me I was on a sugar high. I know that PMR affects everyone differently. I was just wondering if anyone else had experienced a similar flareup after an MRI. It seems every time I ask about this everyone refers me to someone else and so far I’ve never got a good answer. I have another MRI coming in July and the best images come from having the Glucagon. PMR is all new to me and I have learned so much from this site.

[1951grumpa]

On your Mayo Clinic portal you are able to contact the doctor that consulted with you about your MRI and express your concerns. I have always received a response either from my doctor or their nurse that has spoken to the doctor. The same goes for other facilities I’ve been too. Hope all works out.

[Ford29]

Update on my PMR flareup after having an MRI. I am scheduled for another MRI on July 16. My doctor has advised me to go ahead and have the MRI with the contrast die. Everyone that we’ve talked to is not sure what caused the flareup. The decision was made by my doctor that I should increase my prednisone after the MRI for a couple days to see if that will block any flareup.

[HeronNS in reply to Ford29]

If you have contrast dye, make sure a) that your current kidney function has been recently tested and found good, and b) once procedure is over and you are allowed, drink as much water as you comfortably can.

My stepmother was given contrast dye prior to a heart operation, but no one checked her kidney function first, and in the end she was on dialysis for the last year of her life. The actual operation had been a success, but she definitely didn't get her quality of life restored. Since then I've a tendency to sound the alarm a bit.

(This was in the US)