Cough, chest pressure, GCA

[Moaningxcat]

I am being treated for GCA, but had a negative biopsy. I am now taking 40 mg of prednisone and will drop to 35 mg tomorrow. My first rheumatology appointment is May 16. I am in no pain but I am very fatigued and I continue to cough, especially when I speak, and have chest heaviness. My primary care physician is treating me for bacterial pneumonia based on a recent chest X-ray. I am currently taking antibiotics since Monday for 7 days. Has anyone experienced a cough/chest heaviness with GCA or other autoimmune conditions? Is it possible that my bronchi are inflamed? If so, it seems the prednisone would have calmed this by now.

Any thoughts are appreciated. This forum has been helpful to me. Thank you!

[Hidden]

If your primary care physician is treating you for pneumonia based on a CXR then you have the explanation for your cough. Cough is good, its gets the gunk out of your lung. You may require a longer course or a different antibiotic if a 7 day course doesn't clear it. Pneumonia is lower down in the lungs than the bronchi. If you aren't feeling decently better you should get back in touch with yr dr on Monday next. Prednisolone is neither here or there......except perhaps to reduce your immunity a bit.

[Moaningxcat in reply to Hidden]

Thank you. I will contact my general practitioner if I’m not feeling better by Monday.

[Hidden in reply to Moaningxcat]

Or earlier if you get unduly breathless or feel worse!

[Moaningxcat in reply to Hidden]

Duly noted! Thank you.

[PMRpro Ambassador]

As SDM says - you have every justification for a) cough and b) fatigue! You have a serious systemic autoimmune disorder AND the bacterial pneumonia on top - not to mention being on pred and abx, two heavy duty drugs. Contrary to what many seem to think, including doctors, taking pred doesn't immediately confer you with your normal health status. And to be honest - I'm really not sure I'd change the pred dose until you feel better.

[Moaningxcat in reply to PMRpro]

I guess I’m used to bouncing back quickly after an illness and have had a nice, boring medical history up to now. I will be more patient with myself. If I do not reduce my prednisone per my prescription, I will run out before my first rheumatology appointment on May 16…. Thank you for your help.

[PMRpro Ambassador in reply to Moaningxcat]

But this illness of GCA is not one you have for a defined time and then recover - it is a chronic illness with an ongoing derangement of the immune system that continues over a period of years, not weeks and only rarely in terms of months. This derangement of the immune system means the immune system is unable to recognise body as self and it turns on the body tissues, attacking them as if they were foreign bodies invading, like a virus or bacteria. This action creates inflammation, a new batch every day, which makes you feel unwell. The pred does nothing to stop this - all it does is combat the inflammation to relieve the symptoms. The autoimmune disorder chugs along in the background for as long as it takes for it to burn out.

And the pneumonia really knocks you for six, even if you were healthy otherwise. Young healthy adults who develop pneumonia can take months to recover.

And if you need more pred, you need more pred, so go back to the PCP if necessary.

[Moaningxcat in reply to PMRpro]

Thanks for the explanation about new inflammation churning while GCA is still active. I’m kind of stuck in dr. limbo right now. While in the hospital, the rheumatologist said if my head pain returns after discharge, don’t call anyone, just go to the ER. I’d rather avoid the ER, of course. My prednisone was prescribed by the doctor who works at the hospital. Perhaps you are correct in advising a call to my PCP if I run out of prednisone before my first rheumatology appointment.

[PMRpro Ambassador in reply to Moaningxcat]

The "don't call anyone" is, "don't waste time". And it is inexcusable to leave you in a situation where you are short of pred for an emergency. I think you should see your PCP asap - BEFORE you end up in a sticky situation. In your case - I think it would be risky to reduce the pred when you have so much going on. Your PCP may not agree of course but give them the chance.

[Moaningxcat in reply to PMRpro]

Good advice. Thank you. I will contact PCP about this on Monday.

[LynnWeed in reply to PMRpro]

Agree

[SnazzyD]

The pneumonia has been confirmed with an x-ray so I think you need to clear out this infection before trying to attribute your cough and chest heaviness to one thing or another. You never know, it may have been incubating for a while, even before Pred started. It is possible that this course is not quite doing the trick and you need either a higher dose, a longer course or a different antibiotic. A return visit to the doctor is needed if things aren’t improving.

[Moaningxcat in reply to SnazzyD]

Thank you. I plan on calling Monday if no improvement.

[Sharitone]

I had bacterial pneumonia a year ago, after 3 yrs on pred. All I can say is - be really, really kind to yourself. It takes ages to get over pneumonia, even without GCA. That was meant to be sympathetic, not depressing! - so hard to write posts without a tone of voice to help.😉

[Moaningxcat in reply to Sharitone]

I appreciate knowing it can take awhile to get over pneumonia, plus with possible GCA. I’ll take a bit of sympathy! Thank you.