Advice please.

[pmrgcavictim]

I started my PMR and GCA journey June and July 2018. I am down to 5 .5mg prednisolone. Over the last10 days, I have had Temple area discomfort, and niggly bits of headache. Headache medication doesn't help with the headache. I was unable to lay on either side of my head during last night, and this morning both Temple areas are really tender and painful. No GP appointments available (what a surprise), so I phoned Rheumatology for advice, they will get back to me later. Any advice from THE EXPERTS will be welcome while I wait with mobile in hand. Thanks in advance. Trevor.

[PMRpro Ambassador]

I hate to say it - but that is very suspicious, especially not being able to lie on the sides of your head. What about jaw pain when chewing? Fever? Feeling worse than usual?

Have you got plenty of spare pred? Keep it handy and if you get any visual symptoms at all, take 40mg if you can and get thee to the ED pronto. If necessary, call 999, tell them about visual symptoms as they can be a sign of stroke and should elicit a Cat 1 response.

Out of interest - what does the practice do about an emergency? Simply send them to the ED?

[pmrgcavictim in reply to PMRpro]

Thanks PMRpro and SnazzyD for your responses, I knew I could count on you both for good advice. I had the phone call from someone at the Rheumatology Department, offered me a blood test at my local hospital for FRIDAY, I asked if I could have it done anywhere else, incase it is GCA , and FRIDAY is to long to wait. After some searching I was offered 3:20 at Burton Hospital today. Got to take charge these days. I don't have visual symptoms at the moment, but I do have a plentiful supply of PRED, and always carry Pred wherever I go. As to what the practice do in an emergency, I don't know, probably say phone at 8 tomorrow. (111) or ( 999 ) Thanks to you both again, Trevor.

[PMRpro Ambassador in reply to pmrgcavictim]

Bear in mind though that bloods can lag a long way behind symptoms and may not ever rise in a patient already on pred however low a dose.

[SnazzyD]

Try 111 right now unless you trust the Rheumy to get back to you in a timely fashion; they don’t always. Some might say A&E now, especially if it is a bit of a trek and 111 wait times are a bit long (ask). The red flags for me are being unable to lie on the sides of the head with the focus of the pain there too with no joy from the pain killers. When I presented like that it took the out of hours GP 10 minutes to decide to send me to A&E 15 mins away and called ahead too.

[PMRpro Ambassador in reply to SnazzyD]

Does 111 and OOH doc work during normal surgery hours? They used not to. Which was why I didn't suggest it.

[SnazzyD in reply to PMRpro]

The OOH was a weekend. My point there was that just those two symptoms were enough to make them jump. Regards, 111 I thought that too, but for friends this year both surgeries said to call 111 because there are no appointments or it would be quicker in an urgent situation. For one, 111 gave advice and sent a message back to the GP and told them to sort it PDQ which they did in a couple of hours (antibiotics and ref for a kidney scan) one got second lot of antibiotics for severe tonsillitis and advice about when to go to A&E.

[PMRpro Ambassador in reply to SnazzyD]

That's interesting and useful. The head on pillow bit used to be a typical symptom but not one you hear as much about now.

[DorsetLady PMRGCAuk volunteer]

Agree with others- you need medical advice -and now..