I have had PMR for 3 and a half years and generally feel lucky that I am not feeling as bad or fatigued as many on this forum. I am certainly not as fit as I was but age has a part to play. I am 75 and used to be able to do big hikes, Zumba and so on but can still walk 4 to 5 miles and have just moved house. I am hypothyroid and have slightly raised BP and take some meds for that. It has dropped since we moved. So my morning routine is to take my thyroxine and one BP tablet and then have breakfast. I take currently 6 and a half mg Pred and I take vitamin D. I gave up stomach protectors PPI’s and was on Famotidine for a bit but don’t take it now. I take one other BP ( Ramipril) before bed. My question is - should I be taking the famotidine or am I unwittingly storing up trouble. I feel fine and have no stomach issues apart from occasional constipation. Thank you all as usual for being there.
Am I being blasé about stomach protectors whilst ... - PMRGCAuk
Am I being blasé about stomach protectors whilst on Pred?
Hello Stargiver. Personally I wouldn’t take anything for a condition I don’t have. I refused alendronic acid as my dexa scan was ok and also Lansoprazole as I don’t have digestive issues.
For the constipation up your fluid intake and increase fibre in your diet-am sure you know this already 🙂.
You are doing well, it seems, and I’m sure the house move has been good for you.
I’m interested in replies as I don’t take any PPI’s as they were upsetting my bowels so stopped having tried several times and makes. Also on thyroxine, similar meds and also down to 6 1/2 pred! Hoping to go to 6mg end of August.
Strange how some meds cause the problem they were meant to solve or one that never existed in the first place! There must be a name for this: someone here will know.
"Embuggerance" seems as good as any... anyone with a forces background would probably agree!
I love that word and must add it to my repertoire! One of my sons is ex-forces: I daren’t ask him about expressions he has used!
I was a military wife [22 years] and worked in that environment [30 years] - some of it concurrent - so probably heard more than my delicate ears [if not soul] should have!
I don’t have visions of you needing the smelling salts- no offence intended 🤭.
No you’re right there! Never been a delicate flower 😳
Hubby being ex-navy says he’s not heard of that one.
Guess he knows phrases much worse than embuggerance.
He must have led a sheltered life 😊 or never read Terry Pratchett
UK, military, slang - Any obstacle (natural or artificial) that gets in the way of progress.
english_dialects.en-academi...
He’s looking puzzled 🤣
Apparently it’s of Aussie origin. I’ll ask my daughter in Melourne if she’s heard of it…
It’s used in Oz, but according to this it’s UK military slang from 1950s…
Excerpt from World Wide Words site -
Eric Partridge, a noted recorder of military slang, included embuggerance factor in his Dictionary of Slang and Unconventional English and defined it as “a natural or artificial hazard that complicates any proposed course of action”. (Embuggerance itself may be defined in closely similar terms.) He says it was British Army slang, dating from about 1950, which feels about right.
It’s clearly a development of an older British transitive verb to bugger about, to cause someone trouble and irritation. This appears, for example, in exclamations such as “stop buggering me about!” An embuggerance, then, is an instance of trouble or interference so caused.
It does seem that it has been taken up especially enthusiastically in Australia, since of all the reference works I have here, only the Macquarie Dictionary includes it. I’ve been told by researchers at the Oxford English Dictionary that it has recently appeared in Inside the British Army by Antony Beevor and also in Andy McNab’s Bravo Two Zero, about the SAS, hardly surprising places to encounter it.
It made a rare appearance outside a military context in the Guardian newspaper earlier in 2001, in an interview with Louis de Bernières: “In fact, he has had to put up with so much ‘brainless and trivial embuggerance’ he says, that he has come to regret having written Corelli in the first place”. However, in view of the World War Two setting of Captain Corelli’s Mandolin, even that is hardly outside the services ambit (de Bernières once spent what he calls “four disastrous months” in the British Army; whether he picked up the word there is unknown, but it seems likely).
Definitely a term to be used sparingly, and with careful selection of audience.
Wonderful!
I'm pretty sure that I must have heard that word embuggarance before, but as a bit of a potty mouth on the quiet (or maybe not), I'm going to file that away for appropriate use. I'm sure it will raise a laugh.
Be my guest 😏
Do remember "stop buggering about" being a common instruction heard in the '50s! No doubt introduced by returners from the war,
lol I still say that.
Me too…usually when on this forum….🤦🏻♀️ - not the people I hasten to add 😏
Remember that was a common phrase in my home. Dad was in RA during the war.
My dad was a farmworker - reserved occupation - but his brothers were in the army I think. They never ever mentioned it.
Might even have been Mother, she was a nurse.
Think it's been around in our family for always it seems [although not my mother!]... and before I married - but then I was raised in a village just outside a small country town which was surrounded by military - whichever way you looked - Army & RAF.
Dad [North Africa during majority of war, but also Italy] and hubby in RA...
Well, it is an adverse drug event, ADE. Unintentional ADE maybe. Unintended consequence ADE. Or simply side effect:
"Finally, a certain percentage of patients will experience ADEs even when medications are prescribed and administered appropriately; these are considered adverse drug reactions or nonpreventable ADEs (and are popularly known as side effects)."
psnet.ahrq.gov/primer/medic...
When all is said and done, they are all side effects - but the drug was chosen for the one that suited the prescriber's purpose. Have you not heard the Viagra story? It was actually being developed for use in a cardiac condition but in clinical trials subjects have to report all the side effects they experience while taking it. They noted a lot of gentlemen reporting the effect for which Viagra has become famous ...
Very interesting! The things one learns here!
Hmm -very often more than you wanted -or needed -to!
Oh , so you are a delicate flower after all
Harrumph🤣😂
you can't have it both ways!!!!
Of course I can -I’m female… 😊
I don't think we should pursue this further DL😂😂
👍
Could be handy info to know in a pub quiz🤣
…and that’s a fact(oid). 😀
I am a fount of useless but interesting factoids ...
Absolutely invaluable!😀
I hadn't realised that about viagra ( or I forgot), but the other that springs to mind is when they were developing minoxidil for high blood pressure and noticed that male patients were getting hairy. Now sold for male pattern baldness as Regaine.
Factoids sounds like something to do with your bottom. Was that a Kenny Everitt word?
Steve Wright apparently! Though my use of the term is the more North American version - "a brief or trivial item of news or information." rather than that they are unreliable and established through repetition in the media.
abebooks.co.uk/978000720660...
Not that I knew that and never listened to him, only Radio 2 I ever had on was Terry Wogan before my husband went to work. I can't work with the radio on so as soon as I went to the computer the radio was off.
I believe Tacrolimus (protopic) was the same. As given to people after organ transplants and found it was good for severe eczema. I don't know about now but in itits day it was very expensive as my husband was prescribed it after I read about it. Worked really well but as soon as you stopped using it the eczema returned so was a full time commitment.
Lansoprazole did this to me and after 3 years and 6 months of prednisolone my digestive system never went back to normal. Lost of foods now upset me
So sorry to hear this.
I recall from a sociology lecture about 40 years ago the term iatrogenic disease, which means a drug induced or created disease, ie medicine that actually causes harm, presumably alongside the beneficial or positive effects of it.
Interesting. I’m asking myself if inclusion of possible medication side effects written on the patient information leaflet leaves it open for patients to accept or refuse or to cover the manufacturer if things go wrong? A bit of both? I’m tucking away the term ‘iatrogenic disease’ in my memory in case I ever need to use it with a stubborn medic. Thank you.
I KNEW there was a word for it - quite right! Good outline here even if some of the English in the Abstract is a bit wobbly!
I wasn't taking the omeprazole until the pharmacist at the hospital advised me to take it even with the coated prednisolone as it had a systemic effect??He was too busy to further explain so I compromise by taking it now and again, a daft compromise but I feel happier with that. I see that there is a discussion about the pros and cons of these PPI type drugs at the at the AGM in September, perhaps see you both there.
I believe it says somewhere not to take e/c pred together with a PPI. The changed pH in the stomach is likely to affect the way in which the coating breaks down. It is designed to resist an acid environment and pass through the stomach to the lower GI tract before being dissolved in the less acid environment there. It is never exposed to the stomach lining and that is the whole point, With the PPI the stomach may be alkaline enough for the coating to break down and the stomach to be exposed to the pred - just what you were aiming to avoid.
Thank you PMR pro for this really helpful information. I switched to coated pred because of stomach problems which were caused by the pred , although I also have a hiatus hernia. However I am still taking Esomeprazole, although it has been suggested I switch to an H2 inhibitor. I take the pred when I wake up in the night and get some discomfort about half to an hour after. Last night I dropped to 12 from 12.5 and got more pain which suggests that the tablets are dissolving in the stomach. This would be especially likely with the 1mg ones. I might try just using Gaviscon but it is a bit of a risk. Any advice
If you are taking pred at night and the discomfort is half an hour later that suggests it is the presence of the tablet that is the problem - after only half an hour it is definitely not because it is dissolving and the pred is there, they take longer than that. Have you tried taking them with food? I get discomfort after swallowing capsules of any sort if I lie down and I suspect you would be better arranging medication times that allow you to be upright after taking anything,
That’s really helpful. I might try early morning but need to avoid the stomach protector by 2= hours according to the literature. I thought of splitting the dose and take the smaller ones latter in the day as they cause the problem. I will look at the time w hen I get the problem. Rod Hughes said you can get wash back into the stomach from coated pred.
Thanks for all your help
That adds to my confusion about the recent finding of atrophic gastritis and metaplastic intestine. I haven’t routinely taken lansoprazole while on pred nor have I had many opportunities to take coated pred during my taper. I requested some in order to negotiate the lower dose, now at 3.5mg, especially after finding about the polyps in my throat, stomach and intestine. The ENT doctor had doubled the lansoprazole to reduce acid reflux without any mention of the contraindication of coated pred. There was no improvement in the heartburn or acid reflux so I went back to one a day which I take an hour before the pred in the morning.
I hope i will know more after my repeat gastroscopy but meanwhile the gastro nurse said to continue current meds!
I do the same, I take omeprazole now and again for a few days. I've not really had any gastric problems on pred, except for very occasional heartburn. I need another medicine that I can get stuck on and can't stop taking, like a hole in the head. I try to gloss over that topic with HCPs, as there is always a lot of sucking through teeth if I admit that I don't take it, but my lesson was learned with pred. If I had really appreciated how difficult that pred was going to be to wean off, I doubt that I would have started taking that either. Apart from the difficulties that some people have in stopping PPIs, I was also aware that long term use has been linked to osteoporosis and I'm not a big fan if bisphosphonates either.
Hi Gimme, I have just had another bout of diarrhea and am now sure that it is the omeprazole as took some yesterday. Now decided to permanently give it a miss and take the pred with food. Oh my, all these drugs can really mess up the system but I try not to be too antagonistic towards the steroids as they saved me from PMR which had rendered me totally housebound for a while and in a lot of pain. Also recent 60mg dose for eye issues. Have to weigh it all up don't we?
Well, that's the problem that I face. It's a rock and a hard place. I hate taking the pred, as I don't like the way that it makes me feel. But when I flared earlier in the year, I realised that without the pred, I would not be physically capable of independent living and at best, would need a carer. Certainly would need to move to a living space all on one level. Plus, I kept falling over all the time and then couldn't get up off the floor again because my arms were too weak. Only a matter of time before I did myself a permanent mischief.
Good morning Stargiver🙂I'm not a doctor but from my own experience I find magnesium citrate supplements very helpful with my tummy. I wondered if this might help you too.
Best wishes
x
I occasionally take a PPI - when either my rheumy or my cardiolgist has said I should! Otherwise it hasn't been suggested in Italy. The blanket use over years seems to be a fairly UK thing.
I suspect my nurse endoscopist doctor would support their use but they are starting to identify downsides - which I suspect is not unconnected to this use over years of medications that were never designed for that.
Stargiver. I stopped taking lanzaprazole when I reached 5 mg pred. I took it for 2.5yrs before that. i never had any issues with stomach or the drug during that time. It is supposed to reduce the level of acidity in the stomach thus helping to prevent any aggressive issues to the lining. I always took pred with food usually yoghurt sunflower seeds and blueberries. The problem with reduced acidity is that it makes processing what you eat less effective and thus deprives your body of some necessary nutrition. swings and balances as in all things.
I only read the other day about not eating bananas and blueberries together as it affects the flavonols. (I love that combo mix as well)
Bananas on their own. 2 per day. Greek yoghurt.
I love bananas and I love blueberries but, alas, the two together “apparently” aren’t good together
Not a problem is it Doraflora. Just eat them at different times of the day. 😀
but of course! I’ve not got to 72 to be put off by anyone 🤣
As an army wife in a previous life this thread has given me stitches! On a serious note with my Thyroid advisors hat on - many with Hypothyroidism actually have Low stomach acid so some of these medications are doing the wrong thing. It is an area where medical expertise is sadly lacking. A gastroenterologist assured me No one has low stomach acid and he was So wrong. Sorry to butt in but there seem to be a lot of Hypos with PMR.
that's a worry re the gastro person! 😬
Yes indeed it was - at the start he tried to insist that I was iron anaemic. My ferritin has been very high for years! So he frightened me because if it had suddenly dropped I was in trouble. Eventually it transpired he had the wrong patient up on his screen! Then with the exam he asked if the vertical scar from my navel all the way down was appendix. Err nooo it was 2 C sections, Ovary removal and hysterectomy! I did make a complaint and made a note not to accept him anywhere near the subsequent colonoscopy.
Good grief. Avoid at all costs. That is unbelievably concerning. Just wow
I am so glad that I learnt to question and check what is going on!
So important, but many out there assume and believe everything a medic might tell you.
I have found it truly empowering to do my own research.
I wasn’t prescribed a PPI with pred but 18 months in I ended up in A&E feeling like I’d swallowed a piranha chewing razor blades. Rightly or wrongly the pain was attributed to a lack of PPI and my GP hastily prescribed 2 x capsules daily. I only take one and have had no further problems in the last 9 months. I’m currently well and truly stuck on 8mg.
feeling like I’d swallowed a piranha chewing razor blades
I know we do suggest amending diet when on Pred , but not sure that’s high on the list 😳. But hey whatever…
the word is iatrogenic
Indeed
Just saw your profile - every sympathy. I have a colleague with LVV who also suffered from late diagnosis. But at least the GP and hospital are on the case now. Can your GP not make more waves on your behalf?
Thank you. I have just checked my profile and need to update as I have now seen the new consultant twice! He is an advocate of half a mg over 2 months so I am happy with that.
Who is this? Sounds good.
Dr Subrahmanyam PeddasomayajulaBroomfield Hospital in Chelmsford
A mouthful that I've finally mastered.
It's a big trip for me but worth it not to have the stress of the other one telling me to just get off the pred.
I've seen him twice and the next appt is just by phone so we're going to alternate the appts.
Don't they call him Dr Pedda ... No need to ask where he hails from!!!!
Ha. No Dr Mani apparently. @S4andy on here told me about him.
I've heard of Dr Mani - didn't click that was him. He has a great reputation.
It will be interesting to see what happens when I get below 5 (am reducing from 7 to 6.5 at the moment) as he mentioned introducing something else! Which I am not going to say yes to anyway, plus said that my bloods were fine. So he's not all perfect, but I am happy with how things are right now and will see what happens next year as it will take a while to get that low. He is also ordering another Dexa for me next year so that will also be interesting.
Having very recently been told I have atrophic gastritis (inflammation of the lining of the stomach) I am confused as to whether I should have taken a PPI throughout the eight years of taking pred or whether it has resulted from more recent use of lansoprazole to reduce acid reflux. A long term sore throat led me to ENT and an MRI and gastroscopy have followed. Talk about EMBUGGERANCE , not only do I have this stomach issue, I also have an enlarged pituitary gland!
In answer to your enquiry, I haven’t a clue! Still waiting for a treatment plan after months of assorted investigations. I wish I had kept my mouth shut about the sore throat,I was feeling fine otherwise.
Stopped my Omeprazole about three weeks ago, after tapering them down and no ill or other effects so far.
Dried prunes are excellent for constipation. Also rich in vitamins, minerals, and fiber, prunes may support GI and bone health and offer antioxidant protection.....
If I'm not mistaken, thyroxine is T4. For years I suffered with painful constipation until I found a doctor who would prescribe Armour Thyroid (derived from pig thyroid) which includes T3 in addition to T4. My constipation was gone forever, my cholesterol dropped down to normal levels, and I lost 20 lbs.
Very interesting. I've been on thyroxine since my mid 20s and only since I've been on HealthUnlocked have I discovered that's why I've been constipated all my life.
But the LVV and pred hand completely changed all that.
I need to investigate as my cholesterol has always been above normal but I've ignored it.
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