doctors advice about suspected Flare

[1514]

Had P.M.R. for nearly 5 years. Down to 1 and 1/2 pred. Recently had very bad U.T.I. about 1month ago. and started with bad neck pain/ache, shoulder ache and back ache. My E.S.R. levels tested recently were normal , but they have never been raised even at the start of my P.M.R. journey. I have managed the journey so far following advice from this wonderful site. I now feel 1 and 1/2 is not enough and speaking to G.P about something else I asked for advice re flare. I was surprised when she told me to go on 20m.g for 2 months and then follow taper. So I am back to where I am when first diagnosed. Would appreciate any thoughts or advice. Having been a good walker, yesterday walked 15 minutes in agony and fainted. Fortunately with husband and plenty of very kind neighbours were there to help. Has anyone else experienced this ?

[PMRpro Ambassador]

Oh dear - an elementary error that but I suspect a lot of doctors make it and leave patients on too much pred for too long unecessarily as a result,

Our flare protocol is to add 5mg to the dose where you flared for up to 2 weeks and drop back to the dose ABOVE where you flared. If that sorts it - good, if it doesn;t it may mean you need a bit more ongoing but unlikely to be 20mg.

If you have PMR symptoms - your previous, even PMR related, normal is rewritten. Is the UTI properly gone? Do you feel OK otherwise?

[1514 in reply to PMRpro]

Hospital test of urine sample tested negative and regarding U.T.I. feel confident it has gone. I should have also said I am under G.P. this last week because I have been experiencing light headedness . After E.C.G. which didn't show much to be concerned about I am now waiting for heart monitor. The faint I experienced could be connected although I felt different than light headed. I was wondering if oxygen wasn't getting to my muscles it could have been lack of oxygen to brain . That is why I wondered if this could be the case. Probably this all sounds implausable and I am talking through my hat!

[PMRpro Ambassador in reply to 1514]

A 4 minute ECG more often than not doesn't show anything - I know from experience! But they are improving things by requesting a monitor but even then, they only tell you anything if you have an episode of whatever it is while the monitor is recording.

[piglette]

It seems that knowledge of PMR and steroids is not your doctor’s string point. You would normally increase by 5mg for maximum of a couple of weeks and then only do something different if that did not work. I must admit, I think I might go back and question her. You don’t want to be on 20mg of steroids for two months if not necessary.

[Zebedee44]

Hi, have you had any recent blood tested for anaemia. This was the cause of my fainting recently and it seems is related to gastric problems I wasn’t aware of. My doctor is very thorough ( a bit of a rarity these days) and lots of things have come to light since I reported the faint.

[1514 in reply to Zebedee44]

Sounds as though you are very lucky with your Doctor. I did have blood test recently but not sure it included anaemia I will follow this up.