PMR and Hashimotos post viral slump

[FleetRose]

I was doing quite well, slow but steady progress and down to 7mg prednisolone from 20mg two years ago. I was about to start my next taper to 6.5mg but six weeks ago I developed acute bronchitis, possible chest infection (verdict out on whether bacterial or viral) and then pleurisy.

The cough and pleuritic pain took a long time to improve but have now almost gone. However, I feel really unwell in myself. My muscles feel weak and wobbly, I feel shaky and unsteady and I am mentally foggy and physically exhausted.

I am wondering if I did not have the adrenal reserves to cope with this severe infection and should now increase my steroids to help me get over it. Should I treat as a flare or just increase the dose slightly? I do not have pain as such, just achy leg and back muscles.

I have had some better days when I have tried to have a short walk or do some very light exercise (stretches etc) but I end up paying for it later.

My thyroid levels were ok (not brilliant) prior to this and vitamin levels ok too. I would be be very grateful for any advice.

[PMRpro Ambassador]

Oh what bad luck - and it really can take it out of you. Were you confined to bed for any length of time? And did they give you antibiotics?

Post-viral - and post-bacterial - malaise can be very persistent and if you were in bed for more than a day or two then you are likely to have lost a lot of muscle mass and condition.

Years ago a youngish friend of mine - small children so at most late 30 or early 40s - had pneumonia and said it was 6 months before she said she felt really recovered. It is a sad truth that once you are over 50 you don't have the same resilience to illness and injury - however well you may feel before it hits.

I think you probably should have been told to use Sick Day Rules and up your pred dose while you were ill. I honestly don't know whether a retrospective application of SDRs would make a difference, I suppose you could try and find out if it helps you!

[FleetRose in reply to PMRpro]

Thank you for replying so promptly PMRpro. I was given Amoxycillin 250 mg for one week, then Amoxicillin 500mg for one week, then Clarithromycin 500mg which I had to stop after 3 days as I had severe side effects. I’m not sure any of them helped! Do you have a suggestion as to how much I should increase my pred dose and for how long, given that I am over the main infection.

[PMRpro Ambassador in reply to FleetRose]

DIfficult to say isn't it - I think if it were me and given you are at 7mg and have signs of a flare with the aches and wobbliness, I would try the flare protocol and see if that perks you up at all. That means it is a fixed term and you have a plan to go back down again. Have you got enough pred? It might give you a chance of a more pleasant Christmas - but do make sure that you get waited on and pampered!!! No trying any heroics in the kitchen ...

[FleetRose in reply to PMRpro]

I have enough pred so will bump it up by 5mg tomorrow. We have family coming here but fortunately my husband enjoys cooking so there’ll be lots of help. There’s been a lot of work getting to this point, making up beds etc so all that has probably not helped. I’ll take it easy as much as I can!

[PMRpro Ambassador in reply to FleetRose]

Hmm - If I can't time it for my cleaner to make up beds, I lay the clean linen on the bed and ask the guests to do it for me! I can usually manage to strip the used linen, it is loading duvets into covers that kills me!

[Japsquar]

I’m not the one at the moment. Sorry. My husband has not recovered from emergency surgery and is dying, palliative care.sure you understand. Lots of others will help .

[PMRpro Ambassador in reply to Japsquar]

I'm so sorry to hear that - please know we are thinking of you and are here if you want a listening ear using the Chat function. Been there, done that, many virtual hugs.

[Japsquar in reply to PMRpro]

Thank you lots, means a lot, am all over the place generally and with meds, pregablin helping - I’m due a shoulder replacement and have a slipping rib into the bargain. But have wonderful support from daughter nearby and further flung sons x

[DorsetLady PMRGCAuk volunteer in reply to Japsquar]

Good luck with shoulder replacement-had mine done about a month before Covid lockdown in 2020..

[DorsetLady PMRGCAuk volunteer in reply to Japsquar]

So sorry to hear that. Like PMRpro, have been through same situation, so please reach out when/if you need help, or just to offload. Always happy to ‘listen’ - as PMRpro has said using Chat. 🌸

[Japsquar in reply to DorsetLady]

Thank you too, see my reply to PMRpro x

[FleetRose in reply to Japsquar]

Hello Japsquar, I’m so sorry you are going through such an incredibly difficult time. Thank you for taking time to reply to me. I hope you will find comfort and support from the wonderful people on this forum.

[prunus]

Sorry to be so long in replying but I've been in hospital myself and ill. I have finished up on three mg of predisolone after trying three times ot get off it.