Pain in throat: hoping for some advice

[SofiaAlf]

Hi everyone, I’m writing this post hoping to get some advice for my Mum that’s 72 years old. She’s had PMR for 5 years now and has tapered slowly from 30mg to 5mg following advice on this group.

A month ago she started having symptoms of a chest infection. She tried to fight it on her own but after 2 weeks went to ER where she was diagnosed with bronchitis and given antibiotics for 1 week and told to up her steroids to 30mg for 3 days, 15mg for 3 days, 10mg for 3 days then back down to 5mg. Fast forward another week and the chest infection seems to be better but she is now suffering from extreme fatigue, feelings of depression because she can’t get out of bed and what she describes as a very painful throat which is the symptom she’s most concerned about. She describes it as feeling slightly raw and sore to the touch. She feels that it’s muscular because it eases off as the day goes on.

So I suppose my questions would be could this be GCA? Or is it a flare? She’s currently down to 10mg but reluctant to go back to 5mg in case the fatigue gets any worse. Should she increase the dose of prednisone? Any advice would be greatly appreciated. I live in Chile so I’m so far away and not much I can do to help. I’m feeling very worried and frustrated that she’s been feeling so bad for a month now.

[SnazzyD]

There has been a lot going on here. She has been quite poorly and this alone could make her feel exhausted and depressed. Is the soreness on the inside such as when she swallows or in the muscles of the neck? When she says it is very painful, what things are difficult? For example, swallowing or moving her head? Does she have any other symptoms like headache for example? The pain easing off over the day does not necessarily mean it is muscular. Sore throat in the morning could be from acid reflux due to the increased Pred dose and antibiotics, for example.

I wouldn’t be putting the Pred dose up above 10mg without medical advice because the cause of the throat isn’t known and it may not be of benefit. It might also hide symptoms of a new infection or if the old one needed a longer course of antibiotics or different ones. It could be a new viral infection too. To be honest I think she needs to be checked again.

[SofiaAlf in reply to SnazzyD]

Thank you very much for your response.

She says it’s a bit sore to swallow in the morning but mostly just sore to touch. Not sore to move her head but does have a low level headache in the morning for the past couple of days.

Makes sense about not increasing the dose to mask other symptoms. Hopefully she will be able to see the GP in the next few days meanwhile she’s going to try a few things to figure out if it could be acid reflux.

After a virus like bronchitis, how long does the deathly fatigue usually last?

[PMRpro Ambassador in reply to SofiaAlf]

If it was severe, then it can be a few weeks before you really feel better, especially if she wasn't told to up the pred using Sick Day Rules to help her body deal with the illness.

[PMRpro Ambassador]

She needs to be seen by a doctor and the sore throat properly diagnosed. I have my doubts it is muscular - my suspicion would be that it could be due to night time reflux if it improves through the day but it could be all sorts of things. It isn't typical of GCA but she DOES need medical advice and the chest problem my not be fully sorted out. I'm the same age as your mum - I'd be demanding a house visit if I couldn't get out of bed and felt that unwell. And in the absence of that - call the emergency services.

[SofiaAlf in reply to PMRpro]

Thank you for responding. Going to try and get an appointment with the GP but meanwhile she will be trying a few things to see if it could be acid reflux.

[DorsetLady PMRGCAuk volunteer]

Doubt if sore throat is associated with GCA in all honesty… would agree with others, it could be acid reflex and the headache may well be a left over from the bronchitis - it is mentioned.

Also agree, she needs medical advice ..

[SofiaAlf in reply to DorsetLady]

Appreciate your response. She’s made an appointment with the GP for next week.

[DorsetLady PMRGCAuk volunteer in reply to SofiaAlf]

Good, please let us know how she gets on..

[Sophiestree in reply to SofiaAlf]

One of my original symptoms was a sore throat - I have LVV rather than GCA but it is one of the first signs for me of a flare.