Is painful arm and chest a relapse?

[andyclairegp]

My husband was diagnosed with WG in October 2012 and has been treated with cyclophosphamide, rituximab and prednisolone ever since. In recent weeks, his condition had improved and his steroids have reduced to 10mg daily, adding on methotrexate only last week. The disease has caused an opcaity in his left lung, which initially had a very large lesion, and he recently had surgery to clear out his sinus' and insert a gromit in his ear as he'd gone deaf from glue ear! Over the last 2 weeks, he has suffered increased pain in the right side of his chest, which has spread to his right arm. As of yesterday, he can not lift his right arm and last night, upon trying to sleep, his right hand became numb and the pain in his chest much worse. We have seen a duty GP this morning, who has prescribed naproxen for the pain and she is contacting his consultant to recommend a CT scan. As far as I can tell, this pain and weakness seems identical to that which he suffered last summer before he was diagnosed, and of course my concern is that this is a significant relapse...but the doctors don't seem to be rushing to treat him! I hate to keep wasting their time and I really don't want to have to take him to A&E when I'm confident that it is his WG causing the problems. But what else can I do? His other symptoms of sweats, poor colouring and weight loss seem to be creeping back too. I'm extremely worried.

[MPAChi]

Hi, firstly I think you should trust your instinct and ring his consultant...or leave a message with the consultants secretary? Does your husband feel the same as he did before he was diagnosed? I know A&E isn't the best place to be but you might get peace of mind from going there, especially if you tell them the GP is sending him for a CT.

Hope he feels better soon and it isn't a relapse. Good Luck

[Ayla Volunteer]

I agree with HappyV. I think it would be a good idea to ring the consultant and explain your husband's symptoms, he may be able to get an early appointment to see him - I would be surprised if he didn't! As GPs generally look for a non vasculitis cause for anything wrong with us, and have very limited experience of this disease, they are usually, but not always, unable to assess the situation accurately. Your husband's consultant is likely to be the most reliable source of help.

I do hope things improve very quickly.

Ayla

[andyclairegp in reply to Ayla]

Thank you both for your advice. Shortly after I posted, the GP called and asked us to go back to the practice for my husband to have some blood tests. She had spoken to the consultant, who is also arranging a priority CT scan...so things are moving along. Again, many thanks and fingers crossed his pain improves soon. Neither of us want another sleepless night!