A concern stemming from the very few questions I was able to successfully ask of the new to me Rheumatologist without being sssshhh'd.... She ordered a Muscle Enzyme Creatine Kinase lab test be performed, as did my GP a month earlier and after comparing the results, it had dropped significantly from an already low number. Range in Canada is 33 -165, my first test was 30 and a month and a half later 19! Her answer was "that doesn't matter, it just means you're not exercising" and ignored me after I informed her that I exercise every single day. How presumptuous, dismissive and rude! 😡 I knew the importance of exercise and have been religiously putting in the work.
Should I be concerned? Would it be due to the Prednisone? Is there anything I can attempt to try personally to help reverse it?
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newsusy
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You WANT a low creatine kinase level. It is done in cases of possible polymyalgia to distinguish between PMR and myositis of one sort or another. In myositis the CK is raised to quite high levels (multiple hundreds at least) because of the damage being done to the muscles which releases the enzyme. If it is high, it is not PMR.
Should you be concerned? Only at the impossibly rude and dismissive doctor who needs reporting and retraining. It seems to me that the rude and arrogant surgeon caricature has been replaced by rheumies - one is left to ask why some decided to medcine, never mind specialise in rheumatology where you can't cure your patients ever and your duty is to walk beside them and help to find a decent quality of life. Being polite and friendly costs nothing.
Thank you so much for the info. It was obviously her intention to show me who's boss during this initial consult. I was concerned that I would never be accepted by a specialist on symptoms alone (biopsy & ultrasound were negative) and I guess I have to accept this as the lesser of two evils. My GP is clueless, and has the exact same "bedside manner".
Another example that left me confused and maybe you could shed some light on. When she was upping my Prednisone dose to 30mg from 12.5 with no explanation as to why, I pointed out that my CRP marker was 72.7 on my initial blood test & diagnosis, and after 3 months on the prednisone tapering schedule given to me by my GP was down to 12.5, I asked her "does that not show that the Prednisone is working as it should be?". She said we don't go by those numbers. Then why order bloodwork to be done every 8 weeks, specifically asking for ESR and CRP testing? 🤔
Well quite!!!! What a waste of money! Doesn't like intelligent questions does she? I would do all I could to find another but I know how difficult that is. She sounds a close relative of PMRCanada 's first rheumy!
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