had rheumatologist visit | Arthritis Information
Wanted to stop by to give you all an update on my first visit with the new rheumatologist. She not only dx'd me with PMR but also fibro. She kept me at 15mg prednisone daily, she didn't want to increase the dosage because of my size, I'm on the slim side and she added 7.5mg methotrexate once weekly and also folic acid daily. I did let her know that I was still having increased pain starting in the afternoons so she advised me to take 10mg pred in the morning and 5mg in the afternoons. She said some people need to split the dosage.
She did give me orders for blood work to be completed 3 wks after the visit to check out my liver functions. I have another appt in 4 wks.
I haven't had any bad side effects from the MTX and the anxious feeling that the steroids were causing have subsided. So far so good I guess.
The prednisone seems to be working. My thighs are much better, before the prednisone, stooping to pick something up from ground level was nearly impossible. My left arm & shoulder pain has subsided and I am able to use my arm again. Even my right knee is better, no pain under the knee cap anymore. Best of all the low grade fever hasn't returned or the overall body stiffness that I was experiencing every night has stopped.
I do have another question though. The rheumy still isn't sure about the PMR dx due to my age which is 53 and my normal sed rate. She also questioned the fact that my shoulder and knee pain wasn't on both sides of my body.
OK, here's the question. I've read that alot of people with PMR have shoulder/arm pain. Does the shoulder problems normally occur on both shoulders simutaneously? Or has anyone experienced shoulder issues or knee pain on just one side?
It seems like I get alot more good information from this site than from what I've read on the web and I do appreciate the information that has been given here.
[QUOTE=russellcat]
Thanks for the reply, Rick. My pain management doctor was getting ready to do some injections into the shoulder before I was dx'd with PMR and started on oral steroids. The steroids sure made a hugh difference. The rheumatologist and my pain management doctor both think I may have a tear or something else going on with my shoulder but if the steroids keep working as well as they are I'm not having anything else done.
I now have dx's of osteoarthritis, facet joint syndrome, degenerative disc disease (had lumbar & cervical fusions plus have another bulging disc in lumbar area), fibro, & PMR. I've filed for SSDI and am in the appeal process now. With no money coming in and doctor visits monthly, steroids are alot cheaper than an MRI or surgery on my shoulder.
Hi Russellcat,
Good to hear that things seem to be stabilising.
In general,most people with PMR seem to be in their 60s or 70s, but it is not uncommon to find it amongst the 50 age group either.
Though my PMR started off on both sides, it was definitely worse on the right, and several months down the line, if I had a flare-up it would only be on one side, which remains the case, I never seem to get it on both sides now. (Though I have to say that I am in the fortunate position of only having vague twinges these days).
I attended an international meeting of rheumatologists as a patient representative and even they were admitting that after the initial onset of PMR the pattern of pain distribution and type of pain seemed to change and be variable from patient to patient, and they had no idea why!
Good Luck - and take good care. russellcat
visit www.pmr-gca-northeast.org.uk - under Useful Information full diagnostic procedures issued by the British Society of Rheumatologists Issued June 2009 also quite a wealth of information on it as well. Knowledge is Power.
[QUOTE]
russellcat wrote: The rheumatologist and my pain management doctor both think I may have a
tear or something else going on with my shoulder
but if the steroids
keep working as well as they are I'm not having anything else done. [/QUOTE]
I agree Russell. When I went back to the Orthopedic surgeon with followup app. (after Rheumy diagnosed me with PMR), the surgeon said that it was possible that my shoulder pain I started with was always PMR... but, only time would tell. I know now that it was since the original pain in shoulders is completely gone. The only pain I have sometimes is manageable and in the hip area.
I recently reduced dosage to 12.5mg / day. So far so good. Keeping my fingers crossed.
It is interesting to read how PMR affects people in different ways, but the shoulder pain seems to be the most common symptom.
My PMR started in February 2010 with a sore left shoulder, firstly I tried acupuncture, then chiropractic before going to the doctor.
The doctor diagnosed a shoulder impingment and gave me fortnightly cortisone injections into the shoulder joint. The first cortisone injection gave me relief from pain for two days, the following injections made no difference at all.
By this time I was getting pain not only in the left shoulder but in both arms and thighs and the left wrist, I was getting very little sleep due to pain I went back to the doctor and as soon as I described my symptoms he said I think it might be PMR. He sent me for a blood test, a week later (yesterday) PMR was confirmed and Prednisone prescribed.
I feel lucky that I was diagnosed more quickly than in some of the posts I have read in this forum.
canny2010-06-12 03:37:51About the shoulder pain question you had - my shoulder pain started only in one shoulder I thought it was deltoid bursitis I actually got a cortisone inj from an orthopedic dr that my primary sent me to However it was my knee pain much much worse in one only that finally got me scared enough to go to a big city hospital to get some answers so yes both knees and shoulders started with one and spread to the other I also find I have to take my meds in split doses to keep the symptoms at bay and I have told my rheumatologist that my body knows when its time for meds because the pain starts to return Some days when I sleep in and take my meds late I pay for it with an extra few hours of pain until the drugs kick in also when I finally got the diagnosis of PMR my primary told me she thought I was too young I'm 58 with a huge family hx of auto immune disorders go figure also my massage therapist assures me that people with fibro have hard dense muscles that they can feel during massage and I believe her completely good luck!
Parker2010-06-25 02:27:10
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