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Some good information in that vid. I'm never comfortable when drug companies are named as sponsors though.
Interesting that 20mg of prednisone/prednisolone (in Australia 15mg) is given to start treatment for PMR and is supposed to be effective at that dose. At 21:07, he says "The need for higher doses of steroids [more than 20mg] goes against the diagnosis for PMR." Yet quite a few people here say they started at higher doses. Are those doctors over-prescribing or is the PMR diagnosis wrong?
The proposal in the vid that people should be fast-tracked to a specialist to confirm diagnosis before starting prednisone is a nice idea, but in Australia at least, we have a shortage of rheumatologists and long wait lists to see one, sometimes a couple of years. I was referred to a rheumatologist in September and got a letter saying they received the referral and they'll write again when I'm on their waiting list. Four months later, no word. Imagine if everyone had to wait in pain for that long, and imagine the inflammation damage which would likely be caused by such a long delay in starting effective treatment.
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"The proposal in the vid that people should be fast-tracked to a specialist to confirm diagnosis before starting prednisone is a nice idea, but in Australia at least, we have a shortage of rheumatologists and long wait lists to see one, sometimes a couple of years."
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We have that problem in the USA too. Depending on where you live, you may have to wait a few months and travel 100 miles to see a GP --- never mind seeing a rheumatologist. I think the wait to see a rheumatologist might be within a year though.
I live in the rural state of Iowa. We don't have any large cities where most of the specialists practice. Fortunately, in the town where I live there is a 1,000 bed university hospital with all the specialty clinics that serves the entire State of Iowa. I would prefer to see one rheumatologist at every visit. However, if I'm flexible, I can be seen by any of approximately 20 rheumatologists.
I don't know what was so special about me recently having gout added to my list of rheumatology problems. Six rheumatologists came into my room to talk about it. Two experienced rheumatologist were discussing my history and were overseeing the training of the other ones.
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"The need for higher doses of steroids [more than 20mg] goes against the diagnosis for PMR." Yet quite a few people here say they started at higher doses.
I needed a lot more than 20 mg of Prednisone for a lot longer than PMR is supposed to last. I think for isolated PMR cases 15-25 mg should be enough but that assumes you don't have any other conditions. I remember the rheumatologist who diagnosed PMR being incredulous that my inflammation markers were still elevated on 30 mg of Prednisone. She recommended 35 mg as my starting dose. I asked the same rheumatologist 10 years later if I still had PMR. She insisted that PMR was still my primary diagnosis but acknowledged there were other things going on.