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Comprehensive Overview Of PMR

Polymyalgia Rheumatica (PMR) | Last Active: Jan 19 12:56pm | Replies (26)

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@dadcue

"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.

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Replies to ""The proposal in the vid that people should be fast-tracked to a specialist to confirm diagnosis..."

Greetings Dad Cue,
Here’s a link. https://pmc.ncbi.nlm.nih.gov/articles/PMC6649982/
Gout is hyper inflammatory. PMR is inflammation. Rheumatoid issues have increased massively (and others) with inflammation being at the crux. Again, Endothelial dysfunction is now recognized as a central factor in COVID-19 progression and long COVID development. The research is out there as are newer medicines and for some remission.
Best to you.

Interesting that Baby Boomers is in caps in the gout manuscript that @pattiobrien111 attached. The authors are at Alabama - where Sattui did residency.

"Few evaluations of the risk of other chronic diseases in patients with gout have been performed [4]; none focused on adults ≥65 years of age, which is a rapidly growing population owing to the Baby Boomers that will increase in the USA from 34.4 million in 2000 to >70 million in 2030 [5]. "