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First meeting with Rheumatologist for PMR, need suggestions
Polymyalgia Rheumatica (PMR) | Last Active: 6 days ago | Replies (23)Comment receiving replies
My first rheumatologist appointment was today, two years after starting on prednisolone for PMR. He wonders if the PMR diagnosis was correct, as I told him it took a couple of weeks on 15mg to be completely painfree in the mornings, and only after I split the dose. He pressed the joints affected by PMR for pain, and there was none. My original pain was more in the soft tissue surrounding the joints rather than the joints themselves.
He has ordered more blood tests to see the current situation, and xrays of my hands and feet, the hands because there was severe pain there originally and the feet because there are painless new hard nodules on the big toe joints. I'll be interested to see what is found.
He said I was making good reduction progress (currently 4mg) and that I should keep reducing the same way. It was encouraging to hear him say I'm "doing everything right". He wants to see me in four months when I should be at 2mg. He expects that if there are going to be problems, it could be around then. It was a good appointment and I have confidence that he is listening and will be a good partner in treatment.
Replies to "My first rheumatologist appointment was today, two years after starting on prednisolone for PMR. He wonders..."
Why did your rheumatologist doubt if PMR was the correct diagnosis?
PMR is a diagnosis of exclusion when nothing else explains your symptoms. If there are doubts about the PMR diagnosis, I would think a doctor would suspect something else. A "fast response" to Prednisone or a "not so fast response" isn't much to go on for making a PMR diagnosis or changing the diagnosis.
I raised my own doubts about my diagnosis of PMR after it persisted for years. I thought PMR was supposed to burn itself out in a couple of years. At one stage, I didn't think I had PMR anymore and "tactfully accused" my rheumatologist that she only prescribed me Prednisone because she thought prednisone was what I wanted. I'm glad my rheumatologist was very patient with me because I wasn't patient with her sometimes. I just wanted to be done with Prednisone after 10 years. My rheumatologist said PMR was "refractory" in response to my complaints of being on Prednisone for so long.
Now I'm on Actemra and PMR is still my "primary diagnosis." However, my problem has been called "systemic inflammation" and a "full range of rheumatology problems " in the past.
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Really happy to hear that you have a rheumatologist that listens and works with you @megz. Looking forward to hearing your next report!