Is swelling of lymph nodes and lower face part of PMR experience?

@lally
I guessing your symptoms were enough to make the decision to go ahead with the extra dose as a precaution.
Let me know how the biopsy goes.

@lally
When I went to my primary care practitioner with PMR/GCA symptoms, she forwarded my bloodwork to a rheumatologist in Colorado (I live in Wyo). He immediately prescribed 60 mg. of Prednisone out of an abundance of caution, until I could get a bi-lateral temporal biopsy. The biopsy was done 6 days later and the report was negative, however, it stated that that didn't mean that I didn't have GCA. I was on 60 mg. of Prednisone for about 6 weeks, before I could start tapering. This all started in July 2024. I am currently taking Actemra infusions monthly and 1 mg. of pred daily. My rheumatilogist prescribed the Actemra in Jan 2025, when I had a flare and some of the GCA symptoms seemed to be rearing their ugly head.

In fairness to your initial question and your request for comments on something unrelated to GCA I am going to share. My first question would be do you have any other symptoms like swollen lymph nodes that are not classic PMR symptoms? I have been arguing with my Rheumy for 5 years that I may have PMR but too many of my symptoms are not classic PMR. I have also seen an Infectious Disease doctor for the same period of time. He tried testing for dozens of problems and came up empty handed until he recently ran a Bartonella test. The results were a little mixed, but he agrees that something in the Bartonella family is probably at play. We are now culturing to see if the can ID anything - this is a 30+ day timeline. Bartonella is best known as Cat Scratch Fever. Most people recover without even knowing they have it, thus it is never diagnosed or treated.

I had swollen lymph nodes, leathery feeling on the center bottom of my feet, phantom pains in the back of the head, muscle cramps in strange places like the top of my feet, my shins, fingers and hands that would cramp and go stiff. More joint pain than the classic muscle pain, etc. Symptoms were not easily identifiable as not PMR and my inflammation markers were sky high.

Do not give up searching for answers is the best advice I can give you. I know I am a challenging patient, so I have had to learn to work with my doctors in ways I never expected my healthcare to require.

I been reading about DMSO for PMR pain and joint pain..anyone have info?

@jabrown0407 Thank you for your reply. You do seem to get an overabundance of symptoms, causing much confusion as to what may be PMR related -or not. It makes me ache just reading about them! You have my sympathy!
My doctor thought the swelling I experienced was a non-PMR related viral infection, and it would just go away in time, which it has done since I was put on prednisone for (suspected ?) GCA. So what it really was, I don't know, but nothing else has come my way at this point.

@ropnrose That is interesting, thank you. My biopsy is Tuesday, (10 days later). My MD has reduced the 50 mg Prednisone daily that was prescribed for 1 week to 30 mg daily as of this week. I guess I'll see how this works out. No rheumatologist involvement at this point. There seem to be so many questions with this PMR/GCA business and so few answers. Access to medical support is often sparse here in Ontario, Canada. I feel like I have very little idea what to expect as the condition goes forward. But maybe it is so variable that nobody knows what to expect?

You are correct. I think everyone has a different PMR/GCA story. There's no 'cookbook' on symptoms and treating the disease. I wonder why your doctor reduced your Prednisone dosage so soon. Did your vision symptoms dissappear? If you have vision issues, consider seeing an opthamalogist. GCA isn't anything you want to ignore. Good luck with your biopsy.

One thing (of the many) I've learned in this forum is that you have to advocate for yourself. The first 10 months I had PMR/GCA, I kept a daily log of my symptoms and pain levels. I think many of my symptoms were from side effects of the Prednisone. As I reduced my dosage, the side effects subsided. I always had a list of questions for my doctor at each visit.

I can relate to medical support in a rural area. I live in Wyoming and my rheumatologist is in Colorado. After my initial visit with him, I did many months of follow-ups via telemedicine.

@lally I think she did that as a precaution. It seems like most GCA treatments are for around 60mg of prednisone. So she may have done this as a "bridge" until you get the biopsy/diagnosis. My understanding from reading some of the posts is that GCA vision issues can happen suddenly, including blindness.

Good Luck!

@terrym Thanks for your input. The rheumatologist who services our hospital has requested a diagnostic scan for me, and I have had the biopsy done, so it looks like I will be getting the necessary follow-up. I certainly got the impression from the on-line research I have done that one can't risk ignoring potential GCA symptoms.