Willing to help

Posted by staydisciplined @staydisciplined, Oct 9 11:26am

I'm a 49 year old male and just completed my 1st week off prednisone after a battle with PMR that lasted 1 year. I vowed if I can make it through I will help anyone I can.

I have always been in very good shape, athletic, and ate very well. PMR came out of nowhere and the inflammation wasn't showing up in my blood testing. I was in excruciating pain in my shoulders and hips (and it actually progressed into my knee and other areas). I did lose my mother a short time before the pain started, and this may have been the trigger.

I went to 9 different doctors, 4 of which were rheumatologists. I had many xrays, mris, and an ultrasound. I was put on 3 different medications and this may have led to suppressed inflammation values in blood testing. I said to one rheumatologist "I'm 48 and have a high threshold of pain, how can people in their 70's deal with this?". I told another rheumatologist after they told me they didn't think I had an autoimmune disease "do I need to see an oncologist?". It was a scary journey not knowing what I had.

I was relentless finding information. I tracked everything and used AI (ChatGPT) to plug in information. It helped direct me what questions to ask and who to seek. I searched social media for all types of answers.

Some doctors would've left me on prednisone indefinitely since that quelled my symptoms. However, I knew long term use can have adverse effects, so I was committed to getting off it. Since I was started on a moderate dosage, it took me longer to taper off. In other words, a more experienced rheumatologist told me she would've started me on a much higher dosage and then started a quicker taper program.

Finding a good doctor who is experienced matters. Many physician websites say they treat PMR, but it seemed as though I was counseling them on it. I finally tracked down a good one who had PMR patients. I did have to drive 40 minutes to meet her, but it was well worth it.

I was very aggressive in cutting out any potential foods that caused inflammation. I used to eat things I once thought was healthy like wheat bread, skim milk, peanut butter, chick pea pasta and sauce. I cut it all out- no gluten, no dairy, no beans/legumes, no nightshade vegetables (tomatoes, peppers, eggplant). Even the chicken I routinely ate, I eliminated due to higher Omega 6s than organic chicken. I always eat organic foods now.

I stopped drinking alcohol for the first several months and then went to a small amount (1 drink a week). I eliminated beer. If I drink, I drink vodka.

My workout includes 5-7 days in the gym. I lift weights almost every gym session and now do moderate cardio: walk and then jog at 6 mph. I do about 10-15 minutes of each daily. This is enough to get my heart rate up and start me to sweat. Then I go into the sauna for 15 minutes. I do also perform breathwork.

Other miscellaneous things: I run an air filter in my bedroom. I threw out old pans that were nicked up for ceramic. I minimize drinking water out of plastic bottles. I used a nasal dilator to improve breathing at night. I go to bed early and wake up earlier than I have in years and yet somehow get better sleep.

The factors I think that helped most were changing the diet/stop drinking alcohol to heal the gut, and get a sweat doing cardio and then go into sauna to sweat out toxins.

I now eat a more normal diet, but still try and remain healthy with the occasional misstep.

This is a very hard disease to battle. Most people can't comprehend what you go through. It can be lonely along the way. However, if you are disciplined and relentless you can overcome. Best of luck to all of you battling out there. I am not a doctor. I am someone who has gone through the struggle. If I can help anyone I will do whatever I can. God bless.

Interested in more discussions like this? Go to the Polymyalgia Rheumatica (PMR) Support Group.

"Some doctors would've left me on prednisone indefinitely since that quelled my symptoms. However, I knew long term use can have adverse effects, so I was committed to getting off it."
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Sadly ... some PMR patient forums advocate for this approach too. I have never believed the notion that we should take Prednisone and wait for PMR to "burn itself out" without any time limit for how long we can safely take Prednisone. There has to be a better way than that approach for treating PMR.

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Profile picture for stonewheel @stonewheel

So bad that you got it, And, you’re only 49.
I’m 20 years older than you but our journey has been almost identical. PMR attacked you and you attacked it. And, that exactly what I said to my rheumatologist last week. Same diet, sleep, no alcohol, lots of cardio and resistance combined with stretching and TaiChi that I picked up free from YouTube clips and hours upon hours of research. I commonly workout 2.5-3 hours as day x 5 days a week. (Fortunately for me, I’m retired.) And, I drink 3-4 liters of water every day. I believe (and my rheumatologist had heard this) that the more times and the faster that I can get freshly oxygenated blood, loaded with fresh nutrients, medication and supplements to each and every cell in my body while at the same time removing CO2, and liquid and solid wastes from every cell, every day, the faster I’m going to come out the other side. Sleep is crucial. We heal in our sleep.
After 10 months, I took my last Prednisone about 3 weeks ago. I took Kevzara for 8 months and stopped it over a month ago.
PMR attacks healthy people. It made me feel like a beached whale being crushed by my own weight. It crippled me. I tolerated the pain way longer than I should have before going to my PCP for help. He knew what it was. I was hospitalized on January 3 because of Prednisone side-effects for 4 days.
I have some theories about PMR that I have shared with my rheumatologist. Time will tell.
I am glad you are doing so well and you sharing your journey is extreemly helpful. Success stories are inspirational and encouraging. Thanks. Love your attitude. There are several people on here who’ve stuck around to help. I think you’ll get a lot of questions Welcome.

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@stonewheel I’m happy to hear you’re off prednisone and Kezvara. You sound very disciplined and motivated and I know that was a factor in your recovery.

I’d love to hear about your theories.

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Profile picture for staydisciplined @staydisciplined

@kjoed53 I went to several physicians along the way. Rheumatologist number 1 didn't believe it was PMR and prescribed nothing. I had a pain doctor put me originally on 15mg of Meloxicam, but I was still experiencing pain.

Rheumatologist number 2 prescribed me 15 mg of Prednisone. She didn't believe it was PMR, but I convinced her with my data from Chat GPT to start treating it. Eventually, that didn't sit well with me, working with a doctor who was just listening to what I want and clearly didn't understand PMR.

Rheumatologist number 3 wanted to get a true diagnosis and wanted to have me completely and somewhat aggressively taper off Prednisone while he prescribed 75mg Diclofenac Sodium. Once I was tapered off the Prednisone for 2 weeks he tested my blood and since my blood values showed limited inflammation he assumed I didn't have an autoimmune disease. This phase was one of the most painful. I couldn't take Diclofenac to eliminate the pain so I had to start taking 15mg of Prednisone. He basically said it's not autoimmune and I should find another doctor, maybe it was orthopedic related. I got another MRI on the spine, and shoulders, but a spine surgeon said it was normal wear and tear and nothing structurally wrong, and the orthopedic surgeon said I did have a torn labrum (but I've had that for 6 years).

I was back to square 1 with no answers. I spent time on ChatGPT finding the best physicians in the nearby area who handle this. I kept refining the list and ultimately found someone who posted a video that she talked about treating PMR patients.

She told me since I had been on 15mg for awhile and somewhat still having levels of pain- that she needed a more careful taper journey. I describe it as being able to function, but not pain free.

She said if I came to her originally, she would've hit it with a high dosage. I dont know is she this specific number or it is what it is my mind but I'm thinking 40mg or even 60mg. I got the impression she treats it aggressively with prednisone and quickly tapers. Perhaps how it's used in other settings like when people are sick and get a 5 pack (50mg day 1, 40mg day 2, 30 day 3, 20 day 4, 10 day 5, 0 day 6)?

Since I was on 15mg for a prolonged period, my first reduction was to 12.5, then to 10. From there I went down by 1mg every 2 weeks.

She was as committed to get me off the Prednisone as I was, but she said the taper had to be more careful. I hope this helps.

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@staydisciplined My first reaction to your age was, that’s young, 49.
Literature, as you know, says PMR happens at age 70 plus or minus 10 years, rarely younger and never over 90. I think that “never over 90” group is because that age group is so small, comparatively. and at that age one’s autoimmune system is on auto-pilot (doing only the minimum and not out to cause trouble.)
Perhaps those rheumatologists had that preconceived mindset and couldn’t wrap their heads around it.
PMR is a strange disease. It affects everybody differently, and yet similiarly at the same time.
Autoimmune misconduct tends to “color out of the lines” PMR, GCA, RA, PsA, ReA, MS, Gillian-Barre, Lupus, etc., or the lines get blurred.

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Profile picture for staydisciplined @staydisciplined

@stonewheel I’m happy to hear you’re off prednisone and Kezvara. You sound very disciplined and motivated and I know that was a factor in your recovery.

I’d love to hear about your theories.

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@staydisciplined Thank you. Yes sir.
I’ll share theories with you. Let’s put that on hold, it is late and I need to go sleep.
I wish you a good evening.

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Profile picture for kjoed53 @kjoed53

Why were you told that it was harder to taper since you started on a moderate dosage, and what is a moderate dosage? When the rheumatologist told you she would have started you on a higher dosage and started a quicker taper, did she explain the difference between this and starting at a moderate dosage? I thought the idea was to find the minimum dosage that works, but this seems to go against that. Can you please expand on your comment?

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@kjoed53 it was explained to me that when you taper from a higher dose, say 20mg and go down 1mg it only reduces the milligrams by 5% if math is correct .. so say you start at 10 mg and go to 9mg it is 10%… and when you get lower dropping by a full mg or more reduces the % of prednisone too quickly.

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Profile picture for stonewheel @stonewheel

@staydisciplined My first reaction to your age was, that’s young, 49.
Literature, as you know, says PMR happens at age 70 plus or minus 10 years, rarely younger and never over 90. I think that “never over 90” group is because that age group is so small, comparatively. and at that age one’s autoimmune system is on auto-pilot (doing only the minimum and not out to cause trouble.)
Perhaps those rheumatologists had that preconceived mindset and couldn’t wrap their heads around it.
PMR is a strange disease. It affects everybody differently, and yet similiarly at the same time.
Autoimmune misconduct tends to “color out of the lines” PMR, GCA, RA, PsA, ReA, MS, Gillian-Barre, Lupus, etc., or the lines get blurred.

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@stonewheel . Yes since I was 48 at the time symptoms presented, I believe that was a factor in them not appropriately diagnosing me.

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Profile picture for jimp @boo3

@kjoed53 it was explained to me that when you taper from a higher dose, say 20mg and go down 1mg it only reduces the milligrams by 5% if math is correct .. so say you start at 10 mg and go to 9mg it is 10%… and when you get lower dropping by a full mg or more reduces the % of prednisone too quickly.

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@boo3
Totally understand that. I've just finished a taper from 25mg starting in May. What I don't understand is why it's less difficult to taper from 60mg or 40mg than it is from 20mg. There's more steps to get down to 20mg, and then you still need to taper from there with the same caution.

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Profile picture for kjoed53 @kjoed53

@boo3
Totally understand that. I've just finished a taper from 25mg starting in May. What I don't understand is why it's less difficult to taper from 60mg or 40mg than it is from 20mg. There's more steps to get down to 20mg, and then you still need to taper from there with the same caution.

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@kjoed53 . It sounded to me as though there was a consistent baseline established with someone taking 15mg for a prolonged period of time and that’s why it had to be more careful. In other words the body created a dependence on that level.

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Profile picture for staydisciplined @staydisciplined

@kjoed53 . It sounded to me as though there was a consistent baseline established with someone taking 15mg for a prolonged period of time and that’s why it had to be more careful. In other words the body created a dependence on that level.

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@staydisciplined
It is my understanding that after 3 weeks or more of steroids, your adrenal glands may be suppressed, so the taper needs to be gradual regardless of the starting dose. Starting at 40 mg just means you have more steps to get through first. Going from 40 mg down to about 15-20 mg can often move faster. Below roughly 10-15 mg, tapers typically slow down (small steps, like 1 mg at a time at the lower end) because your body has to restart its own cortisol production. The difficult part at the bottom is the same. Am I wrong?

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Profile picture for staydisciplined @staydisciplined

@kjoed53 . It sounded to me as though there was a consistent baseline established with someone taking 15mg for a prolonged period of time and that’s why it had to be more careful. In other words the body created a dependence on that level.

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I didn't think you could do that but I thought it was worth a shot. If you
can think of any other options, please let me know.

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