Connecting the Dots with PMR
Hi, one of the hardest things I find about dealing with this dreaded disease is the unpredictability. My lifestyle and habits are very consistent, but PMR is not. If I could connect the dots and figure out what causes a bad day, a flare, or a good day, navigating this would be easier. My eating, exercise, health habits, sleeping, etc., are fairly consistent, so why do I wake up one day and feel pretty good and another day and feel like I've been hit by a truck?
Has anyone really been able to connect the dots?
Interested in more discussions like this? Go to the Polymyalgia Rheumatica (PMR) Support Group.
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@stonewheel
I have read your journey through this disease and it just proves that trauma and stress to the body is most certainly a contributing factor to PMR. My PMR started when I cut open my heel and needed 7 stitches. I realized there was something else going on when I was feeling fatigued through my recovery. Coincidentally my mother had PMR and when I was sitting on the toilet with pain and had trouble getting up my thoughts went to my mother. I knew what I was dealing with. Hopefully getting treatment early on is going to help me beat this disease more easily than what she went through decades ago.
Happy new year to you and best wishes in your journey to healing.
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2 Reactions@caroljeand Thank you for your reply and sharing about your experience. I hope you are in good care and wish you rapid success to full recovery. Happy New Year!
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1 Reaction@caroljeand Good point and like you said, "Who knows?" It would certainly be simpler if there was some rhyme or reason to it all...
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1 Reaction@cheraloha
I got a wicked case of PMR 5 days after the first Shingrix vaccine and my 2 Drs concur it’s most probably an immune system overreaction. I never had an auto immune disease before this and in addition, while reading in a lot of different places where people give PMR feedback, A great many of them came down with it after a vaccine. I am not an anti-vaxxer, but it makes sense that sometimes your immune system decides to have a haywire reaction. I naïvely thought it would resolve itself sooner than later, though it is much better. Prednisone is a miracle drug and it has helped me a great deal. I don’t think I’m particularly sensitive to it but it’s amazing how trying to get from one and a half mg to 1 mg seems like crossing the Rubicon. That and flumidi…sp. lol. I feel like vaccine reactions are such a controversial subject that they ( Dr’s) just don’t really go there. Very distressing to have such an unknown syndrome. At least it’s under control somewhat
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2 Reactions@esmeralda53 Thanks. All very interesting and totally agree with you. Glad you've got it somewhat under control 🙂
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1 Reaction@stonewheel
I recognize all of your pain, even in my hips although I have two total hip replacements( ?) same as your shoulders.
The orthopedic surgeon told me it was an inflammation of the bursitis (occurs frequently after a hip replacement)
That was before I got diagnosed with PMR and that explained the cause of the pain in the tendons. PET scan showed inflammation in my whole body.
You started at a high dose of prednisone, my reumy prescribed me only 15mg daily for one month and it took about 2 weeks before the pain went almost completely away. Now I only have sore fingers in the morning. I’ll soon be tapering to 12mg and I hope the pain won’t come back..?
My knees hurt a little bit when bending but nothing compared to the extreme pain I was suffering before taking Prednisone.
I felt like I had fallen off a cliff every morning not knowing if I could get out of bed without any help.
I often took a hot shower during the night because the pain was unbearable when laying down.
Good luck!
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3 Reactions@ndep Thank you for your reply. Not knowing anything about PMR until 4 weeks ago, I took the dosage that my doctor prescribed.
As I write this, I am in the ER with a severe blood clot in my right leg that extends from my groin to my ankle. They put me on blood thinner (Heparin) and are considering a surgery (Thrombectomy.) I’m waiting on the vascular surgeon to walk in any moment.
Prednisone, I learned (too late) can trigger blood clotting in some people.
Perfect storm.
I’m trying to keep a positive mental attitude and keep smiling.
(Pause… the vascular surgeon just came and went. He wants to avoid the surgery and treat me with blood thinners. Maybe go home today?)
I wish the best for you and everyone else on this site who have been so kind and helpful to me and each other.
Good bye for now.
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3 Reactions@stonewheel So sorry to hear of your blood clot. There were observational studies with Prednisone and clots, but no proven cause and effect. The higher the Prednisone dose, the greater the risk. The Arthritis Foundation has a blog on that question if you are interested. As a retired family doc, I was not aware of the association, so good to know. Best of luck and hopefully, the clot resolves soon.
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1 Reaction@stonewheel
So sorry to hear about this and I wish you a speedy recovery.
You probably don't need to read about the details of the blood clots I had while on prednisone. The blood clots in my lungs were described as massive, extensive, bilateral and multiple throughout both of my lungs. I was in intensive care for a few days.
My intensive care doctors congregated outside my door and discussed what might have caused such a pulmonary event. A doctor with many years of experience said he had never seen anything like it before. The way all of the doctors were talking, I wasn't sure I would survive! The doctors were not sure how the blood flow was getting through my lungs. There was a great deal of strain on my heart. A single pulmonary embolism is often fatal.
On a positive note ... my body had an incredible way of cleaning up the mess that was inside my lungs!
I listened to the conversations the doctors had. There was a lot of whispering but I distinctly heard that prednisone was the probable cause. I had prior high blood pressure and cardiac arrhythmias but those problems were likely prednisone related too. I was relatively young with no prior cardiac history before prednisone was started.
My medical records only say the multiple pulmonary embolisms were acute and unprovoked. There was no clear evidence for where the blood clots came from. I was told it was a "cascade of blood related events."
When I got out of the hospital, the plan was that I would need to be on warfarin for the rest of my life. Interestingly, about 10 years later after I got off prednisone, the warfarin for the rest of my life was discontinued. Furthermore, within a few years after prednisone was discontinued, all my other cardiac medications were also discontinued.
The following research is very technical statistically but it tries to control for confounding factors like our underlying inflammatory diseases and other causal factors for cardiovascular disease (CVD).
https://pmc.ncbi.nlm.nih.gov/articles/PMC7714202/
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In the author's summary you will find the following.
"What do these findings mean?
We have provided evidence that individuals receiving steroids have an increased risk of developing a broad spectrum of fatal and nonfatal CVDs and that this risk increases with the dose of steroids and with the duration of steroid treatment.
It was previously believed that less than 5 mg of prednisolone was safe long term, but even at this “low dose” patients with immune-mediated inflammatory diseases have a doubling of their underlying risk of CVD.
New treatment approaches that avoid the need for long-term steroid treatment and have better cardiovascular safety profile are required for immune-mediated inflammatory diseases.
All patients requiring long-term steroid treatment should be prescribed the lowest effective steroid dose and have a personalised CVD risk prevention plan that takes into account current and prior steroid use."
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1 Reaction@dadcue thank you. The study you linked is very informative. IMO, every doctor treating with steroids should be aware of this study.
I did have deep vein thrombosis DVT (left leg) which led to a pulmonary embolism PE after a hernia surgery in early 2021. My surgeon, the surgery center and my PCP closed due to COVID-19.
No communications returned from them whatsoever. The hospitals were overflowing and I had to “dance with the grisly” at home. The clot(s) bounced around my chest for a month and finally went away by itself. No blood thinners, no help, no nothing but hope, fortune, and God’s grace. I lived.
Your level of success is encouraging for me.
This hospital is full with flu patients so I was in ER all night and at noon today a room opened up in an Observation Unit/Wing. Prednisone 15mg twice daily resumed along with a Heparin drip blood thinner and Omeprazole for my gut. The surgeon would rather not operate due to the risk.
If the Heparin works, they’ll send me home with an oral version then a blood test visit after one week.
The only pain I am experiencing is constant muscle cramping in my extremities (feet, calves and thighs.) It’s non-stop.
I appreciate your feedback and experience although I wish you hadn’t had the experiences.