Hi.
PMR/Diabetes/CHD
I have recently been experiencing extreme sweating and nausea. Does anyone recognise these symptoms as belonging to any of the above diseases?
A couple of months ago I had a virus. One subsequent visit to the GP told me that this was post viral. Maybe it is, and I should be a patient, patient?
Judging by your post on the other thread I would suggest that possibly either you are experiencing PMR as if it were untreated - the 5mg isn't controlling your symptoms. Or, alternatively, you have been reduced to a dose that is inadequate if your adrenal glands are not responding as they should. It rarely happens at or above 7mg because that is about the amount your body produces normally. If you are suddenly taken down to a dose below that after several months on a higher dose you can be suffering from a lack of the corticosteroid.
Go to your doctor and ask if you can try a higher dose (at least 10mg) for a short time at least - if you feel better you can then try reducing very slowly (as I described in the answer on the other thread) and I'll describe it in more detail if you want. If you had a virus a couple of months ago you may have needed a higher dose of pred to cope with that - that is a well known effect of an infection (not a common cold but in real viral infections) and many doctors suggest a few mg more as long as the infection lasts to cope with the stress on the adrenal glands that they cannot respond to.
If one GP doesn't want to listen and investigate - try another in the practice. If that doesn't work - insist on being referred to a specialist. If you are in the UK it is your right to have a second opinion.
Eileen
Thank you. That makes perfect sense. 
Hello paula-ann,
Some of us do experience extreme sweating as a symptom of PMR. I for one break out in rivers of sweat a few times a day even though I am on a higher dose of prednisolone than you are (12.5 mg). Unfortunately, a side-effect of prednisolone is sweating in some people, so it is hard to know whether it is the PMR or the steroids causing this. Nausea too can be another side-effect.
However, as 5 mg is such a low dose I agree with Eileen that the PMR symptoms are likely to be as untreated.
Hope you get some adequate help with it soon.
All the best,
Christine
Hi Paula Ann
I also have experienced sweating with taking pred but not nausea, but the lower the dosage for me the less I tend to sweat. so I hope you get the right answers when you go back to the doctors.
Thank you Christine I'm really glad that I finally found this web site and forum. So much information and lots of support. I'm compiling a list of things to do, and things to talk to discuss with my GP. Thanks again.
Thanks Linda
Following up from my initial query, things are not going as well or as quickly as I'd hoped. However, I see from many posts here that this is the case. It also seems that knowledge, of ones self and our condition is necessary, alongside patience, confidence and humour!
So, my GP did blood tests, he brought forward my Diabetes and Coronary Heart review by a few weeks, and I saw the Diabetes nurse and my GP yesterday for results. All good.
However, the sweating and nausea persist, and my pain is increasing daily. Night and day. No medication helps to alleviate the pain.
He now suggests dropping off Calchichew for 'a week or two' and if that doesn't improve things, resume them and stop taking Atorvastatin for a week or two, see if that works.
Having then worked as far as he can, on a process of elimination, he will consider referral to a Rheumatologist.
That's the story so far. Thank you for all your help. I just wanted to keep you in the picture.
Does anyone else suffer from constant headache and tinnitus by the way? And with other rheumatic pain, has anyone found successful pain relief? Thank you.
Have you increased the pred dose? If not, nothing has changed from what we said before - if you have reduced the pred too far - the symptoms of PMR will come back unless the underlying autoimmune disease has gone into remission. The inflammation will return if it isn't controlled by high enough a dose of pred - and it sounds as if that is what is happening.
Still the same Eileen. 5mg. My GP won't increase it until EVERYtHING else has been tried. He warns me of all the associated risks. I have developed Diabetes only in the last year, and already have Heart Disease, so I understand his reluctance -- but I do feel desperate sometimes.
Leaving PMR untreated increases the risk of developing GCA so it isn't a simple either/or question.
We are all in the same boat when it comes to pred side effects - but if you don't intend using pred properly then there is little or no point starting it in the first place. Your GP can identify very quickly whether it is a flare of the PMR by allowing you to raise the dose. If the aches and pains are from the statin the pred won't make any difference there - I can say THAT from bitter personal experience. Calci-chew is more likely to upset your stomach than cause aches and pains. The longer he leaves seeing if it is a PMR flare - for which there is little alternative to pred - the worse you will be and the harder it will be to get the inflammation under control.
Nefret is diabetic, I have atrial fibrillation and blood pressure problems - we both still took pred as if we don't our PMR comes back. It just means they need to work a bit harder at controlling things. Nefret has been on pred for 10 years or so and will be on it for life - to my knowledge she hasn't crumbled totally yet because of the pred. I venture to suggest your GP is out of his depth and needs to call in the cavalry. He may save you from something nasty in 10 years time - but he may be leaving you in a lot of pain and disabled for that time and also at risk of something even more disabling.
Paula - I couldn't agree more with Eileen's advice to increase the Pred. In spite of the other health problems, is your GP not aware that untreated inflammation coursing through your body puts you at risk of all manner of nasty conditions? I developed Giant Cell Arteritis (linked to PMR) because PMR was not recognised and therefore untreated the previous year. Among my symptoms at diagnosis were the nausea, sweating and head pain you are experiencing.
If you've been taking the statins for a very long time without problems previously, then a sudden increase in your symptoms is more likely to be due to something else.
As to whether any of us have found successful pain relief, the answer has to be "No" - unfortunately if it is PMR, in my experience nothing controlled any of the pain apart from Pred.
It will be interesting to see whether even a small increase to 7.5 of Pred for a few days would alleviate the symptoms.
MrsO
Thank you both so very much. It looks as if I must go back again to my GP and tell him that I'm willing to risk side effects as I really can't tolerate the pain anymore. Particularly during the night when I can't sleep. I will also mention the risk of GCA. I know he's considered it. But again, he relies on blood test results, and mine are normal.
I'm sorry to hear of your experiences and difficulties, and I'm so grateful that you share here.
I will let you know how I get on when I see him next week.
April. Desperate! So much so that I went to A&E this morning. I turned up at my GP surgery a day too soon in my haste to be seen.
In the meantime, I have become depressed. Big mistake admitting to that. But it scared me, (scares me now), I have never experienced actual depression before. I've been low of course, we all are sometimes. Sad, tearful, fed up; ****ed off. But depression is different. There doesn't appear to be anything I can actually DO about it.
Anyway I digress, and, in case I forget later, thanks for listening.
A&E were kind ans sympathetic, but were unable to do anything for me as my condition is long standing, dating back to January and my first GP visit with Headache/Nausea/Sweating/Weakness. The fatigue goes further back than I can remember and precedes by years my diagnosis of PMR. They called my GP surgery and made me an emergency appointment.
Back at the surgery, I saw another doctor who doesn't know me. (Though my GP was on site). She thinks I'm depressed, (well I did tell her I was depressed). She told me that I was probably depressed before, because people with depression always feel pain more acutely and get tension headaches.
When my GP found no change by stopping Calcichew and Atorvastatin, he has said that it's 'wear and tear' my age, lifestyle and stress. He did say that he would increase my steroids if I wanted him to. What I want, is to know what's wrong with me!
I gave that diagnosis 2 weeks, but I'm desperate now. Back to see him tomorrow, telling him that I have an appointment on Wednesday with the GP who diagnosed PMR for a second opinion. Fingers crossed.
Just came on here for a rant really. I'm feeling like a fool. And very Ill.
"When my GP found no change by stopping Calcichew and Atorvastatin, he has said that it's 'wear and tear' my age, lifestyle and stress. He did say that he would increase my steroids if I wanted him to. What I want, is to know what's wrong with me!"
I do see where you are coming from paula, being in constant pain and feeling ill is not conducive to a happy life - and whether you were depressed before or not, you damn soon become so in this sort of situation. I can't remember how old you are - but I do remember my GP making a similar suggestion to yours with "it's wear and tear" and me being utterly furious. I was, for goodness sake, only in my early 50s at the time!
If you want to know what is wrong, a good start will be to go back to a sensibly high dose of pred - 5mg is neither one thing nor t'other at the moment and you are getting side-effects for no benefit as I think Nefret said. You may not respond as well as you did first time round but giving you 15mg/day would almost certainly iron out one question: "Is it PMR?" If you get a decent response - need not be 100% by any means - but if you feel noticeably better, then you have a fair indication it is pred-responsive PMR. If it doesn't work - then it is something else which needs to be investigated by an expert, not a GP, whatever his gifts otherwise. I had also had fatigue problems years before the PMR struck, almost certainly an autoimmune something or other which finally morphed or something into PMR. Which responded well to pred and I felt human again.
Pred is NOT the devil incarnate. If you have PMR you need not have elevated blood results - I don't, Nefret doesn't, we never have done. And about 1 in 5 patients with PMR don't so we aren't unique by any means. Untreated PMR means ongoing inflammation in the body which puts you at risk of a load of other things. So it isn't a case of pred = risk, no pred = no risk. It's a balancing act in every sense. But you can't tell a patient with diabetes they can't take pred to deal with their PMR - you just have to work harder on the diabetes. Or leave them as an invalid and in pain.
It's fine to have a rant - and that's what we're here for to some extent. But I'd be saying I'd like a few weeks at 15mg/day pred and see if it makes me feel better. It might not, that is always a possibility, and in that case I would expect some more detective work by someone.
Good luck on Wednesday.
Thank you for your support Eileen. I have spoken with my Doctor about this site, the people; information and support. He's not a fan! He tells me that increased steroids WILL make me feel better - whatever the cause of my condition, because they reduce inflammation and increase well - being. That's why he's reluctant to do so, putting the onus on me.
I've been tempted to increase them. But I really do want an investigation by a specialist. And I want a referral from a doctor who believes in me, believes that my symptoms are very real and distressing.
I am 60, not 80. Getting old, but not elderly. Even if I was in my 80's, I wouldn't expect, (or want) to think that feeling like this was normal. I have, like many others, a lot of people to care for. Well, I did, I'm too ill now, even for pleasurable events, like grandchildren sleeping over in the holidays. And life events have been, erm, eventful!! But I've managed, and my glass has not only been half-full, it hats 'runneth over'.
But, yes, you're right. I'm depressed now. Can't shake it. Fingers crossed for Wednesday and my second opinion appointment.
For anyone else out there struggling to get support; understanding. God bless you. You have my sympathy.
Thanks again Eileen and patient.info and all participants.
I wonder if he has ever taken pred? I know plenty who do not find they increase well-being - unless he defines being pain-free as an increase in well-being. In PMR there is only one way to manage it as yet - and adequate dose of pred for as long as it takes. And while he may not approve of the charities and their forums, without them there would be noone to fight the corner for people like you who are being failed by their GPs - many of whom are taking money under false pretences. There are many good GPs - it's a shame about the prats.
Sorry Paula - there's one thing I DO disagree with you on. 60 is NOT "getting old", not in this day and age. I'm now nearly 62, I have "lost" 10 years of my life to PMR - but at the moment I feel better than for much of that 10 years. My neighbour is 3 or 4 years older than me, she walks for most of the morning every day - not a gentle potter round the shops, through the woods on the lower part of the mountain. A couple of weeks ago she and friends went snow-shoeing up to a mountain refuge and back, she parked at 1500m, the refuge is at over 2000m. Another neighbour is 71, she still runs her business, a furnishings shop, and cares for her 26 year old Downs syndrome daughter. She never stops - she makes me feel totally lazy! There are plenty more like them, that is normal retirement - not being so ill you can't do anything.
We are being told we must work to over 65 - but we in our 50s and early 60s are currently being abandoned as worthless.
I hope Wednesday is better.
Ah. You have filled me with hope and made me smile. Thank you.
Hi Paula
"She told me that I was probably depressed before, because people with depression always feel pain more acutely and get tension headaches."
Well in my experience, it's the other way around - people with pain and headaches feel depressed!
I had never suffered with depression until I found myself in severe pain and in bed for several months, undiagnosed (even by a rheumatologist) and therefore untreated. I would often cry just hearing a friendly voice on the phone - now I know that having an auto-immune illness messes with our emotions. I improved towards the end of the year but it was short-lived and more nasty symptoms joined in the 'fun'. Two different GPs still failed to diagnose me, doling out prescriptions for anti allergy meds and anti-sickness meds! I rang the head of the practice in the hope that he would see me urgently and whilst telling him my symptoms and how ill I felt I burst into tears. He told me to see his partner that afternoon. His partner said he didn't know what was wrong with me and asked me to see the head of practice the following week - however, he did ask me if I was feeling depressed!! The following week I was finally diagnosed by the head of practice after telling him that the local pharmacist had done some research and suggested PMR and GCA. I was then horrified to be told that if I didn't immediately take 40mgs of steroids I was at risk of losing my eyesight! I consider myself so very lucky that I still have my eyesight, having been totally failed by 3 GPs and a rheumatologist!
I hope this hasn't bored you, Paula, but I just wanted to show how much I empathise with your present situation.I hope you will have a better outcome from your appointment on Wednesday. We will be thinking of you so do let us know how you get on.
Thank you Mrs O. Not boring at all, I do appreciate hearing other people's experiences, some of which I can relate to. I KNOW that I wasn't depressed before, and I now know that depression is not just feeling fed up, or low in spirit. Bursting into tears when a friendly voice comes on the phone? Yes! I've stopped answering the phone.
I was saddened to hear your story though. No wonder you are able to offer so much support here on the forum. Did you ever feel that it was all in your mind somehow? Because the doctor's couldn't trace the cause. Did you fear that you would never be active again?
Thanks again. I will keep in touch. It does seem to be about determination somehow, and knowledge. Encouragement and information are in abundance here.