Does cold weather cause PMR pain flares?

TRY TAKEING (ALEVE) IT DOES ME WONDERS AND IT IS OVER-THE-COUNTER AT WAL-MART. IM DOWN FROM 10MG TO 1MG

​ONE MG PER MONTH REDUCTION. PRED IS NOT REALLY GOOD FOR THE LIVER AND KIDNETS, MY DOCTOR TELLS ME. IM 75 AND EXERCISE EVERY DAY. I FEEL FINE

                                               WALTER 98524

Aleve can be really bad for people's stomachs.  I had an issue with the prescription naproxyn before it became an OTC as aleve, and can't take it.  One needs to be as careful with it as one is with pred itself when it comes to protecting the stomach.

Pred may not be good for us - but NSAIDs are as bad if not worse for kidneys and heart! Aleve is an NSAID and should not be mixed with pred at any dose on a regular basis - it increases the risk of stomach bleeds. Just because something is OTC doesn't mean it is "safer".

I had neuralgia for a week from the cold wind and the only thing that would help was Advil (ibuprofen). One every 8 hours did the trick. I know we're not supposed to take them with pred but I was miserable and couldn't sleep. I've read that Tylenole(acetominapin) is a real no no.

My GP wanted to give me Aleve for sciatic pain, but decided not to because I was taking pred and she was worried about the interaction. Also Aleve really has no affect on PMR, but does help other symptoms of course. As PMRPro says Aleve also can cause problems with liver and kidneys, along with a lot of other drugs besides poor old pred. 

Before PMR diagnosis the doctor I had then kept prescribing celebrex.  I kept looking it up, wondering why it was still on the market, and not filling the prescription.

My rheum prescribed meloxican to take along with the pred for residual pain while reducing, but I didn't fill it either. Has anyone had any experience with this drug?

Anhaga: Partly I think because for some purposes in rheumatology it does work very well and provides excellent pain relief - there other things didn't. When there was a threat to remove it from the market there was uproar and it survived. But it is being used by doctors who don't know enough about it.

I wouldn't touch it with a barge pole while on pred, it's an NSAID too. Supposedly "less harsh effects on the stomach" - but as I keep saying, less isn't none. And it doesn't work for PMR. 

The question is surely "What is the residual pain when reducing"? If it is a flare you need a bit more pred. If it is steroid withdrawal pain - then the slow slow reduction approach almost always avoids that and has NO side effects.

Well if it doesn't work on PMR then I don't know why she prescribed it. She's so eager to get me off the pred that she'll throw anything at me. 

I'm thinking that I had a flare, I was reducing very slowly and everything was fine, until I got to the 1/4mg, then it hit me. I guess it's my body telling me to go even slower. So now back to 3 1/2, and hope I can get to zero before my appt in February.

On my travels I am amazed how little some doctors know about drugs. A friend who is a pharmacist says she often has to tell them they are prescribing drugs with contra indications. I am also very impressed how knowledgable pharmacists are and you can talk to them like a normal person instead of having to put up with the arrogance you can get from some doctors, particularly if you comment on their prescribing.

Oooh just looked at the possible side effects.  Makes celebrex look like a pussycat.  Heart attacks, fatal intestinal bleeding....  

Ugh, don't talk to me about doctors.my 5 yr old had a really high fever and he just kept saying it's a virus, I can't do anything. In desperation I took her to another doctor at midnight, she had pneumonia.

That's why I didn't get it!

"She's so eager to get me off the pred that she'll throw anything at me. "

That answers your question - and it indicates a degree of ignorance about PMR. As long as the underlying cause of the symptoms is active - you will need some pred. However much she wants you to stop taking pred, it is utterly unreasonable.

I wonder what she'd say if you asked would she be so keen for you to stop your DMARD if you had rheumatoid arthritis? Pred is our DMARD, there isn't a substitute yet. You need as much as you need for as long as you need. And that is the end of it.

A lady on another forum ended up in A&E yesterday, her retired GP friend identified atrial fibrillation and shipped her off, When she asked the lovely A&E doctor about taking the a/f medication with the steroids, he said, "don't change a thing.  PMR is a rotter and you can't live a decent life without the steroids and we don't want you to have a flare". 

So there's someone who's wasted in A&E...

Over on the HealthUnlocked LUpus UK forum we have just had a discussion about polypharmacy, contraindications and side effects. I found an fda publication about adverse drug reactions. Of course I can't give the source here but

"... consider this extract (I think this is just the USA, extrapolation makes it far worse...):

"The first question healthcare providers should ask themselves is "why is it important to learn about ADRs?" The answer is because ADRs are one of the leading causes of morbidity and mortality in health care. The Institute of Medicine reported in January of 2000 that from 44,000 to 98,000 deaths occur annually from medical errors.1 Of this total, an estimated 7,000 deaths occur due to ADRs. To put this in perspective, consider that 6,000 Americans die each year from workplace injuries.

However, other studies conducted on hospitalized patient populations have placed much higher estimates on the overall incidence of serious ADRs. These studies estimate that 6.7% of hospitalized patients have a serious adverse drug reaction with a fatality rate of 0.32%.2 If these estimates are correct, then there are more than 2,216,000 serious ADRs in hospitalized patients, causing over 106,000 deaths annually. If true, then ADRs are the 4th leading cause of death—ahead of pulmonary disease, diabetes, AIDS, pneumonia, accidents, and automobile deaths.

These statistics do not include the number of ADRs that occur in ambulatory settings. Also, it is estimated that over 350,000 ADRs occur in U.S. nursing homes each year.3 The exact number of ADRs is not certain and is limited by methodological considerations. However, whatever the true number is, ADRs represent a significant public health problem that is, for the most part, preventable."

An uncle was on in excess of 10 medications. He collapsed on holiday in Spain and was admitted to hospital. The doctor was horrified at his medication list and stopped them all so he could start from scratch. He went home 3 weeks later on 1 (yes, ONE) tablet feeling much better and weighing 30lbs less, almost all fluid accumulation. He subsequently died at about 90.

I've been told off gently elsewhere today about not having faith in doctors - is there any wonder I am exceeding sceptical? Particularly since "the rate of ADRs increases exponentially after a patient is on 4 or more medications".

I now check myself - having spent 9 months on crutches because a GP knew about an intereaction and "hadn't ever seen it". I do like to educate but not when it is an adverse event for me!

My mum's dr put her on meds for high blood pressure when she was in her 90's. She wasn't on any other drugs. I told her she didn't need it. But she said the dr knew better. She kept on passing out. Not losing consciousness, but just falling over. So she was afraid to do anything in case she fell, and stopped walking and driving all the things she liked to do. They finally took her off them in the nursing home. The exact same thing happened to my mother-in-law. I don't know if it's like that in the U.K., but in the US the poor people in nursing homes are so over drugged.

They put my father on statins and he became like a zombie with neurological  problems, he had real trouble holding a spoon even. I fought for two years to allow them to stop them and a new GP came along and agreed to a two week trial, the change was unbelievable he became the life and soul of the party. In the end we got him down to just taking vitamins and scrapped all the other medication.

Overmedication of the elderly for BP is a major problem. We were close friends with a vascular surgeon who went mad about GPs bringing down "dangerous" BP levels. Whether we like it or not, raised blood pressure sometimes is needed - if there is narrowing of the cerebral arteries for whatever reason, BP needs to be higher to force blood through to the brain so it has an adequate supply. If the leg arteries are compromised then the higher BP is needed for the same reason - poor blood flow leads to gangrene which required amputation. There is often nothing you can do in either case - except allow raised BP to do the job.

As for statins, PPIs - I'm sure there are plenty of other drugs flogged to GPs as the miracle for their elderly patients. That actually contribute to osteoporosis, confusion as far as dementia and other evils of old age and make them far worse.

 And let's face it - you have to die of something, to me a natural quick event is far preferable to having fallen and broken a hip or dementia or gangrene. 

YOU ARE RIGHT ALEVE ,PRED, AND ANY OTHER DRUG IS BAD FOR YOU.  WHEN YOUR DOCTOR PERSCRIBES YOU A MEDICATION THEY COME WITH A LIST OY PROMLEMS THE DRUG MAY CAUSE EVERY PERSON IS DIFFERENT SOME PEOPLE GET SICK EASLY AND SOME DONT. FOR ME ALEVE WORKS FINE

If Aleve works fine for you, maybe you have something else other than PMR.

I suppose I do sympathise with the GPs to some extent in that people are very demanding and expect a prescription on each visit and get quite upset if they don't get one. It is probably a GP's line of least resistance rather than fighting with them and becoming stressed out. People seem to ask for antibiotics for for example everything and quite often get them even though they are totally inappropriate. It is a pity that doctors cannot prescribe sugar pills. 

David has an Italian colleague, a doctor, who has 3 children who are doctors. Mummy is a teacher. When staying with them a few years ago the oldest son had "flu" - it was a bit of a cold really - and papa MUST send him antibiotics now!  To be fair, I think papa didn't comply!

I keep reading though that "The doctor said I have a virus and gave me antibiotics". 

I have also heard the comment that the doctors gave me antibiotics for a virus. I just hope that the doctors were just trying to pacify the patient and are aware that the anti biotics will not work. I heard that a large number of people do not complete their dosage of anti biotics which is also a worry. Although the US seem to be causing problems by giving vast dosages to their animals. I believe that Europe has started putting bans on this. 

There's a fair bit of abx use in food in Europe too - but they don't let on. A lot of the abx resistance problem is the insidious drip-feeding of them in the food chain. Despite the fact they aren't supposed to be given in the last however long before slaughter.

I have heard that too. I suppose it is supposed to be getting better in Europe, theoretically, in that at least it has been sort of recognised. It seems a lot of farmers still cheat. I have never taken antibiotics in my life, but I assume I am actually full of them, although I don't eat red meat which may reduce it a bit. 

Eileen this has been a very interesting thread.My grandmother

years ago was on so many medications that she became so

dilusional and said she was going to commit suicide.I was 2,000

miles away when she called.We had to keep her on the line talking while another family member called the police dept where she

lived.In the end my uncle pulled every med she was on accept

one or 2 that she needed.But what about people like my husband

who has severe RA and has to take multiple meds.He is on mtx

humira,sulfasalizine,plaquenil,nortryptilan,folic acid and vit d.I

worry about him every day and what he has to take.Right now he has an upper respitory infection and has been off his mtx and

humira 10 to 12 days.He is getting more stiff from not taking.But

it will be interesting to see how much more stiff he becomes

until he can take his Mtx again.Maybe he will see that he doesn't

need the humira so much and stop taking.It's a very confusing

ordeal for those who don't know so much about medications but

we're slowly learning.I learn a lot from you and so many others

It very much depends what the polypharmacy is for - and RA is one where the specialists are in charge as opposed to GPs so they are more aware with a better overview. I think. It is the BP/diuretic and antidepressant medications that probably cause most problems. Plus unneeded statins and the like. Mind you - it is the first time I've heard of someone on 3 DMARDs AND Humira!

I wouldn't take bisphosphonates, statins or PPIs if you paid me to - but that is my choice - and anything else I'd expet a good background justification for it.