Does cold weather cause PMR pain flares?
Posted , 12 users are following.
Using the dead slow method I managed to reduce Prednisone from 10 mg to 9 mg over a one month period with no pain. But this week the weather has become cold and wet and I am now aware of low grade pain in arms and shoulders....... I wonder whether it is the reduction of Pred or the bad weather? I am debating whether to go back up t 10 mg again to test the response or to turn the heating up!
0 likes, 47 replies
dan38655 ricky23486
Posted
My first thought when hearing this is that it's the same thing that has happened to me for the past two winter seasons.
I have figured out that the weather as a cause has to do with my not getting outside in the morning for some exercise.
I now force myself to exercise nearly every day, twice a day (usually a morning bike ride and an evening jog), and so far since July I have reduced my daily pred dose from 4mg to 2mg and have kept it there.
My initial rapid onset of pmr occurred exactly thre years ago, after three days of record cold temperatures, during which I stayed inside!
Anniecurd ricky23486
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walter98524 Anniecurd
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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
Anhaga walter98524
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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.
EileenH walter98524
Posted
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".
Anniecurd EileenH
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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.
ptolemy walter98524
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Anhaga ptolemy
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Anniecurd Anhaga
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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?
EileenH Anhaga
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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.
EileenH Anniecurd
Posted
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.
Anniecurd EileenH
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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.
ptolemy Anniecurd
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Anhaga Anniecurd
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Anniecurd ptolemy
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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.
Anniecurd Anhaga
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That's why I didn't get it!
EileenH Anniecurd
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"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...
EileenH ptolemy
Posted
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!
Anniecurd EileenH
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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.
ptolemy Anniecurd
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EileenH Anniecurd
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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.
walter98524 EileenH
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ptolemy walter98524
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ptolemy EileenH
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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.
EileenH ptolemy
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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".
ptolemy EileenH
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EileenH ptolemy
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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.
ptolemy EileenH
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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.
tory38006 EileenH
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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
EileenH tory38006
Posted
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.