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Is is Prednisone reduction, RA or PMR?

Posted , 3 users are following.

connie08789
connie08789

Diagnosed with PMR Nov. 2014, and put on 20 mg. of prednisone daily; 8 tablets - 2.5 mg. each of methotrexate 1 x weekly; 1 mg. of Folic Acid - 1 x daily; and Actonel - 150 mg. - 1 x monthly. Did well, felt good, little discomfort, and then started the tapering of Prednisoneand down to 10 mg. I tapered to fast, had a flare, and back to 15 mg. and felt good again. Back to a very slow tapering. Then this past Nov. 2015, my rheumatologist said that I had moved into RA, and added Pacquenil - 200 mg. - 2 x daily and to continue taperingprednisone with the hope I can get off it. just occasional stiffness especially in the shoulders, and legs and thighs. 

I've finally worked my tapering of the Prednisone to 7.50 mg daily and working on trying to get to 6.25 mg. The stiffness in shoulders, arms, thighs, and legs keeps getting worse as I take less Prednisone. Just wondering if anyone has experienced this as they tapered Prednisone, or if it's the RA. Also can you have RA and PMR both at the same time? My rheumatologist says that I have moved from PMR to RA, but my major complaints are the stiffness in the shoulders when raising my arms, and stiffness in my thighs, and legs which are PMR symptoms. Thanks for your help!!!

 

1 like, 3 replies

3 Replies

  • EileenH
    EileenH connie08789

    Posted

    It is quite possible to have both PMR and RA at the same time, they are different sorts of autoimmune disease with PMR mainly affecting muscles and RA affecting joints. What is his reasoning for saying the PMR has "gone"? I assume his diagnosis of RA is based on seeing some joint damage?
  • connie08789
    connie08789

    Posted

    "She", my rheumatologist, is in and out like a flash at appointments and hard to talk to.  She has excellent reccomendations of her skill and knowledge.  I go in have lab work (blood draws), weight, blood pressure, etc. and briefly see her.  She tells me labs look OK, we'll leave meds as is, to keep working on tapering prednisone slowly, looks at my hands and has me raise my arms over my head, and she's out the door.  Her office is always packed and running hour or two behind on your appointment time. Not a great situation with bedside manner, but there are only two rheumatologists in Memphis area that see medicare patients, and I feel fortunate to have gotten in with her. She has never mentioned joint damage.  I'll try to ask that question next time.  Thanks for your reply.
    • EileenH
      EileenH connie08789

      Posted

      You must tell her when PMR symptoms are returning as you reduce - the blood work will almost always lag behind the development of the inflammation and in many patients they don't rise again while the patient is still on pre. I don't know why, it is just so. Having normal bloods doesn't mean you can continue to reduce pred - it is the symptoms that are always king. If less pred equals symptoms returning, you shouldn't reduce the pred any further until things settle down. 

      But I'd be insistent on knowing WHY or HOW she has assessed you now have RA and not PMR. There is no way of knowing the PMR has "gone" - other than you reduce your pred to zero and the symptoms don't come back.

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