Normal

Thanks for all your input! please keep "plugged" in!😁

Hi Carnut

You mentioned you thought an operation was the trigger for your PMR....4 months before my pred diagnosis i had a foot operation. I was healing well and doing fine. I have read somewhere that the anaesthetic can do adverse things to our muscles, so who knows that may well have been the triggger for yours and mine PMR.....i wish you well with your slow taper if rheumy agrees...

I've had four back surgeries (2 laminectomies & 2 lumbar fusions).

The 2nd fusion was in Jan. 2014, and I did wonderfully afterwards, being able to slowly walk 3 miles by 1 month post-op. Then at 5 wks post-op, I went to bed one night feeling fine, and woke up the next morning feeling this crushing fatigue and having all the muscles in my legs feeling like they were made of concrete. I didn't know it at the time, but this was the beginning of my PMR. It took 7 months to diagnose as I had all these weird symptoms that were mostly lower body (knotting of muscles, severe groin pain, etc.). Then in August as I was shuffling along trying to walk, I snagged my toe on something and twisted my knee, tearing the meniscus in my right knee. Shortly after, I started having a lot of shoulder and upper arm muscle pain. Luckily, my ortho surgeon suggested that I might have some kind of myalgia, and got me started towards my diagnosis. All this muscle pain hurt way more than my back surgery. Fast forward to October of 2017 when I had to have my right knee replaced. I was terrified that it would trigger a flare. I had finally reduced to 2mg prednisone and was feeling pretty decent. My rheumatologist & surgeon decided to increase my dose to 5mg 1 wk pre-op, and continue that for 1 month post-op. I did quite well with surgery and rehab, although my thigh muscles were stiffer and I had to be careful with my exercises, because if I did too much my thighs were so sore I couldn't do anything for a couple of days. All was going good until the beginning of December when the other knee blew up and became horribly inflamed and the size of a large melon. I knew it was bone-on-bone, but had hoped to get a few more years out of it. My rheumy highly encouraged me to get it done too, as he was afraid the amount of inflammation was going to have a bad effect on my PMR. I agreed because it was very painful, but I was also concerned about having two major surgeries so close together because of my history of having a surgery trigger my PMR initially. We agreed to have me stay on the 5mg until a month after the second surgery, then start to taper. The 2nd knee replacement on Jan. 8, 2018 went even better than the first, with me going up and down stairs fairly easily and doing full rotations on the exercise bike by 4 days post-op. THEN, I went to bed the 7th night after surgery feeling good and woke up not good again. Fatigue and lower body muscles not wanting to work and very sore. I'm now 9 months post-op on the 2nd knee and this year has been horrible. I was having a hard time convincing my rheumy that what I was feeling was my PMR, rather than muscles that were just angry after surgery, like he thought. I saw him 3 times over the next few months trying to convince him. He kept wanting me to taper, and I felt I needed to increase my dose to get it under control. This is the first time we've disagreed on anything. I finally decided to take matters into my own hands and upped my dosage to 11 mg. I immediately felt a lot better, but it still wasn't taking care of the inflammation as much as I had hoped. I used that result to finally convince him, and he gave me a 60 mg kenalog injection which whacked out the inflammation, and allowed me to stabilize and then start reducing. I finally got back down to 5mg last month, and attempted to go down to 4.5, but the thigh stiffness returned, so I'm back on 5mg for now. I'm upset that I wasted 4 months of getting worse every day while I tried to convince him, but at least I'm back on track now. I guess the point of this long diatribe is that surgeries can most definitely trigger our PMR, and to careful consider that when scheduling surgeries.

Hi Vickie5

When i had foot surgery i opted for general anaesthetic which i am convinced caused my PMR. Three years before that i had a knee replacement but opted for epidural anaesthetic whereby i had no feeling from the waist down, instead of general anaesthetic and had no problems at all after my knee surgery. I am due another knee replacement and i will most definitely be going for epi. I can't possibly go through PMR again......😢

I think there is a Nobel prize waiting for the person who can identify conclusively which pain is which and, therefore, prescribe the right treatment promptly. Many of us have wasted years of our lives while we and our doctors try to untangle our symptoms.

Hats off to you for all you have sustained.

Just to illustrate the difficulties, I, on the contrary, had no flare after my hip replacement. Why? Who knows?

Given the choice I'd opt for epi. every time, too.

I was last on the list for my hip and they kindly saved my supper for me which I ate with enjoyment and then 'phoned friends and family.

The nurses laughed when I asked whether they had left my socks on. That was how the residual epi. felt when I returned to the ward.

hi BettyE...boy, you're NOT kidding about the difficulties in trying to sort out which is which (PMR or prednisone or God knows what else.....I need a dang score card and a referee to help me!

I had my right knee replaced May 2017, thanks to BettyE's response that it is possible to do with PMR. Fortunately, a flare did not occur to me and it didn't happen. My sugeon gave me three steroid shots three months before the operation in both knees and one hip and instructed that I stay on the 6 mgs that I had been on for a year. May 2017, I did have an endoscopy because of a massive bleeding ulcer (caused by Ibuprofen taken before PMR diagnosis). That episode might have caused a recent flare.