Pmr 87 year old man

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4 years ago my father had a horrible case of pmr now a relapse..,,,My father has loss of appitite become dehydrated, severe fatigue tacky  heart, blood tested at sed  rate of 75,  Given IV fluids and Doctor gave 10 mg if pred for two days and 5 then on..,. Not helping, All he does is sleep, too weak  not eating, in pain.,,, now being told he is failure to thrive and we should look into hospice.... Should we be given higher dose of prednisone to try first???

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8 Replies

  • Posted

    Sorry to hear about your dad suffering. It is much easier to try pred if he had pmr before, then to put him into hospice.  PMR can be debilitation even for much younger individual, let alone 87 year old. If indeed he has PMR relapse, then usually 15-25mg dose is used for at least a week. By that time pain and fatigue should subside. If it does not respond to it, then most likely it is not PMR.
  • Posted

    I'm sorry to hear your father is so poorly but I'm afraid I think it is unlikely that your father's state now is entirely due to PMR.

    However, is it they who have suggested that he has a relapse of PMR? Or is that your opinion since he has similar symptoms? If it is the doctors, why are they not trying the correct approach to PMR? A dose of at least 15-20mg/day for a few weeks would be required and it might encourage his appetite as well. Two days at 10mg won't achieve anything and 5mg certainly won't.

    But have the doctors told you all about his medical condition? If they are suggesting hospice they must have good reasons for doing so and maybe there are underlying medical conditions that suggest that. Many doctors are unwilling to sit with patient's families and talk about their diagnoses in situations like this. Often, however, the hospice staff are more forthcoming - and hospice isn't necessarily end of life care. Their role is make life as comfortable as possible under whatever circumstances exist using medication of all sorts, if appropriate, to relieve any pain. They may well agree to treat him as if it is PMR and see if it makes a difference. I think you should ask to speak to someone from Hospice to discuss how they will approach looking after him.

    • Posted

      Thank you!! So much for your input, I agree with a lot of what you are saying, just want to make sure we do all we can before Hospice if there's a possibility of him being more comfortable and alert....

  • Posted

    How was your father immediately before these symptoms appeared?  If he was " thriving" then, what accounts for the deterioration?

    I do hope you get some sympathetic information.

    • Posted

      He was much better, Walking with a walker(aided) talking, interacting... it was a marked onset of pain in shoulders sides, and then bed ridden in last 2 weeks...

      Thank you so much for your input and comments!!

  • Posted

    Yes! I would say so. A proper dose. At least then if it is PMR there's a chance it would get rid of his pain and his fatigue. That should make him feel a whole lot better. If on the other hand these symptoms don't go then you have to think it's not PMR. I do hope you can speak to a different doctor who can prescribe at least 15mg for a week or two. Feeling for you. Let us know how you get on. 

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