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Thank you...

Posted , 4 users are following.

ailsa29683
ailsa29683

Thank you to those who responded to my question re pre-diagnosis. It has been very useful to hear the different experiences people have had. I'll await the results of the blood test and let you know the outcome. Just one thing, if I need steriods - can the GP prescribe that and have oversight of me or do I need to be referred to a rheumatoligist.

Thank you again.

0 likes, 5 replies

5 Replies

  • tavidu
    tavidu ailsa29683

    Posted

    Your GP should prescribe them, personally I would avoid a rheumatoligist as they tend to try and get you off of steroids quickly which for some is not a good thing. You will find loads of info on this subject on the forum when you have time. Good luck, Dave.
    • erika59785
      erika59785 tavidu

      Posted

      This was my experience as well.  The Rheumatoligist would like me permanently on 5-10 mg of Prednisone.....only if there is a flare, he would allow 15 mg for 1 week and then go back to 5-10 mg.  My GP is more knowledgeable about PMR and I can get an appointment any time if there is a flare, and he is open to the suggestion for tapering of the patient.info website.
  • EileenH
    EileenH ailsa29683

    Posted

    It is usually the GP who prescribes on the basis of the rheumy's recommendations if you have been sent to one. It means fewer problems getting the repeat prescriptions. If the GP is satisfied it is PMR and you respond in the typical way to pred at a dose of 15 to 20mg then there is no real need to see a rheumy.

    As you have started a new thread I can't remember if I mentioned these posts:

    https://patient.info/forums/discuss/pmr-gca-and-other-website-addresses-35316

    In the first post on the thread you will find a link to a paper by the Bristol rheumatology group which is specifically aimed at GPs to add to their knowledge of diagnosing and managing PMR without recourse to a consultant. Your GP may like to read it even if he does know about PMR. 

  • jane0118
    jane0118 ailsa29683

    Posted

    Hi Ailsa

    Your GP should be able to treat you,following the BSR guidelines. you should  only be referred if you meet the criteria, ie are under age 60, have very high bloods ie over 100 for ESR or CRP, have night symptoms etc. or you do not improve with standard treatment. 

    Most GPs treat PMR well, monitor the symptoms with you and help you step down the steroids in an appropriate time.

    i started treatment last month and I am feeling so much better. I can get out of bed, get dressed, get in the shower and have even started driving again. A word of warning, do not do too much. I still get very fatigued, so plan to do less, and do not do anything you can get someone else to do. I took my son out yesterday afternoon and ended being a helper at the community group, doing the washing up, putting away the tables etc, I got home at 5pm and could have gone to bed!

    My Rheumatologist at the local hospital is great, and they saw me within 3weeks as I am 50, and had could not walk my symptoms were so severe. She will see me again in March as she is concerned I may have an atypical presentation of RA which starts off as Myalgia ie muscle pain rather than joint paint. So far so good, my joints are not swollen, and my X-rays show no erosion in my hands or feet.

    Good luck, Jane

    • EileenH
      EileenH jane0118

      Posted

      The criteria aren't quite right - the age for consideration of PMR is "over 50" so being under 60 isn't unusual, under 50 is though and should be referred. Patients without raised ESR and CRP are less common and if the doctor is unsure they can be referred though a confident GP would know that 1 in 6 patients don't have high levels and that they are merely a guide. Any patients with headache/visual symptoms should be referred as an emergency - that means phone call to the rheumatologists and sent to A&E with a referral letter - whatever age and whatever blood levels, high or low. Very high ESR/CRP should trigger a suspicion of GCA - but not necessarily.
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