where does it all end?
Posted , 7 users are following.
Before my last visit to my Rheum. I had my usual blood tests, I had prior to this had some done at my G.Ps. they sent me to a haematologist as my white blood count was too high. I told my Rheum. this. She told me to drop the Pred. which I did otherwise everything was o.k. I then had to see a Cardiologist as I have a rapid heartbeat which I was given Beta-Blockers to reduce. She told me I was pre-diabetes which she was basing on the Drs. blood tests, I wa truly shocked as I hadn't been told this on the later tests or previous ones, I have now got that to worry about as well as the results from the Haematologist, sorry for moaning but sometimes it all gets too wearying.
0 likes, 10 replies
ptolemy catherine34621
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amkoffee catherine34621
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amkoffee
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ptolemy amkoffee
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EileenH catherine34621
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What amazes me more than anything else is the apparent ignorance of many doctors. I have had to explain so much to people who, like you Catherine, have been scared to death by their doctors.
If you are taking pred or any other corticosteroid - your white cell count will be raised. A differential count (looking at all the different types of white cells) will probably show that neutrophils are raised - due to pred. The diff count will also show if anything really significant is going on. No panic.
If you are taking pred it is very likely that your blood sugar will be raised - and a single BS won't tell them anything useful. They need to follow it as part of your ongoing monitoring every few months by doing what is called an Hba1c test - which reflects your average blood sugar level over 3 months. It will probably rise, although it might not - but that is a sign to try adjusting your diet by reducing carbs. It may rise to diabetic levels - that probably would mean you need medication - but it may not. In most people it will improve as the pred dose falls, it is not Type 2 diabetes, it is drug-induced diabetes. High blood sugars are not good for you but it isn't anything to panic about, it needs monitoring and you need to keep an eye on your diet and try to exercise. Again - no panic.
Your cholesterol will also probably rise while on pred. Mine has - I don't take a statin because the one they tried to get me to take made me very ill and the cardiologist said I didn't actually need one - atrial fibrillation wasn't a cardiac event and I'm female, a statin probably won't make a difference.
Raised heart rate is also very common with pred - although it can also happen due to PMR and it can be more than just a fast heart rate so it was good yours was investigated. I have atrial fibrillation - caused by the autoimmune part of PMR. I'm on medication, it is well managed and I am on an anticoagulant which reduces the risk of stroke. There would be something to worry about if it hadn't been identified, as it is, it's pretty good.
As the others say - get copies of your own blood test results. They may not mean much to you - but every result will have a "normal range" in brackets next to it. You can tell if something is not "normal" and can ask your GP if it is something that is something to be concerned about.
Where are you Catherine? In the USA?
catherine34621 EileenH
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EileenH catherine34621
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If you have a cholesterol of 4.9 - I don't think anyone could justify wanting you to take statins! Your weight isn't a problem unless you are one of the people who LOSES weigh on pred - it does happen and can even get to be a problem. The platelets often rise when you are on pred - and will go down a bit as the dose falls.
But whatever - you need the amount of pred you need to manage the symptoms and whether your platelets or the other white cells are a bit high is a bit immaterial if you need a higher dose of pred to manage the symptoms! But if you can walk briskly every day you are obviously on enough - and I'm assuming you have been told about reducing the pred dose slowly to find the lowest dose that manages the symptoms? You don't stay at the starting dose the whole time.
catherine34621 EileenH
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Yes Eileen, I have reduced down to 17.5mgs. at the third attempt after being on 20mgs. for four months, 15mgs. made me feel dreadful as I was only on 17.5mgs. for two weeks before going down again. I felt like a real failure as I couldn't even manage a drop of 2.5mgs, I'm not being dramatic here. I'm not the type to argue or cause a fiss, and just tend to do as I am told, maybe I should have more backbone and be braver, thanks once again, I really appreciate the advice.
EileenH catherine34621
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"I felt like a real failure as I couldn't even manage a drop of 2.5mgs,"
If you are only on 20mg, 2.5mg is more than 10% - and for the majority of people would pose a problem! We realised at the charity some time ago that there are a lot of people who cannot drop that much - yes, you can when you have only been on pred for a few weeks but the longer you are at a dose, the harder it becomes. There is no good reason to struggle with it and this sort of reduction plan was worked out by several people at about the same time:
https://patient.info/forums/discuss/reducing-pred-dead-slow-and-nearly-stop-method-531439
There are a few versions, this is the one I used and which many people on the 3 forums have used to reduce their dose and is now being used in a clincial study in the north of England. It may look slow - but it isn't if it works! It also means you don't have days, sometimes weeks of trying to feel better from the steroid withdrawal discomfort that so may people experience. You can't tell if it is steroid withdrawal rheumatism or a flare - so by making the drop tiny you can pretty much rule out the withdrawal problem.
To ask anyone to reduce 2.5mgs and then do it again 2 weeks later shows a fundamental lack of understanding what you are asking the long term pred patient to do. Go slowly and it will be very different - a fact to which many people on here will attest. Try it - you will be surprised.
catherine34621 EileenH
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