PMR & Asthma needs care, Weight to lose
Hello Miss XXXXX!
I went through your query and before discussing the options for your asthma or polymyalgia rheumatica
we need to seriously consider your weight. You need to lose weight. Exercise, reduce dietary intake, reduce calorie intake, change modify lifestyles. Try to get your BMI (Body mass index
) below 25. When you are able to achieve this goal, more than half of your troubles will vanish.
Poly myalgia is relatively common clinical syndrome in elderly people. Mostly associated with Giant Cell Arteritis
- Do you have this vasculitis? Did you have a temporal artery biopsy ever?
- How long do you have morning stiffness in hip and shoulder girdles? Usualy it lasts for an hour. But steroids help and prognosis is always good. It just comes and goes. So no worries.
- PMR is usually common in northern europeans(more in scandinavians than mediterranians), more in females, more in people above 50 and you are one of them.Its hereditary often so have any one else in your family had it?
- Do you have any other auto immune disease? ( mostly autoimmune in nature PMR)
-have you ever checked your Erythrocyte sedimentation rate? Was it 40 mm/h or above?
Does Pain persist for mor than 1 month and involve any 2 of the following areas: neck, shoulders, and pelvic girdle
-Do you respond well to prednisone 20 mg or less?
Here are some things you need to know about and do something about.
-Steroid has its pros and cons and in your age Osteoporosis(bone degeneration) is common result. So Check for it and use Vitamin D supplements and calcium supplements
to save the trouble.
-You need to be compliant(regular in taking medicine) in steroids taking to prevent relapses, flares, and subsequent morbidity.No on offs periods
-PMR is chronic but self limited disorder. The only goals are to
control painful myalgia,
to improve muscle stiffness, and
to resolve constitutional features of the disease
-Usually 20 mg of prednisolone is enough for PMR but as you take 40 I believe temporal artery involvement as those cases need more steroids. I advise Temporal artery Biopsy to rule out Giant cell arteritis.
-If you have diabetes mellitus
, severe symptomatic osteoporosis or psychosis, then cortico steroid cons outweigh their pros. Discuss some non steroid options with you GP like
Anti TNF agents like infliimab
-you should get a dexa bone scan to see your bone status and use Vitamin D Calcium and bisphophonates to prevent steroid induced osteoporosis.
-you need steroids for minimum of 2 years.Best option is to see a good rheumatologist
monthly and let him decide whats best for you.
Brittle Asthma needs continuos medical treatment with
Beta2 agonists, rapid-acting
Beta2 agonists, long-acting
Respiratory Inhalant Combos
Leukotriene Receptor Antagonists
top to bottom on the basis of severity. bottom one Monoclonal Antibody is for uncontrolledbrittle Asthmas. Discuss these options with you GP and see whats Best for you.
I hope i was clear enough and good enough to answer your query. If you have more queries please feel free to ask. I would be happy to answer.
Otherwise kindly close the discussion and rate the answer as per your experience.
I wish you very good luck and take some very special care of yourself.