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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Sudden Left Chest Pain, Difficulty Breathing, Dizziness And Severe Headache, Prednisone Helps A Lot. Any Long Term Solution ?

I am an endurance athlete and rower....age 50 and in good health. August of 2012, I injured my spine standing up under a table while washing the floor...it was sore locally but resolved well. In Sept 2012, during a 70 mile bike ride, I developed significant pain in the T8 rib area and was noted by physio the next day to have T8 sublux with 5mm displacement. We worked through this and I returned to training/rowing. On Dec 25, the rib displaced again but had reseated by Dec 27 when seen on xray in ER. The reason for the trip to ER was sudden onset Lt chest pain , difficulty breathing, dizziness and severe headache...my concern was for pneumothorax since the Rt side chest pain also became severe. Chest xray and bloodwork were clear and the doctor suggested pain meds, and see the family doctor for CT/MRI. I continued to have now bilateral chest pain, pain with breathing, sharp pain to T8 rib Rt with deep inspiration, On Jan 31, I had extremely sudden onset of worse Lt chest pain, severe h/a and dizziness, rapid resp s(but sats 98% on RA...I use a sat monitor to help me with breathing during hard rowing sessions) and extreme sweating and weakness. Needless to say I had my husband call 911. The chest xray, bloodwork and physical exam came back clear...severe pain persisted along with new burning pain to extremities. Released with instructions to f/up with GP and return if any symptoms worsened. Feb 7 the pain to extremities, h/a, joint pains, fatigue and difficulty moving/working/sleeping became intolerable. I visited a clinic and the doctor ordered ANA and RA b/work for autoimmune ....which have all come back clear. We also started a trial of Prednisone 10 mg daily. The first day of Prednisone brought complete resolution of burning to extremities, it reduced the joint acute pain to 2/10 and allowed me to be able to move normally. I had the energy to work, could sleep and was no longer waking up moaning. I have done marathons all my life, finished Ironman triathlons x 3 and done long distance sport since I was young...this is completely out of character and I am very confused by it all. I get wonderful relief from the Prednisone but do not feel this is a solution for the long term. Any ideas on what to watch for, what to do next?
Fri, 30 Aug 2013
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Pulmonologist 's  Response
you may have seronegative arthritis.consult rheumatologist for considering steroid sparing immunomodulators.
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Sudden Left Chest Pain, Difficulty Breathing, Dizziness And Severe Headache, Prednisone Helps A Lot. Any Long Term Solution ?

you may have seronegative arthritis.consult rheumatologist for considering steroid sparing immunomodulators.