
What Causes Fatigue, Depression, Anxiety And Dizziness When Diagnosed With PMR?

Is it pmr
Detailed Answer:
good evening
thank you for writing on health care magic
Well, I have gone through your history and would. like. to know a few more details as it is very unusual for PMR to not respond to steroid
1. Where exactly is the pain located. is it in shoulders or hip or whole body
2. do you experience good sleep or is it disturbed...and how do you feel in the mornings..
3. any History Of recent mood changes like short tempered or irritability
4. any hHistory Of forgetfullness which has increased recently..
5. any time you have had joint swelling or oral ulcers
6. how much was your esr and crp last checked
Do let me know these queries. we need to look out for other causes since you havnt had much improvement with steroid and all other work up is negative
.
await your reply.
regards
Dr naval


1. My pain is not just in my shoulders and hips; it is all over, not all the time, but at one time or another I have pain from my head to my toes. I have pain particularly in my hands when I move them. I have been tested for Rheumatoid Arthritis, which was negative.
2. I have problems sleeping; I have laid in bed for hours and still no sleep. Currently I take 10 mg. Melatonin, 1 mg. Klonopin and a supplement called Taurine to get to sleep. But then when I wake up the next morning between 8-9 I watch TV for about 90 minutes, then I am tired and usually go back to sleep until at least noon. If I get up at 8-9 I fall asleep in my recliner.
3. Mood changes are not real bad, but I am irritable from time to time. It doesn't take much stress to get me upset. Maybe, that's just my age; I don't know.
4. My forgetfulness is bad, especially my short term memory. I am currently taking a supplement for that too, which seems to be helping some. I lost a sister to Alzheimer's at age 64 (13 yrs. ago).
5. I haven't noticed any swelling; however at times my feet feel "tight." I do have oral blisters from time to time.
6. Results of my last ESR was 58; it was 87 in 3/2016, then I started supplements in 4/2016 and it dropped to 58. My CRP was 1.6 in 3/2016; I can't find my most recent result for it.
I hope this helps. I look forward to hearing from you. By the way my next appt. with my Rheumatologist is Aug. 15th.
Dr. Naval: I failed to answer how I feel when I get up in the mornings. I feel awful. It takes about 2 hours (or less) for me to get "going." My husband is nice enough to fix breakfast for me.
XXXX
Is it PMR
Detailed Answer:
GOod evening XXXXXXX
Well, as per your history it doesnt fit very well into PMR.. Maybe PMR was present initially which has responded well to steroids. But the current symptoms you are having look more of Chronic Pain Syndrome.. Moreoever, if it was an inflammatory condition the response to steroids would have happened by now..
So I feel there is something else we are looking at...
I would like you to read about this diagnosis called Fibromyalgia( Decreased sleep, fatigue, irritability, widespread pain, forgetfullness ) all fit in with it...
www.Rheumatology.org--> patient information--> Fibromyalgia...
DO let me know if your symptoms match...
PS: You are one lucky person to have your husband fix your breakfast :)...I am sure if my wife reads it, she will ask me to learn something from it
Await your reply
Regards
Dr Naval


XXXX
I read the website you mentioned about Fibro. I do have all of the symptoms mentioned. One question I do have. It said Fibro does not cause inflammation. If that be true then why is my sedimentation rate so high. It has been as high as
87. This is confusing to me.
PMR with Fibromyalgia
Detailed Answer:
Good evening XXXXXXX
Sorry for the delayed reply.. Had a presentation in a conference
Well, the fibromyalgia does have some triggering factor and that could have been due to PMR. That may be the reason you have high ESR. ESR does take 4-6 weeks to come down to normal even if the disease is silent. But yes, the more sensitive test is the response to steroids in PMR...If you are not responding to steroids, it is something else going on...
To confirm PMR activity or not, you can ask your rheumatologist if he can run an ultrasound of the shoulder and pelvic area. Ultrasound can pick up active inflammation. If clear, I think we should treat on line of fibromyalgia and repeat ESR after a couple of months to see the fall....MEanwhile keep minimum possible dose of steroids...
Hope the information was useful. Do let me know for more queries
REgards
Dr Naval

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