I have long appointments with my rheumatologist. She is thorough and listens to what I say. She does think out loud which may be disturbing to some. I understand where she is going and I understand she is throwing out possibilities not absolutes. I had a number of revelations but a big one was the possibility of adding polymyalgia rheumatica to my RA diagnosis.
For the last six weeks I have been having excruciating pain in my left hip and my whole pelvic girdle. I was also having excruciating pain in my left shoulder. Life was difficult. I had no idea what was going on. I have a protocol to increase my medrol for flares. I did. Medrol did provide relief. Once I was done with the medrol my pain returned.
My doc listened, examined. She ordered x-rays. She mentioned the possibility of sending me to an orthopedic doc. She mentioned polymyalgia rheumatica. Then we moved on to other issues.
Polymyalgia rheumatica affects those over 65 years. It affects the pelvic girdle and the shoulders. It includes pain in the thigh and upper arm. It is an autoimmune disease and not curable. It is manageable however. The drug of choice is corticosteroids. It is usually started around 25 mg for a month and then tapered to a dose that controls symptoms. The treatment lasts a minimum of one year and may go on for several years. Recurrence is not uncommon.
I felt relieved. It was manageable. There was a solution. Of course, one of the problems with polymyalgia rheumatica is its association with giant cell arteritis. Not good. 10% of those with polymyalgia rheumatica also have giant cell arteritis which is the inflammation of the lining of arteries particularly in the temporal arteries of the head. For now I will deal with managing what I have and be glad it is not worse.