Tuesday, January 02, 2007

Did You Become a Wimp Overnight? It May be Polymyalgia Rheumatica

tidbits that tantalize


Perfect Pairs?

It's Taco Tuesday and that means you should be at Tillie's.

Every Tuesday for as long as you can remember - which, admittedly, is really not much beyond last Thursday anymore - you've been down at Tillie's Diner with "The Gals." You, Emma, Ruby and Gladys, whom you all refer to as Glad on her "good days" and, well... it would be unkind to speak of her bad days' name with that young waitress hovering about.

It's the fiercest battle of Texas Hold 'Em you're likely to see this side of ESPN and it draws it fair share of fans. Not surprising. Everybody likes to be where the action is, rub shoulders with the big grey-haired dogs. But...

You just can't be seen in public like this. First, they'd call your bluff and then they'd laugh you right out of the diner. If only you could get your arms up there to where that blue-grey mop of hair is swirling recklessly about your head. What happened? Yesterday, you were fine, looking forward to teaching Glad a new trick or two - this morning you woke up stiff and weak and, no matter how hard you try, you can't get a brush within a foot of that frizz...

Have you lost your nerve? Doubtful. But, it could be Polymyalgia Rheumatica.

Polymyalgia Rheumatica (PMR) is characterized by a rapid onset of muscle aches and pains. Common areas of involvement include the upper arms, neck, lower back and thighs. The pain is most significant in the morning and may lessen as the day progresses. It is not uncommon to have difficulty raising the arms above shoulder level.

Who gets Polymyalgia Rheumatica? Well, that would be folks quite like "The Gals." It's rare to see PMR in those younger than 50 - the average age at onset is 70 and many are first diagnosed while in their 80's. Though less well known, Polymyalgia Rheumatica is diagnosed more frequently in older adults than rheumatoid arthritis.

Blood tests that assess inflammation are utilized to diagnose Polymyalgia Rheumatica and treatment typically consists of low-dose corticosteroids, such as prednisone. Once treatment is initiated, the nagging symptoms often disappear as quickly as they materialized. The dosage is decreased after the symptoms are controlled and the prednisone may even be discontinued after two or three years. About 15% of those with Polymyalgia Rheumatica also have the more serious medical condition Giant Cell Arteritis, a condition that causes inflammation of the lining of the arteries.

Two Weeks Later:

Ah... You feel great. The rheumatologist confirmed your aches and pains were indeed the result of PMR and, a dose or two of prednisone later, you feel like your "old" self again. You check your hair in the mirror, grab your keys and head to Tillie's, anxious to catch up with The Gals. You think of Glad and hope she had a good day because, after you get done with her, her night is going to be looking very, very bad...

To read more about the diagnosis and treatment of Polymyalgia Rheumatica, see this from the American College of Rheumatology.


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