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Ask Dr. Arun Phophalia Your Own Question
Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor
Category: Medical
Satisfied Customers: 60490
Experience:  MBBS MS. Post doctoral fellowship in Sports Medicine. General surgeon and sports medicine specialist
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I am a 71 yr-old woman and have recently had to register

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I am a 71 yr-old woman and have recently had to register with a GP as a temporary resident, because I am having to live away from home. This GP diagnosed some symptoms I was having [back in Sept] as inflammatory rheumatoid muscle weakness [following a blood test - I have not been referred to a rheumatologist] and prescribed a gradually reducing course of Prednisolone. I have been taking these since mid-Sept [due to reduce the dose to 9mg daily this Thurs] and, to begin with, there was some improvement in my muscle weakness. However, there has been no further improvement in the weakness, and I am suffering unpleasant side-effects from the steroids. I do wonder whether the diagnosis was incorrect and whether the steroids may be just adding to my problems. I have had widespread chronic pain for the last 12 years following a very harsh adjuvant treatment following breast cancer surgery, and also have arthritic pain in various places. The arthritis seems worse since starting the steroids and, because I sleep very poorly anyway due to the pain [cannot tolerate NSAIDS and many other medications] I find the night sweats and hot flushes, that the steroids seem to have caused, to be absolutely exhausting. Also, I think I should be having a Dexascan but have been told there is a wait of up to a year at the moment!
JA: How long have you been using Prednisolone? Has it helped at all?
Customer: It only helped a bit at the start - any improvement seems to have ceased
JA: Got it. Have you used anything besides Prednisolone for this?
Customer: No - that is what the GP prescribed
JA: Thank you so much for your time. Finally, is there anything else in your medical history you think the Doctor should know?
Customer: Think most of it is in my first message, although I do have "occasional atrial fibrillation" for which I take a daily Bedranol 80mg.

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Was any blood work done when you were diagnosed with inflammatory muscle weakness before starting steroids?

Dr. Arun Phophalia and 5 other Medical Specialists are ready to help you
Customer: replied 15 days ago.
I had blood tests carried out which I think were borderline, so I was asked to try the steroids and if there was a speedy improvement that would be the cause. There was some improvement which has not continued

I can do only internet calls.

Do you have a mobile number with WhatsApp or Facetime?

If we are unable to talk on the phone, the phone charges would be refunded and we can continue here.

Customer: replied 15 days ago.
No, sorry I am not on either. Can we please continue without the phone?

Your present symptoms can be due to the adverse effects of steroids.

You may need the following investigations for evaluation;

Complete blood count (CBC)

Liver function tests

Thyroid function tests

Erythrocyte sedimentation rate (ESR)

Serum electrolyte level measurement

Immunoglobulin M (IgM)/immunoglobulin G (IgG) coxsackievirus B titer

IgM/IgG human herpesvirus 6 (HHV-6) titer

IgM/IgG C pneumoniae titer

Autoimmune panel

Anemia panel.

Creatinine kinase and other muscle enzymes and inflammatory markers.

B12 levels.

Vitamin D and serum calcium.

You may be looked for the following;

Thyroid disease

Connective tissue diseases

Chronic anemia

Chronic infections like Epstein Barr virus

Endocrine diseases (Addison disease).

Chronic fatigue syndrome

The following meanwhile would help;

Gentle massage

Deep electrotherapy

Acupuncture

I wish your symptoms resolve soon.

I would be happy to assist you further if you need any more information.
Thanks for using JustAnswer.

Customer: replied 15 days ago.
Thank you. I am not sure how to deal with this under the circumstances. Do you think it would be best for me to see a consultant rheumatologist privately? I do not have health insurance due to pre-existing conditions but do have some savings and there would be a long wait to be referred on the NHS.

Yes, it would be good to see a rheumatologist early, though that might be some expense, it would be worth the money.

Customer: replied 15 days ago.
Thank you, ***** ***** try to arrange that.

You are very welcome.

Wishing you a speedy resolution and all the very best in life.

It was a pleasure to assist you.

I sincerely hope that I have helped you and that I have earned my 5-star rating today!

Thank you.

Stay blessed.