Update on head pain.

[FreeWolf]

I did receive a prompt medical assessment this week. Based on history and bloodwork GCA has been ruled out. The headache I have is being treated with over the counter analgesics. My doctor is very good, very concerned and I think he is right but it is hard for me not to wonder. I've had some unfortunate misdiagnoses in the past but not from this doctor.The headache I have is daily, it is there when I wake up, at the back of head and along side of head up to the eye. The right side is worse. Sometimes, not always, my jaw gets tired when eating but I do have TMJ problems and clench my teeth, my dentist tells me. Have any of you had similar symptoms? Did these symptoms turn out to be benign?

[DorsetLady PMRGCAuk volunteer]

Who did you get the assessment from? Same one who thought you had PMR a month or so ago? and if so, why the chance of view...

As we know blood markers aren't the be all and end all for diagnosis - symptoms are the main key, and also your response to Pred...

.. and a daily headache must be investigated - okay it may not be GCA... and hopefully the analgesics will help, but even if they do, you still need to know root cause.

Jaw could be TMJ issues....have you tried the chewing gum test for GCA? -

sydney.edu.au/news-opinion/...

[FreeWolf in reply to DorsetLady]

Thank you DL for your prompt reply. I have tried the chewing gum test and the results vary, as do the symptoms I described. And yes, the same doc diagnosed PMR. I have tried taking 500 mg acetaminophen two to three times per day and find little change. I wonder, if you have time, if you could Google "SSRI treatment and inflammatory markers" and tell me what you think this research indicates especially with respect to CRP levels. I read the information but I may have misinterpreted the conclusions. I have been on SSRIs for 30 years. Unfortunately a psychiatric history impacts medical decisions. I was once diagnosed with hyperventilating in the midst of an MS attack which resulted in left-sided numbness and weakness.

[DorsetLady PMRGCAuk volunteer in reply to FreeWolf]

Actually PMRpro is best person to read and advise on “SSRI treatment and inflammatory markers”. She has medical background -I don’t -and she will read your reply - so hang on and you’ll get an answer.

As you say, psychiatric history impacts medical decisions. Shouldn’t do.. but sure it does.

Best wishes.

[FreeWolf in reply to DorsetLady]

Thank you. I'll be interested in PMRpro's take on the research.

[PMRpro Ambassador in reply to FreeWolf]

I'm not sure - not my field at all but I think what you are hoping for is that SSRIs suppress CRP and so your results are not entirely reliable? Is that correct?

But I think the whole thing is not as simple as that and I suspect what they were looking at was the relationship between depression and inflammation and whether the effect of the SSRIs was achieved by suppressing inflammation. Without reading the entire paper it is very easy to come to that conclusion - and it may not be the case.

As you say - as soon as mental health comes into the equation, all sense on the part of some doctors flies out the window!!!

[FreeWolf in reply to PMRpro]

I think you are right and yes, I did want an explanation for not having data to back my fears. However, after reading older posts in this forum, I'm of the opinion that my symptoms are very like those of others who have musco-skeletal issues. I think I'll lay my worry to rest for a while. If this forum did not exist, I'd be very uninformed and I'd probably be going down some deep rabbit holes. Thanks to all for sharing your knowledge.

[PMRpro Ambassador in reply to FreeWolf]

Up to 20% of patients don't have CRP/ESR out of normal range. Some people don't develop this acute phase response for some reason. My markers were raised for ME but never above normal range. Doctors sometimes take lab results as gospel truth - they may not be.

[FreeWolf in reply to PMRpro]

I will have to keep this in mind. I truly hope I don't go down this road but it is wise to be aware. Truth be told, it is fine to trust your doctor but you also have to trust yourself and how you feel. Hopefully it all works out for the best. Thanks for your words.

[Koalajane]

my normal ESR range is low in single figures. My doctor said that when my level was 29 that it was normal but my nurse told me she thought it was high for me as she had looked back over my records!

[FreeWolf in reply to Koalajane]

That is interesting. I expect that the nurse is more in tune with you and hopefully her opinion matters.

[Koalajane in reply to FreeWolf]

It does indeed. She is my diabetic nurse and when she said my ESR was high for me she looked at me and said “you are hurting aren’t you?” Bless her she is wonderful