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polymyalgia rheumatica - case

Posted: Wed Oct 23, 2002 8:57 pm
by Joy Lucas
As requested -

Female, 61, retired, 3 children, diagnosed with PMR over 2 years ago. Was
going to come and see me a year ago but declined as the sx improved on their
own! for a while, but now very bad and getting worse.

started in shoulders and hips and pain in neck
initially started left side but at present the right side is the worse
pain described as mainly bruised but can frequently be like a knife going in
very stiff and difficult to walk
accompanied by headaches - moving up from occiput to cover whole head
head pain described as dull and tight
whole body feels tender and bruised but > as day goes on
> gentle motion like driving a car
<< cold damp weather

one year before the sx began her husband had a nervous breakdown
she took time off work to help him through this
it was a big strain for her - lasted nearly a year

describes herself as easy going, peace loving
not ambitious at all, just wants a comfortable life
likes bowling, reading
easily pleased
likes dogs and cats
memory really bad - can't remember dates or events very well
(this got increasing <<< as the consult progressed)
extremely forgetful
talks slowly and thoughtfully

has a fear of heights - specifically looking down on water from a height
feels the pull intensely - could easily jump

brother died from a brain tumour in 1949 when 14 years old
client has a h/o scarlet fever (I began to feel that there might be a
connection with scarlet fever and PMR??? this is where the susceptibility
began - could others comment on this?)

not at all confident
felt she should have done more with her life
cannot be in front - not a leader
wants to be told what to do
can't deal with confrontation
cannot cry easily

likes to be alone - likes own company

she has slowed down immensely since she has been ill
takes her forever to do things
she was really struggling to answer the questions, to focus

appetite average
not very thirsty
very sensitive to alcohol - flushes up really easily

bladder and bowels ok now
has h/o cystitis

menstrual history ok
3 pregnancies and births - all easy

sleep quite deep but wakes several times to go to toilet (urinate)

extremely fed up with condition - it has changed her so much
not getting anything out of life and not looking forward to anything

feels very sleepy all the time, could fall asleep now she says

tells me about her history of migraines
started when she was 10 years old
she was playing the piano and the music first went blurred then she
temporarily lost her sight
then saw lots of colours and double vision
sensation of numbness in the face and round mouth
very nauseous and sick
one time couldn't speak
has had these ever since but no pattern to what starts them
not had them since the PMR was dx

she was getting to looked flushed, tired, in obvious pain and was really
struggling to answer any more questions - her mind was just not up to it, so
I finished the interview at this stage

It is early days but I am very confident of the remedy prescribed, if anyone
wants to work out the remedy.

But I must say (as we always keep saying) this is just one individual case -
others with the same diagnosis could be any one of hundreds of remedies.

Regards, Joy Lucas