Low grade fever and muscle pain

[windchime]

I have a low grade fever that started about a week ago along with muscle pain all through my back and shoulders. I thought the back and shoulder pain was because of pulmonary rehab and the work outs, but now I'm not so sure.

I've been on 15mg of pred for about 10 days now, down from 17. I'm still on CTX and have been since Nov 30th. It feels like a flare from what I've seen described, but can that happen when still on the heavy meds?

I did have dental work done on 3/5 and pre-medicated with 2000 mg of Amoxicillin. On 3/12 I was at the endodontist and he checked the roots to see if there were any problems, there weren't. The low grade fever started on 3/21 along with the muscle pain and isn't there every day, but most days. I have no teeth or gum pain. I was at the dentist today and he said my gums look great.

Doesn't feel like I have a sinus infection and I don't have sinus involvement. My nose has been a little more "runny" as of late, but pollen is coating our cars and everything else down here right now. Chest is clear, no coughing, tightness, or wheezing.

Could the reduction in pred cause both of these symptoms? I know it can the muscle pain, but the fever? Since I can't come up with anything else I was planning on upping my pred back to 17mg tomorrow to see if that helps. Any other ideas?

[Dirty Don]

Hey Cindy, I've been doing the dental thing too lately and nothing has gone wrong yet doing the premedication thing. But, a low grade fever could indicate something still awry with the dental work. I fear the possibility of a sinus infection almost obsessively at times (not my fault...docs have preached clean sinuses to me for waaay too long!). Pred doesn't do anything with fevers to my knowledge. But, it seems many, if not most, of us have a level of pred that seems to be difficult for us to get past...yours may be around these numbers...mine was a bit lower, and I'm on my 2nd try to get even lower...trying not to anger the Prednisone gods again...sheesh!

[windchime]

The thought of a sinus infection just makes me sick. I spent 3 months last year and 3 rounds of antibiotics to finally get rid of an infection. It just isn't feeling like that though. In fact it doesn't feel like anything except the "old days" when I was diagnosed with fibro and I hurt every evening unless I took Ibprophen. Liver enzymes are up a bit so I'm trying to stay away from the IB, but even that still doesn't define the problem. Hope your dental work and your quest for lower pred is successful.

[vdub]

Ah, good, you are back to the default font. That other one was so tiny I couldn't read it. Yeah, I'm getting old.... :-)

You took all of the same steps that I have taken whenever I've had dental work done. I think your guess of it possibly being allergies is probably as good as any. Allergies can really cause some bizarre issues.

[Alysia]

our Dear Cindy.
I am sorry for you :sad:
fever is not a good sign according to my doc. I am always carrying thermometer with me to check fever. I think that you should go for labs asap to check your CRP, ESR, CBC and others.
fever is an indication for some infection or virus. it can be a cold/ flu (going with the muscles pains). but also infection not wg-related (maybe in the teeth? ) or, hope not, infection which is wg-related.
my doc always say to check the "direction" of symptoms and if they are getting better, worse or the same. If they are getting worse, please go to see a doc.
prayers and hugs and please update us :hug1:

[windchime]

Today I upped the pred to 17mg and so far no achy shoulders or back. The fever usually starts later in the evening, but I'm feeling better overall today so will be surprised if the fever shows up. Sooo was it the pred or whatever it was has run it's course. That's the 64 million dollar question....... Maybe I'll experiment and go back to the 15mg of pred tomorrow and see. Thanks all for your responses.

[pberggren1]

Fever usually indicates infection. If you are having nose symptoms, chances are it is sinusitis. If the symptoms worsen then I would see a doc in a week or so. You may need an antibiotic.

[windchime]

If it's an infection it's a very subtle one, other than the fever of course. I dropped the pred back to 15 mg today so we'll see what the weekend brings. If the fever comes back I'll see my PCP next week. Promise. :biggrin1:

[drz]

Once you are considered in remission for awhile and if any symptoms come back, it can be a sign of a flare.

Even in remission residual symptoms can vary in intensity. For me they seem to increase, with any infection and they decrease again after treating the infection. My Weg expert doesn't consider these a real flare, just a variation in my residual symptoms since it doesn't require any major change in my treatment regime.

During pred tapers some increase in body aches and pains often happen but these usually disappear in a few days. If not then the pred taper is too fast or too big.

If the symptoms are significant and if there is any lab work supporting an increase in inflammation markers, then some change in treatment plan might be warranted.

Symptoms of Wegs usually get better after you begin appropriate treatment but it doesn't mean they will all go away at once as it can take some time to recover from the initial attack of Wegs. Mine persisted several months after starting on RTX and CTX. During this time they varied in intensity but were never as severe as the onset when I was first correctly diagnosed.

[windchime]

Thanks for your response drz. I increased my pred for one day and everything seemed to go away and hasn't come back. (Fingers are crossed.) I actually felt pretty good this weekend and attended family get together. It's possible that I have a bladder infection or something female as things aren't feeling right. Waiting for a call back from my PCP now. So we'll see.

[drz]

Lab work can give you some indication of a possible infection as inflammation markers like CRP and WBC tend to increase when there is an infection. i usually get some extra lab work done if I am uncertain as to what is going on inside.