I have had some unusual and fairly severe upper abdomen pain (with very early fullness - couldn’t really eat anything), as well as some severe (but fairly standard) central chest pain that seems to be indigestion.
I have been increasingly relying on NSAIDs over the last 6 months , then had a stress flare that prompted me to start taking steroids a a significant dose daily.
I stopped both the NSAIDs and steroids, and was markedly better with a day, and 90% better within two. Christmas period, so no access to doctors except the ER, so I didn’t go down that road. Have previously been diagnosed with asymptomatic GERD and esophagitis.
My usual GP, who is great, is not available for five weeks.
I imagine that given the severity (I lost two kilos in 5 days), I should essentially know what to ask for when I go to an unfamiliar GP. I’m not able to postpone the decision making or consult until my regular GP gets back, as I’m not functional at home or at work without regular NSAIDs and flare treatment steroids.
If anyone has been through this experience and knows what the normal process would be, obviously first to rule out anything dangerous like an ulcer (no blood in stools, though last iron reading was within normal range, but abnormally low for me, 3 months ago), and then how does one establish if it is safe to recommence NSAIDs or steroids, and information would be gratefully received
NSAIDs are scary stuff – at least for me. When I took naproxen sodium, within a short amount of time (10 minutes) it felt like a knife going through my stomach.
I can take ibuprofen with food and not have trouble, except if I take huge doses for a long stretch of time (huge meaning 3,000 mg per day for 3 weeks). Then I started having some stomach problems and blood in my stool.
Have you tried ibuprofen rather than naproxen sodium?
NSAIDs can cause increased risk for stomach ulcers and heart attacks, so I would be very cautious if I were you. Yes, your chest pain could be indigestion, but don’t completely rule out your heart. I’m sure your doctors will do tests to see where the pain originates.
Pepcid (just plain) works really well for my indigestion/heartburn. With the heart meds I take, the doctor wanted me to also take Pepcid–I think one of the heart meds can cause indigestion…I’m not sure about that, but anyway, it helps.
The PPI is not a bad idea considering there may be some other stressors in your life… If you ar using OTC, that is usually half the dose as prescription (don’t know about OZ.) Call your docs nurse and ask. A bit more might get you through this rough patch…
Thanks Tntlamb, I’m using prescription, though I think it’s the same dose either way here. I had only been taking it “as needed” on the direction of the doc until those issues arose.
It seems like whilst it hurt a lot, the fast resolution means it’s unlikely there was lots of damage. I think I’ll plan to keep off the NSAIDS and prednisone for the next week and a half while on holidays, keep taking the ppi regularly, and get some bloods done.
If it seems to remain good, and there’s no reaction from the doc to the bloods (they call me if there’s anything alarming), then I’ll plan to resume the NSAIDs as needed when I go back to work. And the next Rheumy visit (about 4 months), if I’m still taking close to maximum dose of NSAIDs to remain functional, I’ll let him know and have the biologics switch talk in ernest. Well, it’s about 2.30pm, without the NSAIDs and /or prednisone, it’s time for my nap!
Poor you @Jen75 that’s a reallly rough way to spend this holiday season. Can you up the dosage of PPI anyway? I up a similar one (from 20mgs to 40mgs) when necessary although the reason for that is overindulgence of food and drink rather than naproxen. However I do take naproxen but truly don’t yet suffer any stomach issues and never did on steroids either. My understanding is that alot of celebrex types are better than the naproxen and all can be gastric coated too, rather than just add another tablet. But for severe heartburn etc I’d always go down the pepcid liquid stuff too. However it’s really rare for me to suffer too much.
My thoughts are until the results of a blood test you’re not going to know when is ‘safe’. But I would have thought they can be done now with your substitute GP and a better NSAID than Naproxen prescribed too along with just recommencing steroids. The blood tests result should surely be back within 24 hours as in before New Year and you can go from there? I’m not sure how ‘shut down’ Australia is this week though. Any chance you could phone your rheumy too? Big hugs.
Hi Poo, Thankyou for your thoughts it was already Celebrex that seemed to cause the issues, so I think I’m on the best thing I can be there.
I must admit that without any instruction I upped my ppi from 20mg to 40 when things were bad (anything to stay out of the ER at Christmas!) , and that was the same time I stopped the Celebrex and steroids, and things improved, so perhaps I’ll keep that up for another week.
I will do the bloods soon, but I was taking 25 mg prednisone for around five days, so to get some real picture of what’s going on, probably best I put a week or so between that dose and the blood tests.
The Rheumy is usually on holidays over January, but you are right, I should try to call him, just in case he’s not
I was 90% improved by Christmas Day and was very grateful I got to eat the lobster I cooked and spend Boxing Day with my little girl!
