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Discussion Starter #1
I have been having chest pain for the past three days. It is not unbearable, but I also have a very high tolerance for pain. It is on my left side up under my ribs and it is a very sharp pain when I take a deep breath or cough or laugh. It is much worse when I lay down rather than when I am standing up.

It is the weekend here and I don't want to call my Rheumy, but I was wondering if I should go see my regular doctor or my Rheumy? Also, I am already taking Relafen (NSAID), Plaquenil and Prednisone 10mg daily. What else would they give me? Will it just go away on its own?

Just wondering what the difference in the symptoms of pleurisy and pericarditis are and what you think I should do?

Thank you everyone!

Andrea

Official diagnosis is Collagen Vascular disease, but treating as SLE.
 

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Hi

Hi there,

I have just joined and have posted in the not diagnosed yet section!

2 yrs ago I had Pericarditis I was admitted to hospital with chest pain, I had it in my ribs and the pain went into my back when I breathed in, lying down made it worse so I slept sitting up for a week, until I could'nt stand it anymore, i went to my GP who sent me to hospital, i had anti-coaglant injections and stayed in hospital for 4 days, It did take a few weeks but it did clear up.

They said that rest was very important. I would go and see your GP though.
 

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Hi Andrea :hug:

What you describe does sound like pericarditis, especially as it's worse when lying down. They may increase your Pred for now, but your disease activity does need to be re-assessed in light of this new problem. Whichever doc you think is more adept at doing that and whoever can see you fairly quickly. You can get fluid around your heart from this inflammation and that's no fun!

It could get worse, mine ended up like beci's and I could not lie down at all in the end, it just hurt too much. For me a couple of days in hospital with IV pred seemed to do the trick. Each of us is different in what will work, that's presuming it is Pericarditis. Any chest pain should be checked out very quickly really, it's hard for us to assess it ourselves, especially given many of us do have a high pain tolerance and lupus symptoms are all over the place.

love
Lily
 

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Hi Andrea,
I agree to get it checked out by the soonest available doctor.
As for whether it percarditis of pleurisy i don't know.
I ahve never suffered pericarditis but have had pleurisy a couple of time sand i couldn't not lie flat either it was extremely painful.
You should definately tell your gp and i would have thought they would check bloods first and take things from there.
Blood clots on the lung can cause pleurisy and with this you would usualy have an elevated d dimer aswell, if this was the case you would have an x ray and a scan of the lungs to show it! And if its suspected you would be given an injection to stop th possible clot getting any worse while investigations are carried out.
I am sure that there would be indications in blood of pericarditis aswell.
So whatever the case its important to get it checked.
If its the weekend i would call out of hrs doc and get their opinion.
I hope you get this sorted out.
Good Luck

Take Care

Cassie :)
 

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Hello Andrea
I understand wanting to get an idea of what's going on so you can get relief as best you can before seeing the doctor but we have to be careful about making decisions whether to see a doctor or not self diagnosing. If your rheumy gave you his on call or out of hours number you should feel free to use it.
There are different causes for pleurisy, such as infection or embolisms, although it is common from inflammation caused by a CTD, so treatment will vary.
If there is a fever or shortness of breath or other oddities then it becomes an ER situation.
Pericarditis can be mistaken for a heart attack - the pain is in the centre below the breast bone and radiates left.

All chest pain needs to be taken seriously so see whoever you can see first but go to ER if there's signs of worsening, fever, difficulties breathing. Definitely call your rheumy to let him know. When you get to see him ask if you should have called him earlier.
My doc was mad with me when I was once reluctant to call him- he said what did I think he had given me his number for !

Let us know how you are getting on please
Good Luck
Clare
 

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Discussion Starter #6
Thank you everyone for your advice. The pain seems to come in waves and then when I laid down flat after I got home from work last night it was very sharp and hard to breathe. However, I managed to sleep and it seems better today.

I actually work in an Emergency Room, so I think I will take one of the docs or nurses aside and have them check me out. My mother keeps telling me it is indigestion, but I have had heartburn for many years (even very severe that feels like a heart attack) and this is very different.

As for calling the Rheumy, I feel like I am calling them every few weeks to adjust my meds or because of a new symptom. My husband still makes me feel like I am a hypochondriac when I tell him of something new that comes up, even though he knows good and well I have a disease. They are so busy and when I call for advice, it takes a day or two for them to get back to you. God knows what it would be like on a weekend.

My GP is wonderful, but she tends to go a bit overboard on the tests and such to cover her bases. As you guys know, I already owe a small fortune in medical bills due to lupus and the thought of a bunch of tests that are not really needed makes me sick.

I have shortness of breath when the pain gets bad, but otherwise I seem to be moving O2 well. I have a bit of a small dry cough and no fever or illness along with it. The pain is worse when I bend over. However, like I said, it seems to be getting better and less persistant as the days go by.

Thank you again for your posts. It is so nice to turn you here when I have questions or need a push to take care of myself. I have started keeping my aches and pains and discomforts to myself and sometimes I feel like I suffer in silence because no one really understands. They try, but they can't really understand. I am glad you are all here! :p

Take care and I will keep you posted.

Andrea
 

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Hi Andrea,

I am glad that it seems a little better today. Sometimes these things happen and don't linger, let's hope that's the case for you.

If you are calling the Rheumy that often with new symptoms and med adjustment then it's entirely possible that your whole med regime needs looking at. I don't know what you are on right now, but with the correct treatment then this should not be happening. It's possible to have a long term med regime so that you have fewer flares and they are not as severe. Of course working in an Emergency Room would be quite demanding :( so it may be more difficult for you to achieve that than someone else.

It always annoys me when someone's significant other has trouble understanding the disease and they say it makes them feel like a hypochondriac :( :mad: You would be the best judge as to why he is acting like this but quite often it's a bull headed reaction because they feel powerless to fix us and so they take a stance of "it's not happening and it can't be possible for any disease to do this. So I will just bury my head in the sand and hope it goes away, if I don't admit to it, it isn't there". Sound familiar?

I hope your pain subsides and wish you better days ahead. Oh btw my Pericarditis always felt slightly better when I leaned forward although lying down definitely made it worse and quite unbearable.

love
Lily
 
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