Age: 74.0
Sex: M
Vaccine: VARZOS
Symptoms: Polymyalgia rheumatica, Pulmonary function test, Red blood cell sedimentation rate, SARS-CoV-2 antibody test negative, Sleep study
Clinical narrative: On 2/1/2020 I received my second shingrix shot. I was advised (as usual) that I would experience stiffness/soreness. However, within 24 hours I had sore throat and dry cough. On 2/2.2020 I began experiencing pain and stiffness in all muscles and joints which continued to get worse each day. On 2/21/2020 I went to my PCP since I could not raise my arms to shoulder height and had difficulty walking. I was put on a 12 day prednisone (40-30-20-10 mg) regimen. The pain was alleviated until the 10 mg does at which the pain and stiffness returned. On 3/12/2020 the PCP put me on a second course of prednisone (again 40-30-20-10 mg) and advised if it to worse I should see a rumatologist. I inquired if it could be Covid and should I be tested to which he said no. On 3/23/2020 I began experiencing a pronounced shortness of breath with rapid heart rate with minimal exertion (resting HR of 85 to exertion rate of 155-165). This concerned me since I am very active (having spend an average of 55 minutes a day exercise for 234 continuous days working out on various combination s of exercises on a treadmill, recumbent bike, rowing machine, soloflex, weights, and back exercises suggested for a bad back). When the shortness of breath made it difficult to exercise and having a third course of prednisone, I saw a rumitologist who advised I get heart tests and pulmonary function tests. He also kept me on a progressively reduced prednisone level to address polymyalgia rheumatica -- varying several times as symptoms would increase and decrease. In July, I did go for EKG, echocardiogram, chemical stress, and an imaging test -- which showed no problems with the heart. I again asked if this could be Covid, to which the heart Dr asked for an antibody test, which came up negative. Considering the length of time from initial symptoms and the potential for false testing along with the persistence of antibodies with extended time I accepted the results. i have also gone to a pulmonary physician and had x-rays, breathing tests, a 'sniff' test to fluoscopically scan lung function and in addition had sleep studies. Only thing determined was possible sleep apnea -- which I question since I get 8-9 hours sleep and am not napping the next day. Also, my wife says I do not stir at night. To date, I have maybe recovered about 10-20% of the breathing I lost and the heart rate is still high with minimal exertion. I can work out on the bike for limited time. My research on the internet led me determine that possibly the shingrix 'deactivated' virus caused a polymyalgia rheumatica response. As the prednisone was increased and extended over a long period of time literature shows that some people have a shortness of breath and increased heartrate response to the drug. Several of the doctors have doubted my analysis and said the symptoms were chance occurrences. As an R&D scientist/engineer in industry, I have learned there are essentially no coincidences in life or test results. I now still believe I had a reaction to the shingrix with a resultant response to the treatment with prednisone. Likewise, I have considered that I potentially had Covid and with early treatment with prednisone steroid I may have been put into a long haul status. To date, I have not been tested for Covid, and would wonder if residual virus could be detected in long haul persons. In any case, my life has been seriously affected with several thousands of dollars of testing saying I am healthy yet have these symptoms continuing. At my current prednisone reduction schedule, I should be off prednisone in July 2021. Even with reduced prednisone dosage changes, I've seen only marginal improvement in breathing/heart rate. When this began I was 73 years old and in my opinion I was physically in the mid 30 to mid 40's due to my exercise regimen. Rheumatologist diagnosed polymyalgia rheumatica based on CRP and sed rate.