Should I move to a warmer climate to improve my life ?

[chubbycheeks]

I have had had PMR for 2 years and have several long stays every year in warm climates. When in the UK I have discomfort in all major muscles and now starting problems with joints. When in a warm climate I am like my old self and have no pain or discomfort whatsoever. Is it anything to do with Barometric Pressure or just hot climates are good for PMR sufferers

[PMRpro Ambassador]

I don't know - I live in northern Italy which has a much warmer climate in the summer but much colder in the winter. I don't really notice that much difference overall but it is very obvious that damp and windy weather (which is unusual where we live) makes the PMR worse. I don't enjoy very hot weather (by that I mean above about 29C) but can tolerate it as long as it is dry heat and I don't have to exert myself outdoors!

However - before you move abroad to live think hard: it isn't the same as being on holiday by any means. We had lived abroad before for 10 years so knew what we letting ourselves in for in every respect and also speak the local language fluently (German where we are). The health service here is good - other areas are less good and you need fluent Italian when further south. Healthcare cover is particularly important when you have a chronic illness and it is also important to be able to communicate well. Living outside the EU brings other considerations too at our age.

[chubbycheeks]

Many thanks for your response. We live 4 mths of the year in Spain not in a tourist area and have done for the past 8/9 years. We look at it as living there not being a holiday. I am just trying to get my head around why I can move and have no discomfort within a day of getting off the plane into the warmth. The village we live in is over 3500 ft above sea level does this makes any difference to muscles and pain ?

[PMRpro Ambassador in reply to chubbycheeks]

See my response to Pipistrelle too.

I live permanently at about 3000ft and I don't think that makes that much difference. But you aren't the only person to find they feel much better in Spain. The biggest difference for me between the UK and our Italian place is the lack of stairs - when in agony in the UK I felt much better after a few days there even in the winter just because I didn't have to climb stairs a few times a day!

When I said "it isn't the same as being on holiday" I meant the fact that living there 12/12 requires a lot of changes, not least being restricted about how long you can spend in the UK and having to use the local health services for everything as well as other things that are different as a permanent resident.

[Pipistrelle]

I wonder has your doctor tried for a differential diagnosis of perhaps, Vitamin D deficiency? The symptoms can be very similar to PMR and would improve in a sunnier climate because you'd be getting more Vit D from sun exposure. I had PMR for 2 years and during that time was back and forth to California, in Hawaii and also went through the sunniest summer in Ireland/UK in years and extra sun made no difference to my PMR. The good news is, if your problem is actually Vit D deficiency then simply having your doctor give a prescribed level of high dose Vit D could end your pain and you do not need steroids etc. I'd go immediately and ask for Vit D analysis blood test, if this hasn't been done recently, and talk to your rheumatologist/GP about the fact that you have no pain when in a sunnier place. Just cannot see how you'd have such a dramatic change if your pain were due to PMR.

[PMRpro Ambassador in reply to Pipistrelle]

You'd be more likely to have a dramatic change from the PMR than from the vit D - it would take days for the vit D level to have any effect even if you were out in the sun at midday with no sun screen (that reduces the amount made by over 90%) and most of us living in cosy climes don't do that - it is simply too hot at that time. It is more likely that the warmth helps with vasodilation so the blood vessels are better able to supply blood to the muscles - I think the PMR symptoms are due to some form of the GCA inflammation affecting the microcirculation, the very very fine blood vessels between the arteries and the veins. It would certainly fit at least.

[Pipistrelle in reply to PMRpro]

Yes you are right and that occured to me too, but alternatively, can't see how a single day in the sun would improve PMR either, except either way as an improvement in mental state helping symptoms -- I'd certainly be more cheerful and uplifted in Spanish weather than in Irish! lol But if the improvement is sustained only when in sunny weather -- I'd definitely want to check Vit D levels as an alternative diagnosis, not least as so many GPs would not do this test as a matter of course. Interestingly, my mother lives in Calif and works daily in her garden and nonetheless had Vit D deficiency requiring a supplement, so anyone anywhere might find they have this problem (in this era of sunscreens and more people staying sedentary inside rather than going out). And I've gone from someone with olive toned skin who rarely ever burned in my Calif youth, to having a sun-sensitivity that causes a rash when I am in places where I get high sun exposure, even if I use a high factor sunscreen.

[PMRpro Ambassador in reply to Pipistrelle]

I used to tan well until PMR but I can't really remember when it changed. With pred it was horrible. I also developed a rash that coincided with wheat use - no wheat, no rash. That improved a lot on higher doses of pred (didn't go away) but at the moment, on a low dose of pred (4mg) it seems that my immune system is heading back to normal. I think there are a load of factors that contribute to PMR problems and that is why we all appear to be so different with PMR - I don't think it is one illness, pred-responsive PMR covers a load of different things, just doctors don't think that way.

[Pipistrelle in reply to PMRpro]

Yes you are right and that occured to me too, but alternatively, can't see how a single day in the sun would improve PMR either, except either way as an improvement in mental state helping symptoms -- I'd certainly be more cheerful and uplifted in Spanish weather than in Irish! lol But if the improvement is sustained only when in sunny weather -- I'd definitely want to check Vit D levels as an alternative diagnosis, not least as so many GPs would not do this test as a matter of course. Interestingly, my mother lives in Calif and works daily in her garden and nonetheless had Vit D deficiency requiring a supplement, so anyone anywhere might find they have this problem (in this era of sunscreens and more people staying sedentary inside rather than going out). And I've gone from someone with olive toned skin who rarely ever burned in my Calif youth, to having a sun-sensitivity that causes a rash when I am in places where I get high sun exposure, even if I use a high factor sunscreen.

[chubbycheeks in reply to PMRpro]

I have my vit D checked regularly. The way I feel in Spain is like the temporary feeling I have after a hot shower and able to move freely. So your explanation of vasodilation ( although I have never heard of the word) makes sense. Many thanks

[PMRpro Ambassador in reply to chubbycheeks]

It just means the blood vessels dilate - get wider - so more blood can get through. Sorry!

[Pipistrelle]

"Vitamin D deficiency symptoms

Vitamin D deficiency may be characterized by muscle pain, weak bones and fractures, low energy and fatigue, lowered immunity, depression and mood swings, and sleep irregularities. Women with renal problems or intestinal concerns (such as IBS or Crohn’s disease) may be vitamin D deficient because they can neither absorb nor adequately convert the nutrient."

From womentowomen.com/nutrition/...

[jinasc]

You may want to read up on Vit D Deficiency.

patient.co.uk/health/vitami... This site is one used by both medics and patients.

And, pmr-gca-uk-northeast.org.uk. One the home page, left hand side, click on Newsletters Then No 6 Dec 2010, page 2 a GCA patients experience with Vit D Deficiency.

By the way it is an exclusion test before being diagnosed with PMR, often it is overlooked.

[warthog]

Chubbycheeks, you say that you are starting to have joint problems. Could it be that you have some form of arthritis as well as PMR? I lived in different tropical countries for over 30 years and it was common knowledge among other expatriates that arthritis pains improve dramatically in tropical heat. Several friends had elderly relatives come and stay for a month or two and it was a regular talking point.

[optimist-ok]

Hello Chubbycheeks! As well as PMR/GCA, nearly 3 yrs now, I also have arthritis in lower back & thumb joints. I've just had 1 week in SE France & was virtually pain-free for the week. The dry heat did make a big difference. Since the onset of the illness I have been prescribed Calcichew-D3 twice a day shouldn't think I am deficient in the D vit. Aches are back now!

[Polywotsit PMRGCAuk team member]

Hi Chubbycheeks! It's interesting that you feel better in the warmer weather. I used to live in Italy and did so until I got PMR. I found that the hotter the weather, the worse I felt. And I am someone who normally loves the heat. While in Sicily I was in the worst pain and walking with a stick. The only way I could get relief was to go into the sea. So maybe different people have different reactions. It may have something to do with the humidity. Spain tends to be dry, whereas the parts of Italy I was in were pretty humid.

[chubbycheeks]

Hi Kate, The relief I get in Spain is the same temporary relief I get when I stand under a hot hot shower every morning/night !