Risks of emotional stress

[Cinka]

Hi All! Have just read Daisychain12 post re increasing pred peri-surgery, which I am aware of, but I was not aware that emotional stress could have such potential dire consequences, tho' I know we that we should aim to avoid this as far as possible.

Quite scary to think we could end up in ITU!

I am asking about this now, as I have had an extremely stressful couple of weeks following the death of a family member, whose funeral I am attending tomorrow.

I am currently taking 15mg Pred, tapering by 0.5mg -ish per month.

I do take hypotensive medication but would appreciate advice as to whether I increased or not increase - that is the question?

PMRpro, Dorsett Lady..

Thanx 😊😊

[PMRpro Ambassador]

No, at 15mg you should be fine. It is once you get to under 10mg/day, the physiological level, that it becomes a problem. If you have been fine thus far you probably will be fine tomorrow. Just be aware that if you feel unwell you should not simply ignore it.

[Cinka in reply to PMRpro]

What should I do in those circumstances - increase Pred slightly? 😊

[PMRpro Ambassador in reply to Cinka]

Depends how unwell you feel. If you are nauseated, weak and confused, have back or abdominal pain, chills or fever then call the emergency services saying you are a long term pred patient and have been taken ill. They should respond as an emergency and give you an injection. If you are able, take a dose of pred, though that still takes an hour or so to take effect.

This is the reason we should carry a steroid card - though how much use they are I don't really know. It is more likely to happen in an Addison's patient who is on hydrocortisone than anyone with PMR on above 10mg pred - but if you stop the pred suddenly for any reason that is what could happen. One forgotten dose is unlikely to cause a problem, the PMR would probably get you first, but being ill for a few days with D&V would be enough to potentially cause trouble so don't hestitate to call a doctor if you do have such an attack.

[Cinka in reply to PMRpro]

I have GCA - possibly PMR too!

Thank you so much for your prompt reply.

You are so appreciated - don't know what we would all do without you!

😊xx

[DorsetLady PMRGCAuk volunteer]

Hi

From my own experience I was on 20mg when my husband died.

I didn’t have a relapse nor any adverse effects in respect of my GCA. Of course I went through the normal bereavement feelings, but it didn’t affect my illness.

Although, as I have said numerous times before, during the previous six months my inflammation markers shot through the roof causing my GP to panic somewhat. Again no GCA relapse, but the inflammation was certainly raised by stress!

You always have the option to increase, but personally I wouldn’t ‘just in case’!

Hope tomorrow goes as well as it can.

[Cinka in reply to DorsetLady]

Thank you, DorsetLady. That is certainly helpful.

Where would we be without our Aunties!

Hope all is well with you. Take care.

😊 xx

[Telian]

Didn't read this until today, how are you after yesterday?

[Cinka in reply to Telian]

Sorry, Telian - don't know how I came to miss your post.

I wasn't too bad on the day, thank you - it was the following day I felt the effects and I did up my pred slightly. Am back on track now but will be so glad when I don't need to take it any more! - abw!

Hope you are ok yourself?

Take care and enjoy your evening - well, whats left of it ..

xxx

[Telian in reply to Cinka]

Don't worry - it happens. Pleased you're back on track. xxx

[Cinka in reply to Telian]

Thank you, Telian. Hope all is well. xxx