Advice on PMR for lawyer: Help needed please! I... - PMRGCAuk

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Advice on PMR for lawyer

Andypan profile image
21 Replies

Help needed please! I am in the middle of a very stressful divorce from an incredibly abusive husband. In the latest batch of legal documents, my husband is challenging my PMR diagnosis and everything that goes with it and my lawyer has asked for me to comment on this. As background, I was diagnosed with PMR in May 2019 aged 51, had to go up to 30mg pred before I had any relief and have tried to reduce pred as per advice on this forum ever since. I have had several flares along the way (which I am convinced were brought on by stress), and currently on 14mg pred daily. My husband has stated the following: a) 'PMR resolves spontaneously after 5 years in all but a few cases, therefore I should be better by now', b) 'There is no reason why I cannot go back to working full time (I currently work part time 3 days a week which I find a struggle as it is). c) 'There is no risk to my health from PMR, the only risk is from my use of steroids, so I should be weaned off the steroids as soon as possible', d) The ongoing use of steroids beyond 5 years could imply addiction, which leads to even more serious health risks and will shorted my life considerably, thereby taking me outside usual actuarial considerations'.

Obviously my husband has no idea what he is talking about, it is all deeply offensive, but his goal is to prove that I should by now be completely back to normal, I should stop taking steroids immediately and because I am on them, my life expectancy would be shorter than normal, which means I should receive a lower financial settlement. I would be so grateful for any robust forms of words which I can use to the 4 statements above.

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Andypan
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21 Replies
SnazzyD profile image
SnazzyD

What a nightmare! You know what we’re going to say about that twaddle but to be honest if it is for legal reasons you need a medically qualified statement from an up to date doctor! If you want references to take to your solicitor to make it clear that the medical opinion is worth pursuing there are some. Others will have some I’m sure so sit tight, while I have a look too. Have you tried calling the PMR/GCAUK helpline also? They could be a great help.

Andypan profile image
Andypan in reply to SnazzyD

Thank you so much for your reply. At this stage I need a few robust lines to go back to him on the points he has made just to put him back in his box. If he pushes it further at a later stage then I might need a proper medical opinion.

PMRpro profile image
PMRproAmbassador

Can't say what I'd like to here however - you do NOT become "addicted" to pred, you become physiologically dependent since the adrenal glands are unable to work properly and that really isn't the same thing. Weaning off steroids for that is different and it is downright dangerous to stop steroids precipitately and would put you at risk of an adrenal crisis which can make you seriously ill at best, be life-threatening at best. No doubt that would suit him down to the ground!!

There is an article in the Newswire by Prof Sarah Mackie as part of the Myth-busting campaign about duration of PMR. It has commonly been held that about 5% of patients have PMR for life and the propensity to relapse is life-long.

Will try to find something later but I must go out just now.

Andypan profile image
Andypan in reply to PMRpro

Thanks so much. I will look at the article and grateful for your comments about pred above - that's the sort of thing i want to be able to go back to him with at this stage.

SheffieldJane profile image
SheffieldJane

The words that occurred to me wouldn’t be useable in polite company. What chumps he and his lawyer are. I have never heard the like. This kind of nonsense will add considerably to the legal costs and absolutely do nothing for his case except show how petty and vindictive he is. PMRPro will bring the professional words. You are well shot of him, rise above it all and with quiet dignity,let him pass out of your life.

PMRpro profile image
PMRproAmbassador in reply to SheffieldJane

Oh my daughter's ex had some similar rubbish that defied belief too!!! They are very sensitive about losing what they perceive to be their rightful "share" of what was built up together during the marriage!

Andypan profile image
Andypan in reply to PMRpro

Thank you. You and Sheffield Jane have hit the nail on the head. He is indeed very petty and vindictive....

DorsetLady profile image
DorsetLadyPMRGCAuk volunteer

Agree with others, and yes please do call the Charity’s helpline - 0300 111 5090.

I’m sure they can steer you in right direction whilst we are looking for links… or words [polite ones of course so not referring to himself!].

As mentioned by PMRpro- have a look at this and the links within -

pmrgca.org.uk/pmr-myth-bust...

Andypan profile image
Andypan in reply to DorsetLady

Thank you so much Dorset Lady for the link, that will be invaluable.

DorsetLady profile image
DorsetLadyPMRGCAuk volunteer in reply to Andypan

Hope so… you deserve better - good luck.

Dochaz profile image
Dochaz

I have no scientific or legal background to help, but sending positive thoughts and encouragement to you. You will have to fight on 2 fronts simultaneously, the medical condition and the legal battle. I'm sure that with the help of this forum and your "real life" friends, you'll get the expertise and the moral support you need.

Best wishes 😘🍀💪

Andypan profile image
Andypan in reply to Dochaz

Thank you for your kind words.

random901 profile image
random901

Andypan, this is so stressful for you. I hope you have a good solicitor. My divorce was pre-GCAPMR diagnosis, but I recognise the vindictiveness and greed here. And it continued when I came to claim child maintenance (son 15 at the time.) Another ploy was a refusal to declare his financial assets. I do hope you have a supportive circle of friends. Sending you my heartfelt good wishes 🌺

Andypan profile image
Andypan in reply to random901

Thank you - that all sounds very familiar!

PMRpro profile image
PMRproAmbassador

pubmed.ncbi.nlm.nih.gov/403...

says 40% of patients require therapy for more than 4 years. It is unreasonable to suppose they will all suddenly get off pred in a year after that.

link.springer.com/article/1...

says "High rate of long-term glucocorticoid (GC) treatment is recorded in polymyalgia rheumatica (PMR), being 77%, 51%, and 25% of patients still on GCs after respectively 1, 2, and 5 years."

25% of patients still requiring pred at 5 years is a pretty high rate of longterm PMR.

academic.oup.com/rheumap/ar...

is a UK study and they say that "We show that 40% of PMR patients are still treated after a median of 5.16 years."

This means a lot are still requiring steroids beyond 5 years. One study in the USA found a median time of 5.95 years to discontinue steroids - so half of patients require steroids for more than approximately 6 years. They also established that, apart from cataract, there is not a higher incidence of adverse events in patients who took steroids compared with a cohort who did not.

medcentral.com/rheumatology...

There is no evidence that PMR shortens life expectancy - but it is documented that PMR results in a high level of disability when not well managed with steroids. Indeed 3 out of 4 studies that reported it suggest there is a reduction in mortality.

arthritis-research.biomedce...

acrjournals.onlinelibrary.w...

It is generally accepted that untreated PMR results in considerable disability and premature discontinuation of corticosteroids results in relapse.

Hope something here is helpful. The links include a couple of review articles so they cover a lot of studies without having to look at each individual one.

Andypan profile image
Andypan in reply to PMRpro

Thank you so much PMRpro, that is all extremely helpful and will give me some ammunition to go back to him with.

Sillydogsmum profile image
Sillydogsmum

I am two years into a yucky family legal matter. It depends whether he has put the stuff in documents given to the Court who are asking for info or whether it is just in his writings to your solicitor, who should be able to guide you as to how much info you are obliged to disclose at whatever point you are at, and offer a robust reply on your behalf. Just give the basics of what, when , confirmatory blood tests, medication, specialist opinion etc. If your PMR is like everyone else's this should be a nice long chronology of medical and practical woe!! All fact, no emotion!! Dont be bounced into a self justifying defensive response. You don't have to follow the format of his questions that are designed to slant your reply to favour his point of view. You could chat the need for how much detail with your solicitor rather than putting it in writing to him/ her initially?. If needed down the line, medical report from your GP, or Rheumato might be helpful if they have been positive for you. If he wants more info he can pay for a medical report.........Make sure you have seen your GP recently so he knows how you are/ have been.

Sharitone profile image
Sharitone in reply to Sillydogsmum

You make some excellent points, SDM. Including that he should pay for any medical report. After all Andypan is not an average, and the fact that a doctor is prescribing steroids for her, speaks for itself. Unless he is questioning the competence of the doctor!I would hope that the solicitor would be able to work this out by her/himself

Andypan profile image
Andypan in reply to Sillydogsmum

Wow, thank you so much. That is all absolutely spot on. At this stage, I am looking for a robust rebuttal to his questions which will hopefully lead to shutting down this avenue before it goes any further.

Sillydogsmum profile image
Sillydogsmum in reply to Andypan

I find that I get all churned up just before and on the day I receive any documents and can sometimes misinterpret their content but if I give it 24hours I read the docs more accurately and am better able to give them a more considered response. Best of luck, its not at all easy to deal with.🫂

Sillydogsmum profile image
Sillydogsmum

Would have to be very careful who one chose for an independent medical report down the line.... Solicitors who deal with medical claims often are more clued up on medical issues. Mine ran that element informally past a colleague.

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