Type 2 diabetes, stress and Pred

[butterflyfarm]

Already diabetic when diagnosed with PMR, I ended up in hospital with keyto acidosis. 4 years later after a heart attack and stent I had reduced to 4 mg of prednisolone. Suddenly, about 6 weeks ago the tops of my feet and ankles swelled up massively with horrible pains and burning pins and needles so bad it was hard to walk. My stress levels are ultra high as my husband is receiving end of life care at home for bowel cancer at this time. I never thought it was the PMR and was taking pain killers unsuccessfully. I decided to up the pred to 10 mg and the pain and swelling disappeared completely within 2 days. Has anyone else experienced this type of foot problem. Many thanks to all you wonderful people who give advice and help.

[Fatsiajaponica]

So sorry to hear about your situation, no wonder you are having issues with so much stress and worry. I am not super knowledgeable being recently diagnosed but I would not be surprised if it is related to PMR given that the pred worked. Did the swelling go down as well as the pain? Thinking about the heart issue. Best get it checked with the GP just in case. Others will be along with information Sending my best wishes, take care🫂

[butterflyfarm in reply to Fatsiajaponica]

Thank you for your reply. Yes the swelling also went down as well. I am obviously on my feet a lot up and down the stairs to care for my husband. I see a diabetic nurse next week and shall ask more questions then. If you pardon the pun it gets my foot in the door of my g.p. surgery. The pain was like having walked through a field of stinging nettles.

[PMRpro Ambassador]

If it hadn't responded so quickly to pred I'd have wondered about cellulitis but there is a syndrome called RS3PE syndrome that can cause very swollen feet and is often seen alongside PMR at the start. It responds very well to a moderate dose of pred too. The tight swollen skin can be very painful. If I remember rightly, a few people have experienced something similar as they reduce pred, they have increased the dose and it has gone away and not returned. Most peculiar.

Can you not have your husband's bed moved downstairs to save you having to do the stairs? I couldn't have coped - luckily I live in a flat - although at the end when we needed a hospital bed the only place for it was the living room.

[Hidden in reply to PMRpro]

Thank you so much for your reply. I googled RS3PE and the symptoms described were exactly what I was experiencing. Even down to the pitting.

My husband also has a hospital bed but the only place it would fit with all the other paraphanalia was the upstairs back bedroom. We have downsized to a smaller house. However, now that the pain in my feet and ankles has gone and I can sleep again at night the exercise is good for me. Also I do have agency helpers, paid for be the NHS, who are wonderful people who wash and generally help him with toileting as he is now very thin and weak but I could not manage to lift him on my own. Married for 55 years and we soldier on!

[PMRpro Ambassador in reply to Hidden]

I only have 3 rooms and my bedroom has a built-in double bed so that wasn't an option. "His" room was simply too small - so that meant we had to clear out the living room - and it is a living room, lounge, dining room and kitchen area in one and not that big even so. It was October - would have been so much better earlier in the year as my 4th "room" is an enormous balcony but that was where everything was dumped! I managed, no helpers, it was just after Covid and nothing was available. But the last 10 days our daughters were visiting, for a week supposedly but he must have been waiting for them and fell off a cliff a few hours later. One is a nurse and had done EOL care before, the other works in the ED and had a crash course. We had been together over 50 years but I didn't make my 50th wedding anniversary.

However - don't underestimate its effect on you. Been there, done that. It is hard. Hugs.

[Hidden in reply to PMRpro]

I am not sure how I am now Lavender4, but that is my name for the diabetic forum. But to continue. Did your husband have comatose days and then days when he rallied? It certainly doesn't help the stress levels with the PMR. I do understand what you say about the effect it is having on me and I shall have counselling after the dreaded event. I was sorry to hear that you did not have any helpers but that your daughters managed to be there at the end. You give such wonderful help and advice to all of us. Kind thoughts to you. X.

[PMRpro Ambassador in reply to Hidden]

When the end came it was very sudden and to be honest, there weren't that many days for that! The girls arrived on Wednesday evening and within hours he didn't know where he was of what he wanted. He had actually been pretty good the previous 4 or 5 weeks after a week on the palliative unit and then in the space of about 4 or 5 days went from able to stand from lying and get to the bathroom alone to unable to stand at all by the Monday before they arrived. But I couldn't get the community nurses to believe me - that was the hardest I think. Then after they arrived, it was only 8 days, the last 3 he was totally out of it and we couldn't believe how long it took. Then he waited until I and the nurse daughter went out to get food - it was a holiday weekend and shops would be shut for 2 days. By the time I got to the shop and parked the other daughter phoned to say come back, It was ironic - she didn't want to be alone with him.! I think it affected her more than me to be truthful. I'd known it must happen for years - they hadn't seen him all through Covid.

Be kind to yourself - if you need to talk, I'm here, use the Chat to be private,