yo-yoing preds due to stress

[Nanatoo]

Over Christmas I overdid the social side of life and paid for it. With advice from this site I upped my preds by 5mg for 10 days and got the inflammation under control again returning then to a dose just slightly higher than I’d been on. The inflammation mainly seems to attack my thighs the most making walking very difficult and stairs a major effort so it was so good to get “back to normal” Unfortunately over the half term break we were called on to house/pet sit for the family at late notice and whether it was the stress of the late call up or the fact they live in a 3 story house and one of the pets is a dog I had another flare, mainly thighs again. I thought maybe it might be the fact of so many flights of stairs so tried paracetamol but the pain is very different and after a couple of days decided to treat it as a flare. It certainly was that as the inflammation eased after a couple of days.

My question is am I doing damage by yo-yoing? I promised myself I wouldn’t overdo things but we’re house/pet sitting again for two weeks at Easter. My daughter-in-law’s family all still work or are not available to help and we live close by,which is wonderful most of the time,but a bit too convenient. Saying “ No” is not an option and I think because most of the time I look and act ok the fact I have PMR is forgotten.

[DorsetLady PMRGCAuk volunteer]

My question is am I doing damage by yo-yoing?

Well you probably aren’t doing yourself any favours….as we often say the more times you flare, the harder it becomes to get things back under control.

Honestly neither are you doing yourself any favours by always saying ‘yes’.. I know it’s difficult but perhaps once if you said ‘no’ - and explained why then, you might not be taken for granted…

You might think that’s a bit harsh, maybe it is, but your health comes first, and if you don’t explain to family it’s too much sometimes, then they don’t know.

[SnazzyD]

I don’t think one can say for sure. It may mean your cumulative dose will be greater than if you hadn’t yo-yo’d over time with whatever risks that comes with for you personally. When you say no is not an option, do you mean you don’t want to let people down? From the outside there does seem to be a bit of taking you for granted which is not a good long term strategy especially as you are already finding your limits. To be fair to them, are you being honest with them about the impact?

[PMRpro Ambassador]

You may not directly be doing DAMAGE by yoyoing, but you run a very real risk of finding that after every yoyo you find it harder to get the inflammation under control and to reduce the dose again. And extended time on higher doses of pred can do damage.

Saying no IS always an option - looking after the dog now and again is one thing but 2 weeks in another house when you aren't well is neither fair nor reasonable. It must be made clear that this is something that makes you more unwell and must be limited. Remind them that not all disability is visible and that you have a serious systemic illness which luckily can be managed well with a powerful medication PLUS lifestyle changes to keep the dose of corticosteroids as low as possible. In the longer term, high doses of pred are really not good for you and if they care about your longterm health, your family must accept that you are at an age and have an illness where you cannot be expected to drop everything and run to their aid at the drop of a hat for more than occasional days without seriously impacting your health. It is stressful and stress and PMR really don't mix well!

The large number of stairs is really not helping - it sounds as if you have a degree of trochanteric bursitis associated with your PMR and stairs are poison to that. I live on the second floor (UK parlance) but luckily there is a lift - I couldn't live here if there weren't.

[Sophiestree]

I'm guessing there's a reason why they cant be in your own home?

[Pixix]

saying ‘no’ is an option, with my husband in hospital with pneumonia & myself on week 9 on crutches after a bad fall, I’ve found a situation where a cry for help brings ‘no’ as an answer. You are sick. That’s the reason you can’t help! The dog can go to kennels or to the many house sitting, pet sitting agencies that are available. It’s very selfish of them to see you as the ones who will pet & house sit!!