Traveling with PMR

Posted by kmb181 @kmb181, Jul 31, 2022

I am thinking about taking a cross country trip, for the first time in six years. My close cousin is getting married.
Most days my PMR pain is still high, even on 6-8mg. of Methylprednisolone. It gets a little better as the day goes on, but most days I have to push myself.
I am trying to decide between flying, or taking the train in a roomette.
Can anybody weigh in on the pros and cons of these options?
I am worried about not enjoining the trip if I’m in pain, but I have already missed out on so much in life.
Kathy

Interested in more discussions like this? Go to the Polymyalgia Rheumatica (PMR) Support Group.

@pdxmac

I've had PMR for a little over a year, and am currently on a 6 week warmth seeking trip to the south to visit family and also see if the warmth helped the PMR. I won't likely try something like this again even though the warmth has been beneficial. I had tapered down to 20 mg of pred before the trip but had to go all the way back to 20 (on rheumy advice) due to a concern about GCA and that is very disheartening. I did what I could to make the trip manageable, including purchase of a Lab Cushion seat for the long plane ride and a Rx for a low dose anti-anxiety med some travel is always stressful. Both of these things helped but not enough. I found finding medical help difficult while on the road and I had to spend several days in recovery mode on several days for various reasons.
That being said - this is only my experience and I'm weighing my own costs / benefits. I love my home and friends and the setback wasn't worth it. But I'm a little high strung anyway so the trip set me up for trouble. And I haven't been dealing with PMR for years and years, so I wish I'd just been more patient.
I hope this is helpful.

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CORRECTION: I had tapered down to 10 mg. 🙁

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I’ve had PMR since 2011 and have not let it stop me traveling. All in USA and Canada. I’ve flown a have a dozen times , many long thousand plus mile car trips. Camping, hunting and fishing trips. One flare on a hunting trip, I was pretty slow that year…. I’ve seen 3 rheumatologists at Mayo Clinic and the trip there is 6 hours and never was a mention of traveling too far. During my first year a friend came to me a said he heard I had something serious. ( his wife had been fighting cancer and other ailments for some time) . I said no! I explained briefly what it was and said it cause a lot of discomfort but I will not die from it. If anything the medicine will kill me, as I was also on Methotrexate.

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@grumpa

I’ve had PMR since 2011 and have not let it stop me traveling. All in USA and Canada. I’ve flown a have a dozen times , many long thousand plus mile car trips. Camping, hunting and fishing trips. One flare on a hunting trip, I was pretty slow that year…. I’ve seen 3 rheumatologists at Mayo Clinic and the trip there is 6 hours and never was a mention of traveling too far. During my first year a friend came to me a said he heard I had something serious. ( his wife had been fighting cancer and other ailments for some time) . I said no! I explained briefly what it was and said it cause a lot of discomfort but I will not die from it. If anything the medicine will kill me, as I was also on Methotrexate.

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Thank you for your encouragement. My hesitation is that I have a trip planned for Switzerland at the end of May, 2025, and a number of years ago, my mother had GCA. It would really trouble me to get GCA while travelling. In addition my PMR is now considered a pre-existing condition and my travel insurance will not cover anything related to that.

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@pdxmac

I've had PMR for a little over a year, and am currently on a 6 week warmth seeking trip to the south to visit family and also see if the warmth helped the PMR. I won't likely try something like this again even though the warmth has been beneficial. I had tapered down to 20 mg of pred before the trip but had to go all the way back to 20 (on rheumy advice) due to a concern about GCA and that is very disheartening. I did what I could to make the trip manageable, including purchase of a Lab Cushion seat for the long plane ride and a Rx for a low dose anti-anxiety med some travel is always stressful. Both of these things helped but not enough. I found finding medical help difficult while on the road and I had to spend several days in recovery mode on several days for various reasons.
That being said - this is only my experience and I'm weighing my own costs / benefits. I love my home and friends and the setback wasn't worth it. But I'm a little high strung anyway so the trip set me up for trouble. And I haven't been dealing with PMR for years and years, so I wish I'd just been more patient.
I hope this is helpful.

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I am on my second big trip since getting PMR in March 2024. It took doctors 2 months to diagnosis PMR. Started at 15mg prednisone and went up to 20mg. Felt pretty good tapering slowly to 12mg. First trip ok but sore after long flight to Alaska. Second trip started on December 5th with long flight to Thailand (about 20 hours). I felt better than expected at around 12mg dose. Doctor said to taper by 1mg every 3 week. At 10mg had alot of finger and hand pain and tingling.
Also neck and shoulder pain from carrying heavy day pack. I have found myself feeling better walking as much as possible and avoiding certain foods. Got case of travelers diarrhea and PMR symptoms increased. Went back to 10mg from 9mg. Feeling better but still have morning hand and wrist soreness.

Good luck to all.

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@dbloom

I am on my second big trip since getting PMR in March 2024. It took doctors 2 months to diagnosis PMR. Started at 15mg prednisone and went up to 20mg. Felt pretty good tapering slowly to 12mg. First trip ok but sore after long flight to Alaska. Second trip started on December 5th with long flight to Thailand (about 20 hours). I felt better than expected at around 12mg dose. Doctor said to taper by 1mg every 3 week. At 10mg had alot of finger and hand pain and tingling.
Also neck and shoulder pain from carrying heavy day pack. I have found myself feeling better walking as much as possible and avoiding certain foods. Got case of travelers diarrhea and PMR symptoms increased. Went back to 10mg from 9mg. Feeling better but still have morning hand and wrist soreness.

Good luck to all.

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Thank you for your comment. Do you increase your dose back to the previous dose every time you have a setback?

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@aisp3b

Thank you for your encouragement. My hesitation is that I have a trip planned for Switzerland at the end of May, 2025, and a number of years ago, my mother had GCA. It would really trouble me to get GCA while travelling. In addition my PMR is now considered a pre-existing condition and my travel insurance will not cover anything related to that.

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I understand your dilemma. A thought. Ask your Dr. to give you extra prednisone in case of a problem. Also I think Europe is more a tune to PMR/GCA and you could go to an ER there if you have an issue… I hope it works out for you. Whatever your decision. Be at peace with it.

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@aisp3b

Thank you for your comment. Do you increase your dose back to the previous dose every time you have a setback?

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Yes. I emailed my Rheumatologist and was told to go back to previous level for 3 weeks.

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@aisp3b

Thank you for your encouragement. My hesitation is that I have a trip planned for Switzerland at the end of May, 2025, and a number of years ago, my mother had GCA. It would really trouble me to get GCA while travelling. In addition my PMR is now considered a pre-existing condition and my travel insurance will not cover anything related to that.

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is a fully refundable ticket purchase an option ??

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@nyxygirl

is a fully refundable ticket purchase an option ??

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I am usung ecredits which will expire. The cost of the tour is $4500 which wil not be covered by insurance if any health issue ocurs related to PMR since it is a pre-existing condition. Most importantly, I am concerned if I got symptoms of GCA, as my mother had that and almost went blind just before being diagnosed.

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@dbloom

I am on my second big trip since getting PMR in March 2024. It took doctors 2 months to diagnosis PMR. Started at 15mg prednisone and went up to 20mg. Felt pretty good tapering slowly to 12mg. First trip ok but sore after long flight to Alaska. Second trip started on December 5th with long flight to Thailand (about 20 hours). I felt better than expected at around 12mg dose. Doctor said to taper by 1mg every 3 week. At 10mg had alot of finger and hand pain and tingling.
Also neck and shoulder pain from carrying heavy day pack. I have found myself feeling better walking as much as possible and avoiding certain foods. Got case of travelers diarrhea and PMR symptoms increased. Went back to 10mg from 9mg. Feeling better but still have morning hand and wrist soreness.

Good luck to all.

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Hello @dbloom and @aisp3b I was talking to someone today who apparently has had a flare up of his PMR, (his wife is taking chemotherapy currently) He mentioned something about time zones -- he wishes he had tweaked the timing of taking his 10 mg Prednisone while in Oregon for 10 days ( vs. his home in RI) . SO I hope you'll manage very well on your trip to Switzerland ! Sounds wonderful !

The circadian nature of IL6 is mentioned in : PMRandIL6 website*.

"The effect of IL-6 on fatigue, mood,
and sleep was a result of its ability to stimulate the
hypothalamic-pituitary-adrenal (HPA) axis.43 In a study
of patients with PMR, IL-6 levels demonstrated a
circadian rhythm that peaked in the early hours of the
morning and correlated with the duration of morning
stiffness. "
* wow , which BTW seems to have much more info since I first stumbled upon it 1.5 yrs ago.

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