Hi My Friends,

How is life going for you this week?  I hope it is fabulous!

What challenges and wins have you encountered?  Have you had much pain or side effects from your meds?  How is your journey towards remission? 

I know life is a rollercoaster with PMR.  I am thinking positive thoughts for all of us today :)

Today I want to share with you about my trip to Ireland.  

After this trip, I know that international travel for those of us with PMR is possible with a lot of prep, some good luck, a positive attitude, and a wonderful travel partner.

A month ago, my husband and I traveled to Ireland on a group tour with some of his co-workers, including his boss.  Although it was a trip of a lifetime, I was quite anxious about going as I did not know how my stamina would be for a 10-day trip abroad.  I was mainly concerned that I would embarrass Steve in front of his co-workers by seeming elderly and disabled. 

My worst fear was that I would have an adrenal crisis (I have adrenal insufficiency due to long-term steroid use) which would bring the trip to an unfortunate screeching halt with a lot of attention and concern directed at me. 

I would find that horrifying!

Although I had a few minor blips with my health, overall, the trip went smoothly, and I enjoyed it very much.

As it happened, I had a bad sinus and ear infection right before I was to fly.  That worried me as I did not want to be miserable on the flight due to painful pressure from my congestion.  To avoid this problem, my doctor increased my steroids considerably, which made the flight painless.

In addition, the Prednisone also took care of any PMR pain and stiffness during the trip's first few days.  So this little side illness was a blessing in disguise as I felt like my old self when I arrived in Ireland.  We walked everywhere while in Dublin as we stayed right in the city.  It was fun exploring the old pubs and ancient architecture. 

Please note: I also took a little nap every day before dinner to keep my endurance strong.  I had to give up some of our self-guided afternoon tours, but it was worth it!

Obviously, I could not stay at 4 times my normal dose of steroids.  My doctor informed me that I could taper to my previous dose rather quickly once I was done with the "steroid burst".  My ears and sinus felt good when I was done with the prescribed (increased) dose of Prednisone so I promptly started a steep taper on day 3 of our tour. 

As you may guess, I did have some troubles at this point.

I have always felt lightheaded as I tapered, and my adrenal insufficiency has compounded my low blood pressure and dizziness.  This issue caught up with me one morning as we were touring the Immigration Museum in Dublin called Epic.  

I believe that I embarrassed my husband a wee bit (in Irish brogue:) while at the museum.

For this tour, our group walked (very slowly) through the maze of underground dimly lit rooms.  As we stood around while the tour guide talked about the history of immigration, I began to sweat.  The room started to swim.  I became lightheaded and thought I would pass out.

I quickly sat down and tried to look interested in the guide's speech, which now resembled a buzzing sound droning on and on. 

This feeling did not pass.  I began to grow worried as I did not want to lose the group as they moved on and I was afraid to stand up. I had no idea where to go by myself in the large meandering museum, and I was becoming disoriented.

I tried to keep up with the group, but many rooms did not have benches to sit on. With my head spinning, I walked a few rooms ahead and found a bench to sit on.  I really just wanted to lie down.  When my group caught up, I tried to look like I had important business to do on my phone to disguise my disintegrating health status at that time.

I know my husband was embarrassed by me at this point, but I was trying to discretely make the best of my worsening situation even though I was losing it.  I was very close to adrenal crisis, so I stress-dosed with hydrocortisone from my purse and hoped that it would kick in quickly.

After a bit, I tried to keep up with the group as everyone had left me.  I leaned heavily on whatever wall or display I could and prayed I would feel better.  It was a scary and disheartening episode for me as I felt the need to pretend to be Ok while I was in pretty bad shape away from all comforts of home.

Luckily, an hour or so after I took my extra steroids, I began to gradually feel better.  We then got on the tour bus to do some bus sightseeing for a few hours, so I was able to rest and began to feel like myself once again.

After this episode, I upped my steroids a bit for the remainder of the trip. 

I was glad that I did as the same scenario as the museum happened to me again at the airport in Shannon at the very end of our trip.  Unfortunately, on that day, we had our flight home canceled.  We had to stand in the ticketing line for many hours due to the flight change and I once again felt faint. 

This time I upped my dose of steroids right away and drank plenty of fluids.  I was grateful that my husband was there as he let me sit on his luggage which was a hard-sided suitcase.  Having a "chair" to sit on during the long hours of wait helped considerably when my blood pressure dropped.  However, I was very glad to be able to sit in a real chair once we got on our way.

Due to the numerous reasons that required me to "updose" on my steroids, I was essentially pain and stiffness free the entire trip!

I was thrilled to be able to tour the scenic countryside of Ireland with ease and without looking like I was crippled. The quaint villages and green pastures really were very charming.

Another concern that I had when planning the trip was about the food.  I follow a pretty strict Paleo diet to control my inflammation in hopes of remission from PMR. 

When I had traveled to Tennessee earlier in the year, I had a wicked time trying to find wholesome food that was not breaded, fried, or candied.  So I wondered what kind of diet offerings are available in Ireland?

For those who have traveled abroad, you may already know that the European diet is MUCH healthier than US fare.  I had NO trouble at all finding fresh food that fit my strict dietary needs.  Even the truckstops and smallest pubs had plenty of food that was nutritious and delicious!  The soup in Ireland is wonderful, and many are gluten-free!

The picture below shows a snack my husband and I shared at a local pub.  I especially enjoyed the tea time every afternoon while my husband was sold on the local Guinness beer:)

Another highlight was when we toured Blarney Castle and the famous Blarney Stone. I walked to the top of the castle where the stone is located.  However, there were moments when I regretted my decision due to the steep stairs. 

Per the local tradition, my husband kissed the Blarney Stone located at the top of the castle.  However, I passed on that lucky tourist attraction after seeing how you have to contort your body to bend over backward to actually kiss the stone (plus with Covid, who wants to do that!).

On the last night of our trip, I was so pleased to finish strong as we stayed overnight at the famous Dromoland Castle near Shannon, Ireland.  This ancient castle was very posh, historical, and fun!  I enjoyed poking around the rooms, talking with the more-than gracious staff, and touring the beautiful gardens and grounds.

So my advice for big trips such as this one is to:

1.  Plan ahead.  Build-in plenty of rest and downtime into your schedule.  You may need to give up a few "tour" stops to work in the rest time you need, but you will be glad that you did in the long run.

2.  Bring plenty of extra steroids and pain meds (of choice).  Remember to always keep a bottle of water on hand.

3.  Have a travel buddy who can stick close to you.

4.  Check out the meals and menus ahead of time.  I knew my itinerary and checked the menus online to see what food the restaurants and hotels offered,

5.  Take an elevator or "sit out" portions of a tour if needed to conserve energy.

6.  Schedule bus tours instead of walking tours when you can to save energy and prevent "overdoing it".

7. A hard-sided suitcase was an unexpected life-saver for me as it made a handy seat in the airport where just about any unexpected delay can put you over the edge.

8. If traveling to a new time zone, I had double dosed and that seemed to hold me pretty well.  Ask your doctor prior to travel about any recommendations on this topic.

Overall, I would call the trip a success!  I took it easy as needed but was still able to take in all of the sights.  It indeed was a trip of a lifetime, and I am delighted that I went.

Would I go again soon?  Probably not.  It was a bit taxing.  But I am glad that I took advantage of this opportunity and made lasting memories with my husband.

Take care, my friends, and happy travels!

Donna