Rheumatoid Arthritis, Prednisone and Exercise

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Today is the first day that I feel a bit OK in a while.  Pain mostly controlled by oxycodone, prednisone sitting at 20mg but I need to take it lower, because my blood pressure and heart rate are both too high.

So I went to gym.  I drove 15 minutes to walk for ten minutes on a treadmill and do some stretches,  and then I drove 15 minutes home again.  Now I am recovering at home with a big bottle of water to rehydrate.

Why?

Because exercise fights many of the dangerous side effects of prednisone.

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Prednisone causes osteoporosis, the thinning of bones. This is irreversible.

Weight bearing exercise strengthens your bones, and prevents bone loss.  Taking a calcium supplement or getting a lot of dietary calcium is important as well.

Prednisone increases blood pressure

Exercise reduces blood pressure

Prednisone increases cholesterol

Exercise reduces cholesterol, again, in combination with a healthy diet, full of lean protein and plant based foods.

Prednisone increases your resting heart rate.

Exercise conditions your heart, making it work more efficiently.

Prednisone causes anxiety, depression and mood swings.

Exercise improves anxiety and depression and evens out moods.

Prednisone use can lead to avascular necrosis – bone death due to interrupted circulation to the bone. 

Exercise improves circulation.  That might be a long bow to draw, but it can’t hurt. Also see above, on osteoporosis. Exercise can prevent your bones becoming brittle enough for AN to begin.  I also have Raynaud’s Phenomenon (secondary Raynaud’s), which points to poor circulation.  Poor circulation is improved by exercise.

Prednisone causes insomnia.

Exercise can make you physically more tired and help you get to sleep, and stay asleep longer.

Prednisone causes slow wound healing.

Exercise increases blood circulation, which improves wound healing.

Prednisone causes weight gain.

Exercise combats weight gain.

 

Of course there are a tonne of side effects that exercise does nothing for – headache, dizziness, nausea, eye pain and blurred vision, easy bruising, cataracts and glaucoma, increased appetite (exercise will probably make that even worse, in fact), pancreatitis, acne, menstrual irregularities, loss of libido, rashes…the list is pretty endless.  It’s easy to see why doctors (and everyone else) hate prednisone, and don’t want to prescribe it long term.

The longer you are on prednisone and the higher the doses, the more likely you are to experience side effects. And some of these side effects can be pretty serious.

But there are things you can do to try to minimise side effects, and exercise is the big one.  I’ve been on prednisone at high doses (in Rheumatoid Arthritis terms) for about six years now I think.  It is very unlikely I’ll ever be able to get off it.  So my only choice is to try and mitigate the risk.

Exercise also generally recommended for inflammatory arthritis.  It strengthens the bones, ligaments and tendons which support the joints.  Exercise improves cardiovascular health (the number one killer for RA patients). Exercise improves lung function, the number two killer of RA patients.

Ten minutes doesn’t sound like much, and it isn’t. But even a little bit helps, and it’s a start, and something to build on.  I doubt I’ll be able to exercise daily, maybe not every second day even.  I’m aiming for three times a week, but we’ll see. My body will tell me what its capable off. There are definately days when any form of exercise is impossible.

But pushing myself to use my body also helps my self-esteem.  RA or any chronic illness can take away your choices, can dictate what you can and can’t do.  Exercise gives me a sense of taking back some control.  Fighting back.

On the downside, exercise increases my pain levels, no question.  It hurts, plain and simple.  But I’m going to hurt anyway.

And given that even light weight bearing exercise and cardiovascular work is likely to considerably extend my life, and improve my quality of life, I will continue to make it my number one priority, every day that I can.

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