Age 54: Purpura…prednisolone…moon face…bring it on!

Diagnosis: Idiopathic non-thrombocytopenic purpura


Third week for my prednisolone treatment for Purpura. When I decided to take the course, it was not easy for me to just take it on, I have to weigh  the pros and cons , the risk (side effects) and the benefits it will give and the relapse after gradual withdrawal of the medication. Unfortunately, one cannot completely uncouple the good from the bad sides of steroid treatment.

After reading all the side effects:(13 % of patients taking more than 10 mg for 2 weeks course, side effects will be  visible) I have to take 40 mg a day (8 tablets every morning) oh:-( Got no choice, i started noticing ecchymosis (hematoma) on my upper arms as well.

both my upper and lower arms
both my upper and lower arms

Common side effects: headache, abdominal pain, increase appetite ,blurred vision, dizziness, irregular heartbeat

More common: increase appetite will lead to gained weight to having “MOON face”


So I gather:

The first week: abdominal pain , I wake up every morning at 6 o’clock  to eat my breakfast, so I can take the medicine without stomach irritation. I also take the tablets with minimal water.

Though I don’t have any vision problem or dizziness, I opted to stay at home for two weeks, to give my body complete rest and free from stress. But it is always impossible not to have one, I didn’t have any mood swing though.

Irregular heartbeat: at times but nothing that is worrisome.

Increase appetite : YES oh yes!!!

Has anyone been under the weather and didn’t visit the refrigerator as often as you can. huh food ! I started counting my calories intake but i can not control, my hands and extremities were trembling…like come on…grab me please!

It made my metabolism sluggish and temptation to eat more, so I figure out, if i can minimise my calorie intake and have my daily exercise into a minimum, I  wont be gaining a lot of weight.

My daily breakfasts consist of oatmeal with a top fruits and milk:

Oranges: vitamin C helps reduce stress, also well-known for boosting immune system

Sweet potatoes: satisfy the urge of eating carbohydrates. they are packed full of beta-carotene.The fibre it contains help your body to process the carbohydrates in a slow and steady manner.

Avocado: the monounsaturated fats and potassium in avocado helps lower blood pressure. Avocados have more potassium than banana.

Carrots: low in calories, I can munch like chips without worrying of getting fat. It is also a top source of Vitamin A and beta-carotene for healthy skin, bones and teeth.

Vegetables salad and strips of chicken or tuna for lunch.

Drink: increasing water intake will also prevent dry mouth which is also common side effects of the medication.

Exercise: I kept it into a minimum of 45-50 minutes everyday, nothing strenuous.

After 2 weeks, the blood spots are almost gone.My medication was reduced to six tablets a day for another week and 2 tablets everyday for another week to complete a month course and complete blood and urine test afterwards. Positively looking forward for full recovery, yahoo!

Image 2

So did I gained weight?

Image 1

I am a work in progress…


Age 54: I was perfectly unscathed until….

Beautybeyondfifty is turning fifty-four next month. Turning fifty and beyond was full of excitement, filled with new events, full of activities…beautiful life! I would say being healthy is the utmost concern of everyone my age. As I always remind my sons, “HEALTH is WEALTH”. If you are healthy, your mind and body is healthy, you can think and do well in class or at work, eventually,a healthy efficient person earns wealth 🙂

Though I may look like sweet and slow, in reality, I am energetic and poised! I exercise regularly and eat a balanced food, though I stay away most of the time from carbs, I double my servings of fruits and vegetable and added proteins on my diet. I haven’t got any serious sickness for the past 15 years except for occasional headache, which is tolerable.

So, Whats the big fuss??

Oh well, it started last Friday the 13th of this month, we’re having so much fun at the pool when I accidentally fell and one of my leg got caught at the metal rails of the ladder. Nothing big, just a  bruised and some scratches which was taken care off immediately.

I went home walking normally, I felt some bumps and bearable pain, so i applied some ice and medicine (quantomine) and protected it with elastic socks. the following morning, I saw some red spots above the area of bruised and scratches, so i thought, its nothing but as the days goes by, the small pin point red dots are becoming more and bigger and I thought for a while, I ‘m having allergy from the medicine that I applied , though it wasn’t itchy.


I remained calm and keep hoping that it will clear away by itself, until I noticed that there was no blister, my bruises and scratches from the accident was already gone but the skin rashes was getting more reddish and bigger, so I decided to see a Dermatologist and to my surprised! He said…it is not skin is not skin disease.. it is PURPURA!

progressively getting more
progressively getting more

Huh! yes, I am a health care practitioner but let me remember what is PURPURA? Suddenly the word, Petechiae, Ecchymosis ,Purpura are all playing in my mind. These three terms are all referring to bleeding that occurs in  the skin.These are all skin manifestation of underlying cause of bleeding. Clotting factor deficiency?

As the doctor was explaining to me, he was writing a prescription and laboratory test, not only one… a lot! Oh God! I was walking alone to go to the nearest laboratory for my blood test and at the same time trying to remember his words, Purpura, blood test, platelets, predlon (Prednisolon) huh! what a day!

So this is me, my unscathed legs

my legs at age 54, photo taken last august 2013
my legs at age 54, photo taken last august 2013

and this is how it looks now after 12 days.


Alright, I don’t want this blog to be like a textbook but let me try to explain in simple words my condition.

What is PURPURA? (MedlinePlus Medical Encyclopedia)

Purpura is purple-colored spots and patches that occur on the skin, organs and in mucus membranes including the lining of the mouth. It occurs when small blood vessels join together or leak blood under the skin. When the purpura spots are very small, they are called petechiae. Large purpura are called ecchymoses.

in other is blood spots

He ordered blood test like : CBC, ESR ,Creatinine in serum, CPRH , basically , he wanted to know my platelets count (platelets helps the blood clot), to see if I have infection or inflammation, to see if my kidney is functioning well and my other organs as well, so he can also determined if I can take the Predlone (Prednisolone ) safely without complication. Inshaallah! (commonly uttered word in Saudi arabia at the end of every sentence : may God permits!)

Tentative Diagnosis: Idiopathic Thrombocytopenic Purpura (ITP)

What are the causes?

Idiopathic meaning unknown! oh my! but related to blood clotting disorder. It is divided into : NonThrombocytopenic (normal platelets count) and Thrombocytopenic (a very low platelets count).

Me: huh? how can you treat if the cause is unknown?

There are factors of course like, it appears commonly in women, venous hypertension usually appears in lower legs, senile purpura which appears in elderly (I’m still in middle age), trauma ( impact of pool accident? ), scurvy (i don’t have vitamin deficiency). Well, I guess at this point, I would consider it as an autoimmune disorder.

Anyhow, to make the story short, I got my blood test which is all in normal count. Thank you Lord!

It’s probably my spleen or bone marrow is in limbo and thought that my body is under attack and trying to be a hero not knowing thats a normal platelets. that’s explain why i have purpura.

So, what now?

Initiate prophylactic treatment to boost immune system: Prednisolone (corticosteroid)

Rx: Prednisolon 5mg (8 tablets every morning) for two weeks.

8 tablets at one time every morning wow!
8 tablets at one time every morning wow!

then repeat blood test etc…etc…

What are the things I should avoid?

-STRESS hahaha you must be kidding?

-contact sports, strenuous exercise

Ladies, if you are familiar with the steroid complications, then your guess is right…MOON face, huh who wants to have that? and many more (that would be in my next blog).

for now, wish me luck!

God speed.