You get the invitation in the mail and tear open the cream-colored envelope with the silvery, cursive calligraphy with mixed emotions — you’re thrilled to be invited to celebrate with your friend or loved one, but at the same time you worry about whether you’ll feel well enough to put on a smile and dance alongside everyone else.

Attending a wedding or other special event when you have a chronic illness like inflammatory arthritis has a unique set of challenges — the trials and travails of travel to and from; enduring hours and hours of the ceremony, cocktail hour, and main event; squeezing your feet into heels and your body into formal wear that’s almost certainly less comfortably than your go-to sweatpants; making small talk; dancing; standing more than usual; staying up late … we could go on.

Essentially, it’s about understanding how a change in routine affects your disease.

“Not understanding what the physical requirements are for attending any event or going to a new place is very stressful,” says rheumatologist Nancy Shadick, MD, MPH, an associate professor at Harvard Medical School. “In addition, the change in routine sometimes can be stressful in terms of anticipating, what am I needed to do, how far do I need to walk, how much energy will I need to do all the activities.”

“Understanding what’s required and what you’ll be doing physically is the best way to handle these kinds of changes in routine,” she says.

This topic came up during a recent #CreakyChats Twitter chat, and our community had a lot to say about how they’ve made adjustments to help attend special events like weddings while managing their disease and not feeling totally crappy in the days after the event. Check out their best advice here.

1. Be prepared to leave early — no guilt, please!

Rarely plan to stay for entire event. Bring a snack in case I can’t eat any of the food served. Sit on the end of the row for a quick escape to the bathroom. — @FragrantGrace

Indeed, leaving early was a common theme in our Twitter chat and something it’s natural to struggle with. You don’t want to upset the bride or groom, but chances are, they’re just thrilled to have you be able to attend at all. Try not to feel guilty for doing what you need to do to take care of you.

As Amani Omejer wrote on The Mighty, “I would love to drink with you and dance until 3:00 a.m., but I can’t. It’s enough of an achievement that I am here at all. When I say I’m going to sleep, don’t try to get me to stay — I feel rubbish enough as it is, having to leave early. Let me go, because I am so easily swayed to stay and then almost always regret it the next day when my pain levels are so much higher and I feel even more ill than I did the day before.”

2. Streamline your schedule

Lots of extra sleep beforehand. Tell wedding party (or whoever) that there’s no offense to them if I have to cut out early. Cut out any unnecessary activities that could be energy sucks. — @AnnieGriff7

In addition to possibly leaving the event early, you might need to pick and choose how much you’ll participate in all the related events and festivities. Maybe you don’t attend the rehearsal dinner, so you can be better rested for the main event, for example.

3. Ask the hotel for better accommodations

Called ahead at hotel to get 1st floor room or closest to elevator, non-smoking. Planned for HOT outdoor wedding with battery fan, sunscreen, extra water in my bag. Also time to recoup in my room. — @morse_tami

4. Rest up in advance

I make sure that I rest up so that I may attend. After attending the event, my recovery is usually a day or two! I also make sure to take extra prednisone (approved by my doctor) as a precaution. — @stacielou2

Dr. Shadick echoed this advice. “When patients who are given a prescription for prednisone for their flares anticipate that they’re going to have a lot of difficulty getting through a strenuous day, they can consult with their doctor if they need to take a little extra prednisone for a physically or emotionally demanding event.”

5. Ditch the high heels

Bring flip-flops in purse for dancing at wedding! And if able I stay an extra day or 2 to recoup if I’m able! — @TerezHumphrey

6. Bake in travel time

I’m prepping now for flying to wedding Friday. Scheduled flight day before wedding to give time to rest after arriving, got hotel with microwave to heat beads for pain, packing meds in carry-on, wearing dress I own because I don’t have energy to shop, wear flats. — @Dividivigirl

In addition to giving yourself extra travel time, Dr. Shadick emphasized how important it is to stay active during long flights or car rides. “There’s something called gelling phenomenon, which can occur quite dramatically in people with inflammatory arthritis,” she says. “When you’re seated or in a still position for a while you stiffen up. If you’re able to move around during a long plane trip or car ride, you’ll feel much better when you get to your destination.”

7. Ask the airline for extra help

I always try to allow a travel day if possible, I will use airline assistant to get me to the gate, I get pre-board pass it depends how I feel sometimes it’s easier. — @RaBionic

8. Don’t shy away from using your assistive devices

I def have to take it easy days prior in hopes of avoiding any aggravating of body/joints or flare. Always making sure airline knows (if) I need help and will be checking a mobile scooter. — @TerezHumphrey

“If you do need a cane or a walker, bring it with you,” says Dr. Shadick. “There’s no reason to not use the things you use on a daily basis just because it’s a special event. Just don’t worry about it.”

9. Keep things in perspective

My daughter’s wedding was Friday. I used a wheelchair and paced myself. I did everything I could to assure a good night’s sleep. I was able to walk down the aisle with help and danced from my wheelchair. Not ideal, but I was present and that’s what mattered. — @kelle4fsu

Follow CreakyJoints on Twitter (@CreakyJoints) to partake in our #CreakyChats and other important convos.

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