I feel you on all counts, Derek.
I also HATE prednisone. I have two more doses of 5mg tomorrow and Monday, then I'm done. But I almost think the month and a half of Prednisone, at least for me this time around, was a good program. Here's how it went for me:
Discharged from hospital at platelet count of 47 at 80mg Pred
following week my platelets were 80, and I tapered to 60mg
Following week my platelets were down to 57. Tapered again to 40mg
Following week platelets went up to 128, tapered to 20mg
Following week platelets were up to 137, tapered to 10mg
Last week they were 149, and I've now tapered to 5mg
It makes me wonder if the short-term Dex treatment doesn't really give your antibodies a chance to "forget" or reset from thinking platelets are an invader. I'm no doctor or scientist, so I have no clue.
But if I were you, as much as I also hate Prednisone, it might be worth giving that a month. I don't think a month is enough time to give you osteoporosis.
On another note, while on Prednisone, I WAS concerned about diabetes coming out of it. So I cut almost all carbs from my diet, basically a keto diet (although you will not ever get into ketosis). I didn't gain weight or get a moon face and my blood sugar didn't really seem affected on that diet. I also exercised every day. 4 mile runs 5x per week and lifting at the gym 2x per week.
Also I read up about the role of gut health and the immune system and it seems like there's a significant relationship. So I started taking daily prebiotics (fiber, basically) and probiotics. Again, not a Dr. and I never asked my own dr about it. So you might want to ask yours before following any of my layman advice.
Good luck whatever you decide! Keep us posted.