Nagmad, you are quite right putting yourself first and if your SIL is approachable, have a word with her, explaining your health issues if you feel you want to. I don't think it's particularly generous of your SIL to invite you, as there are are other people going anyway. No, you shouldn't have to be there if you'd rather not. As SueDonim suggests, send a card for the birthday or whatever they are celebrating, I wouldn't bother with a gift every time.
Good Morning Thursday 5th November 2026
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. That alone would be enough to make me want to stay at home. 