Wondering what to do! (long, sorry)

frogmella

Hi all,

I am 36 and have facet joint arthritis at l4l5 which is the level above my fusion (l5s1). To cut a long story short it took quite some time to get the diagnosis as the reason for my ongoing pain.

Anyhows, I now know that it is certainly that level in my spine causing the issues as I had facet joint blocks there 10 weeks ago and an epidural for good luck! They worked a treat but have been wearing off for a few weeks and the start of this week has been bad! But not as bad as pre injections so I shouldn't moan I suppose!

I am a Chemistry teacher. Because I had my fusion hardware out last August due to infection and then had ongoing pain and fatigue ever afterwards I never went to work last academic year. I tried to go back after the May half term (when the injections had kicked in) but my ever understanding (not!) school made me go and see occ health first, thereby making enough delay that I didn't manage to get back before our term ended (independent school, finished end of June). I wanted to go back then because I am worried about going back on an emotional level as well as the physical. During my absence I have had next to no contact from them. I did arrange meetings in an informal way with one lady who is now SMT but is a friend and we had discussions about my return, but when it came down to it it was a waste of effort! No one in my dept has been in touch so I am a bit worried about support/reactions etc. I know that the head of science is always moaning about "skivers" being off ill etc.

I am going back in three weeks. I am part time and my hours have been reduced massively due to lower numbers of classes so I only have to work 25%. We have a two week time table and I have two mornings one week and three afternoons the other so I work half the days if that makes sense?
So, from a phasing back point of view I think the hours are ok.

My worries are that I have been managing with the return of the pain, espescially this week, by "opting out". So I stayed in bed yesterday morning rather than getting up and out for my usual swim. I won't be able to do this when I have to go to work so how wondered what strategies other people employ to cope?

I am scared because at the end of the 2010/2011 academic year I was in awful pain and suffering with the infection in my back and working was horrible. I could only just manage to go to work and then stagger into bed a lot of the time! I just don't want to end up back in that hole!

I don't like taking strong painkillers very much because they make me feel "out of it" and that isn't good in a chemistry lab! But I wondered if I should use this last three weeks of holiday to "harden" myself to codeine to manage the back pain when I am at work? I know that when my disc went I was taking 100mg tramadol 4 times a day and at first it was awful and I just had to sleep but after a few weeks they were ok. They never touched the nerve pain though!

I am trying really hard to get myself back into the best physical shape I can at the moment. I swim 4 times a week and have upped my distance, I do aqua once a week, I walk every day, do my PT exercises too.

I take naprosyn and omeprazole daily and have been taking amitriptyline for nerve pain since about April. I am switching to gabapentin now on the advice of the Physio because she thinks it might help with some of my muscle twitches. The GP thinks it might help with the "muzzy" head too. ie removing amitrityline should make me less muddled!

I saw my new surgeon today and he says maybe I can have another set of injections but I can't have them forever. He did say that probably I am going to end up having that level fused too. (gulp). I am trying to avoid that after my awful experiences last time!

So, in summary, I am asking
1) How do others cope on the stronger drugs at work? Can I harden my self to them? Will they still work if I do?

2) How can I get the people at work to see that although I am back I am not "better?

3) Is there anything else I could/should be doing to help myself?

Thank you for reading. I am sorry to have gone on. I thank you for any advice and words of wisdome in advance.

dreamdaisy

Oh gawd, frogmella, what a dilemma. I work at home, I'm a private tutor for dyslexics and over the years my work load has dropped to a very low level and even then at times I struggle to cope. I manage on cocodamol (usually about four a day), taking the first two about an hour before I start then the other two when I go to bed to help me settle. I work through the holidays too.

The hours sound manageable and you will need to sort out a new routine for yourself to make sure you can handle them. Surely this has to include pain relief and this is the time to start 'experimenting' with what can help and what can't. As for the non-understanding staff members there is not a great deal you can do to change their attitude apart from recommending they have a look on here and telling them about the Spoon Theory. Also point out that there are around ten million arthritics in the UK, that the vast majority of those have OA and that they may well be adding to that number as they age. That should shut them up. I wish you well. DD

valval

hi i am sorry i am no help have no experiance of this but if you take loads of pain meds you do not feel the benifit the body does get used to a certain level from my own experiance i am sure others who can help will be along good luck val

suzygirl

I find gabapentin to be wonderful. It takes away most of the nerve pain, leaving it more manageable. Have you tried taking amitryptyline earlier?

You could contact Occupational Health to see if they can offer any advice or help. Staff members will either be supportive or won't understand. But we always are here for you.

I wish it all goes well for you.

frogmella

Hiya! Thanks for the support guys, it is so nice to chat to people who understand.

I take my ami at about 6pm at the moment (although stopping tonight) and that means I can get up at 6.40 am to go for my swim. I like the morning swim because the people are nicer and I have made quite a few friends there. They have been really supportive the last few years.

I did think I would build up resistance to the codeine if I am honest. Maybe, if taking the ami away takes my sleep away too, I will go back to my pre ami routine of taking a couple at bedtime.

My physio recomended the gabapentin because I have nerve damage that gives me muscle twitching in my calf and I have quite a lot of leg cramps too. I thought maybe I would take both (gaba and ami) but my GP thinks it will zonk me out too much. I have had quite a bit of nerve pain relief from the ami so I am hoping the gaba will do the same just with fewer side effects.

I think you are all correct in what you say about the work thing - I think I am just going to have to be totally professional with them all and forget about being "friends". I had thought that some of them cared but obviously not! I will be there so little in non contact time that I can avoid them. Just hope I can keep my mouth shut on a bad day!

I have been thinking about resigning and doing private tutoring etc so that I can take some of my stress away. I think that I will have decided what to do by Christmas!

The occ health woman that I saw wasn't that helpful. I might go back though when I am "normal" and let her see if she still thinks the same then!

Thanks again for all your support.