Managing pain

[trishabhowmik]

Hlw ladies.I live in UK for3 years.I am a doctor.I have stage 4 severe endometriosis and adenomyosis. I have lots of pain during my periods.Now I am starting my job in NHS.I am scared about doing job with long hours duty during period..Anyone else in the similiar situation.. How are you managing pain while doing job?This is my first job in UK. Can anyone help me with that.

[Lasa]

Hi mainly on mefenamic acid tablets and tens machine but when it's too painful and fatigue it's just rest x

[Lindle]

What stage are you at with your endo treatment - in the UK this must only be dealt with in a specialist endo centre?

[trishabhowmik in reply to Lindle]

I have stage 4 endo..endometriosis specilalist centre..

[Lindle in reply to trishabhowmik]

Presumably you are awaiting surgery - it's hard with waiting.lists so long. Are you not on any hormonal treatment to stop your periods in the meantime?

[trishabhowmik in reply to Lindle]

I was on before..bt now I will be on ivf treatment.. After that my consultant will go for surgery.Actually I am concerned about starting job, is there any flexibility If I cant go to job for one or 2 days for the reason of my pain..I am scared about that..

[Strongspirit7 in reply to trishabhowmik]

This is something many with endometriosis suffer with its the unpredictability of pain and fatigue that can affect work. Probably something you should discuss with your manager. Everyone has different ways of dealing with pain and different medications. Doctors usually advise paracetamol but other pain relief is available. I remember being at work and had bled through onto my seat and had a client. Very embarrassing.

[Lindle in reply to trishabhowmik]

It will depend on how significantly your symptoms affect your work and how much time you will need to take off, including the fact that you will have surgery at some point which will need time off. Presumably you have told the new employer about it, If you need more time off than the average person would then endo can be considered a disability under the Equality Act 2010 and they would need to make what are considered reasonable adjustments.

unison.org.uk/content/uploa...

[trishabhowmik in reply to Lindle]

Thank yu so much..Do yu think I should inform my manager after I joined the work..I will be starting my work as a doctor..So may I know If I have periods with severe pain how should I manage on that day?

[Lindle in reply to trishabhowmik]

You don't have to disclose a disability but if you don't then an employer is not required to allow you reasonable adjustments. I think it is something only you can decide based on how you expect your pain to affect you on a day to day basis. If you expect to have 2 days or so off work a month with painful periods due to the condition I personally think it would be best to tell them so that they know that this is very different from a healthy person having period pain.

With regard to how to deal with pain I should put another post on to see how others cope - maybe a heat pad?

theguardian.com/higher-educ...

[Pecas in reply to trishabhowmik]

trishabhowmik congratulations on your new job.

You may find useful the following two links:endometriosis-uk.org/sites/...

endometriosis-uk.org/sites/...

They are from Endometriosis UK website and provide information on your rights and a guide for the employer regarding employees with endometriosis.

I would also suggest that you check your employer's sickness policy. There you will find information such as how to inform them if you are ill.

In addition, I strongly advise you to familiarise yourself with the Equality Act 2010 and reasonable adjustments:

acas.org.uk/reasonable-adju...

assets.publishing.service.g...

I do hope you find all the support you need.

[Lamagarden]

You will be entitled to sick leave if you are poorly.

[trishabhowmik in reply to Lamagarden]

How may I get sick leave? If I have period on my working day, in NHS the working hours could be 10 hrs. So on that day If I m not able to go to work for severe pain due to endo, how should I inform my manager or get sick leave? Because due to endo and period date I would be not known about my date and pain? So how can I get sick leave?

[vic777 in reply to trishabhowmik]

Hello, it's the same as other sickness, you contact your manager that day before your shift starts to let them know that you are too unwell to work. I would certainly mention it to occupational health too when you have an assessment for the job, as they can provide your manager with recommendations and reasonable adjustments.

[trishabhowmik in reply to vic777]

Thanks very much..

[hazzahill12]

Hi , you will also have an occupational health dept working for the NHS so I always inform them to start and then my manager. I didn’t have a specific changes but making everyone more aware so if I needed time off or regular toilet breaks management are aware. Xx

[Cailleach]

Hi, good advice about informing your manager of health issues, if you are comfortable discussing that with him/ her. Also referring yourself to the local Occupational Health Service - you will be seen by a doctor there who can make recommendations of how your employer could help you without disclosing your medical details. You will be informed of how to take sick leave during induction but normally you can call in before the start of a shift, or go home during a shift if you become unwell. Sorry if this seems basic, I was not sure if this is what you were asking, Your contract will tell you about sick pay, generally you would only get statutory sick pay until you have been there fore some time.

You probably need to work out what would help you at work when you have a bad period - shorter hours, more breaks, more time in the office and not on your feet - then you know what to ask for.

It is a difficult situation when you start a job, because you want to make a good impression and of course you will be working under pressure as are your colleagues. Personally I think it’s best to be honest from the start and let them see that you are trying your best to make it work and meet the organisation’s needs,

The link Lindle gave from Unison has lots of useful information about how you should be treated. If you are having any problems with your local manager over this, contact HR or your own union.

I hope everything works out for you and thankyou for joining the NHS!

[trishabhowmik in reply to Cailleach]

Thanks very much for yur kind support..May I know when should I be eligible after joining? Probably from the first month I cant apply for sick leave?

[Cailleach in reply to trishabhowmik]

I think other answers covered this. You can go off sick if you are not able to work, from day one. It is an issue of whether you will be paid. Your contract will cover this and you should get a copy when you start if not before as you have to read and sign it. I think a good point was made already, normally you would be given a health questionnaire before or when you start ( should be before). It is confidential, put in all the information about your health issues and it will go to the Occupational Health Department. They will probably ask to see you.

Re the IVF, you may need time off work for treatment appointments, though if you’re being treated privately you may be able to work it round your shifts.

[Inonge1]

Hi,I would first look at the company's sickness policy.

This will tell you how to report sickness and what other resources are available for you.

Good luck.

[Louisewhite84]

Hi,

I have endo and have worked in the NHS for 17 years now. Your sick pay will depend upon which contract you have. If you are on a bank contract which means you choose what shifts you work you will not get sick pay in the same way. If you are on a permanent contract you will automatically get sick pay.

There are benefits of being sick with a bank contract in that you will not have to go through the absence management system. People who are contracted will still have their sickness levels monitored and this will trigger different reviews at each point. You should be referred to Occupational Health by your manager but if you have a condition you are aware of and have concerns you can self refer and get advice about reasonable working adjustments. They will always do an Occ Health check before you start work so you can mention it then. They may advise your manager uplifts your sickness triggers which means you have more sickness absences before you trigger HR processes etc.

I have always been supported in my role with my illness and mine is bad enough that I am waiting a hysterectomy. Being honest with your manager should get you the support you need so I would advise it. The NHS has a huge female staff group so you will not be the only one who has similar problems! Good luck with your new job x

[trishabhowmik in reply to Louisewhite84]

Thanks very much..Do I need to inform occupational health department regarding my endometriosis health condition before joining? Sick pay mean is it paid leave? How do I manage? Suppose in nxt month I have period and on that day I have got my shifts for 10 hrs and I could not go to work as I have severe pain it lasts for 2 days that I could not move from bed..on that situation, how may I inform and by whom should I report instant If I got period on that day? Help me pls.😭

[635703 in reply to trishabhowmik]

Yes inform occupational health of endometriosis before joining. Sick pay means that when you are off sick you get paid. This depends on your employment contract type. For example, if you are a permanent member of staff you get full sick pay but maybe after you pass your probationary period. IF you are on a temporary contract (known as bank staff or locum Dr via agency or NHS) you get no pay, or very little pay.

You will need to phone in sick. This is usually your Line Manager and these rules are in The sickness policy. Which is on staff website. You need to give them as much time as possible to find a replacement Dr. So if the night before you have bad pain, you call them and leave a message. Some employers you have to speak to the Line Manager on the first day of your absence due to sickness. So get a copy of the sickness absence policy and understand it.

You can ask your Line Manager, so if I am sick what do I need to do? This is an acceptable question.

Do you have a pain management plan with your Dr? Ask Gp to prescribe pain medication and explain you’re a Dr yourself. This might help you be able to not have as much time off.

Hope this helps.

[trishabhowmik in reply to 635703]

Thanks very much..really helpful for me

[BookBimbles]

Hello

I also work in the NHS. Check your employer policy for ‘attendance’ and ‘well-being’ when you start work, and arrange to discuss with your manager. Also look at what flexible working policies you have. If your periods are regular can you swap shifts to avoid working those days? Or have some agreement in advance to make up shifts later if have to last minute cancel. Join your union and they might also be able to advise/ support. Your employer should tell you what to do if too sick to work but usually it’s phone in as soon as you know. You can also speak to Occupational Health for advice confidentially, and they can then support you and you managed to work out ‘reasonable adjustments’ under the Equalities act. But it may come down to your Trust’s flexibility and attitude to well-being. Since Covid some NHS trusts might be more supportive … goodness knows the NHS needs every member of staff it can get!!!

For pain relief and working through the pain - I just always had to pace myself and accept I was not going to be manage as much work - and I’d tell trusted colleagues I was in pain. On top of pain killers, having times to sit down with heat patches / hot water bottles helped. TENS really helped (period specific ones like My Oovi or Ovira - and there’s others).

Finding the best pain relief tablets helped - obviously you’ve got choice of Naxoproxen or Mefanamic acid to try lighten flow, if you can take them. Plus Paracetamol for basic pain relief. But I found actually I needed prescription level codeine - upto 60mg every 4 hours (max 240mg in day). But I need laxatives with this and have Naloxegol plus Laxido to keep my bowels moving nicely. I’ve gotten these via a good GP with special interest in Gynaecology but I am under hospital specialist Womens Health. I’ve also been referred to the Pain Clinic and there’s a lot to be said for stress management, relaxation techniques. All that pain will probably result in pelvic muscle disorder so request referral to specialist pelvic physiotherapists if you’re not already - and try seeing one privately while waiting. I’m reading books ‘Beating Endo’ - it really explains why MDT approach needed, inc pelvic physio, good diet, pain management. And has some basic pelvic stretches that you can start with.

Best wishes x

[trishabhowmik in reply to BookBimbles]

Thanks very much for yur kind reply..I have one question, my period is somehow regular..but +- 2/3 days vary.. Suppose my shifts are given before,and my period comes unknowingly today,,and I have shifts how can I manage then? By Whom do I need to inform instant? Do i apply any sick leave..I dont know anything..could u pls help?

[BookBimbles in reply to trishabhowmik]

Those are questions for your line manager.

I think others have answered your question in their replies too. Pecas has given some good advice.

You could phone / email your recruitment officer to request copies of all relevant policies.

You can also contact occupational health ahead of starting your job - or they might contact you. They should get you to do a health questionnaire before you start work to check you have all the immunisations and vaccines needed.

You need to make sure you’re getting all the pain relief you can from your GP. And get referred to specialist pain clinics if you’re bed bound by pain each month.

[MaggieSylvie in reply to trishabhowmik]

Is there something you could take to keep your periods more regular? That would help make planning at work easier. Having extra help in place once a month might not be a bad idea anyway, with the state the health service is in. Just a thought, but I know, it's all about costs. Good luck. 🤗🤗

[635703]

Are your periods regular? This way you can adjust your schedule or rota to when pain is the worst. Are you on your feet all day? Or sitting all day? Will you be a Junior Dr with long hours and shift work?

I use diclofenac suppository 50mg, when pain is bad and can have upto 3 per day. I eat little and often a handful of nuts, banana, strawberries, kiwi fruits, carrot sticks and hummus to stop nausea and keep energy up. keep fluids (water) up too.

Ginger and cinnamon supplements I add them to a breakfast smoothie which is a chocolate protein powder with probiotics. Usually I use Field Doctor website to have nutritious microwave meals to eat to reduce stress and get enough rest. When tired I eat chocolate and crisps and fizzy sugary drinks - not the best for your body but sometimes you have to to stay sane.

Massage my stomach at night and get early nights to help with fatigue. Epsom salt baths for 20 mins 3 times a week to relax muscles, no strenuous excercise afterwards, stay wrapped in towel and relax. BeYou period patch on stomach and back, BeYou CBD balm where it hurts the most.

Look up Jessica Duffin The Endo Belly Coach as she has free resources on pain on her podcast. Henrietta Nortons book how to take control of your endometriosis is a good solid book, based on science.

Wishing you all the best x x x

[trishabhowmik in reply to 635703]

Thanks very much for your information. My period us regular but sometimes it vary from 2-3 days..but its always earlier..my role would be a junior doctor rota with 10 hrs shift. Thats why I am worried about that..can you pls tell me If I want to manage my rota before how may I proceed with that? As I am new to NHS I dont know anything..so whom.should I inform if I want to manage my rota? Or do I need to inform the other members? I have stage 4 endometriosis with adenomyosis.. Actually, I also need to take suppository 3 times a day..I feel so tired need to take rest for 2 days..my body became so fatigue at the time of my period.so that is my concern in this stage hoe may I feel to perform my job with long 10 hrs..if anything wrong happens in my workplace, how may I manage the situation?

[635703 in reply to trishabhowmik]

If you tell occupational health before you start, they can make what is called reasonable adjustments and make recommendations to your Manage to help you not need 2 days in bed, if possible. So you explain to them. For example, they MAY give you more toilet breaks, maybe you need to shower and change scrubs. Or maybe they can let you sit down on bad days. This is known as a reasonable adjustment as you have a health condition that limits you, this is designed to help you do your job. I don’t know if your Manager could adjust the rota to your bad pain days or not - you can ask occupational health this question.

You don’t need to inform any colleagues at all. Maybe this may change but for now, you need to settle into your new job, get to know them and pass your probationary period.

If you feel unwell at work you have to discuss with Line Manager in private.

Take lots of healthy snacks, fuel your body well, take vitamins, manage stress well, conserve your energy for work. All the things that help you to be well and stay well.

Do you have a surgery date? A treatment plan? This helps Managers to know it’s a temporary situation.

[trishabhowmik in reply to 635703]

Yes I have..I am under endometriosis centre.. My consultant referred me for surgery..but before that I may need to go for IVF as I didnt conceive before..my IVF will be starting soon as I am doing it private.. Thanks for yur help..I think I should let the occupational health team know about my condition before joining..

[635703 in reply to trishabhowmik]

Yes and so many good replies on this thread with specific NHS employee experience.

It’s normal to feel stressed and anxious given your circumstances and if English isn’t your first language, I am in awe of you!!

Please be so gentle and kind to yourself, how you would treat a Patient or a loved one. You are doing your best, one day at a time.

Huge hugs 🤗 💕

[MrsMarlene]

I work for the NHS and have informed my managers about my endo/adeno/pcos and keep them updated with treatment plan as I have an op booked for hysterectomy. I am stage 4 endo with frozen pelvis and its extremely uncomfortable for me to sit on office chairs. Luckily I have been given a works laptop for the days I cant work in the office. I have an agreement with my manager to work 2 days in the office a week, but only when I can manage.

Have an honest discussion with your manager and find out how they can support you.

Sending you lots of hugs 🤗

xxMissMxx

[trishabhowmik in reply to MrsMarlene]

Thank yu so much for yur help