Hi All, I am fortunate to have a flexible arrangement for my part time job, so much of the time can choose when and if I work. However this week and next week are major events in my work calendar.
Yesterday, whilst working with 400 children I experienced severe back pain. This pain is familiar. The first time it happened was when someone drove into the back of my car at red traffic lights some ten years ago. I have had the pain a few times, when extremely stressed, lasting for seconds only.
Yesterday it lasted a good few hours. I am under no illusion that, despite my loving my job, I must have felt stressed for this to happen.
Firstly, can I take painkillers when taking pred to help with this unrelated PMR pain whilst I am taking pred?
Next week my hours will be longer. Three days of rehearsals with three evening concerts. I am conducting a commissioned work by Royal Opera House that I have taught to over 1,000 pupils. Thus am relied upon to deliver this part of the programme. I have already asked my boss to have a contingency to cover other 'jobs' I would have been covering on the day!
I will be able to sleep and rest for up to 2 hours after rehearsals, before the evening concert each day. Knowing how I struggled yesterday, working with 400 pupils from 10am till 2.00pm, this upcoming commitment will be tough to honour. I am self helping by working with boss to reschedule rehearsal times for my contribution so that this session is shorter for me.
I will have been taking 15mgs of pred for 2-3weeks when this event happens. My doc is on annual leave. I will try to speak to Rheumy but may not succeed so I ask experienced members - could take a small 'top up dose of pred' to see me through?
I normally take 15mgs at 7am and start feeling achy at about 9pm, but yesterday was exhausted and struggling by 4pm, so need a strategy in place before I attempt to honour commitments next week.
Once this commitment is honoured can rest until September as all other work commitments can be put on hold!
Thanks.
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Marilyn1959
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That is quite a daunting schedule for the early days of PMR, when all exertions are felt twentyfold. If at all possible, try to have a do nothing but rest a day or two before the most demanding days and for recovery afterwards. I understand that the positivity that flows from enjoyable, satisfying activities is also valuable. Do use willing little hands to fetch and carry for you and try to command from a seated position.
I went for years without pain relief but now find that Tramadol helps with my Cervical Spondylitis pains and has a calming effect ( I know, I know). It doesn't touch PMR pain. If what you are experiencing is a back spasm the my husband swears by Diazepam in extremity. He has found himself lying flat on the floor in an adjacent room to where he is expected to deliver a speech to several hundred people., in agony, and has been delivered by this muscle relaxant.
There is scope to up your Pred dose, I would be tempted to go up to 20 mgs for the most demanding days and hopefully be able to return to my former dose soon afterwards.
Everything else in your life will have to be put on hold and then you may be able to make the after party.
I hope it all goes brilliantly. Don't be shocked by how prolonged the recovery period is afterwards though. Good luck, delegate, delegate, delegate! 💐
Wow that's a lot to take on in your situation, and as you say very stressful, so best of luck.
As S/Jane says delegate as much as you can, and also sit down when and where you can.
You can take painkillers with Pred, but preferably not ibruprofen- although gel used sparingly was okayed by my GP. If it's purely muscular then heat, or cold patches or gel may also help.
You could up your Pred for the days to get you through, I probably would stay at 15mg in morning as usual, and maybe take an extra "top up" during afternoon. Depending on tablet size you have, you could try 2mg or 2.5mg - you can cut 5mg tablet (so long as uncoated) - you may find that's enough. If not then up to 20mg, again as Jane says so long as you're only on it a few days you should be able to drop back down to 15mg fairly easy.
I'm not convinced a top up of pred will help this sort of problem - it doesn't usually do a lot for the fatigue in PMR, that is a component of the autoimmune disorder which pred doesn't touch. But there is no real harm in trying - and the way DL suggests is also how I'd go about it as it sounds as if your antiinflammatory pred effect isn't lasting 24 hours.
The back pain sounds more like muscle spasm - it warned you by the short sharp attacks, now it is saying you aren't listening! Personally, I didn't find painkillers helped and really you shouldn't use NSAIDs with pred but the occasional dose may be OK. Never tried oral diazepam but maybe an NSAID gel used sparingly would help.
I agree with PMRpro - anything you can do to relax the muscles in your back should help. And after all this is over try to get some help, possibly from a physiotherapist who understands PMR, to prevent it happening again. Other than your health issues it sounds like an absolutely wonderful experience which many of the young people will remember forever. Good for you!
You lot are AMAZING!!!!!! I cannot believe how quickly you respond to someone in need!!!!!!!
SHeffieldjane - spoke with boss re contingency plan and have delegated all other 'jobs' to colleagues, other than for the elements of the programme I am 'indispensable' for. This has reduced my rehearsal session on each day to two hours rather than six, thus gaining extra four hours rest period between rehearsals and evening performances. Nothing that can't be shifted in diary beyond last performance evening so can rest for however long it takes.
PMRpro - agree that anti - inflammatory pred probably isn't lasting full 24hours, but only slight discomfort from 9pm till when I go to bed. As I don't have any problems sleeping at present, and again relatively slight discomfort in mornings until next dose of pred kicks in, I prefer to run with this rather than increase current dosage at present.
PMR pro and HeronNS Agree also with 'it warned you with short sharp attacks and it is saying you aren't listening' - you got it in a nutshell PMRpro! Managed it better today with two doses of paracetamol 8.30am and 1.00pm but will take advice and see if physio will help longer term. Think stress levels were also lower today as this was second day of workshops and journey in was less stressful because I drove in later missing rush hour.
SheffieldJane - will explore diazepam as a future quick fix remedy.
DorsetLady - will implement your strategy of 2.5mg pred top up as an 'on the day emergency measure' if need be.
Have arranged with my boss that for times when I am not required to lead from front, I will be to the side of the auditorium where I can sit / stand and be free to adjust my position to my hearts content.
HeronNS your last sentence tells me you already understand what drives me to find the solutions in order to make it happen for the children.
Thanks to you all. I now have a plan and will let you know how it goes xxxx
Just occurred to me - I used to sit against a radiator when it was really bad and that helped. When I was immobilised by it I sat in an upright chair (the wing sort, you know what I mean?) with a hot water bottle on the really bad spot.
Marilyn, you thought a 'Celebrating the Positives' thread would be good. Well, you are going to have one heck of a post to kick it off after this! Good luck with everything, hope both you and your students have a wonderful experience,
Marilyn, I have back problems too. I use Volterol gel to help with it (and on my knees). My gp prescribes it but you can buy it. I also take paracetamol based painkillers to help with the non-pmr pain. Hope your project goes well and you are able to rest when its over xxx
Hi All, just to let you know the music festivals went exceptionally well. Thanks for all your help in planning the management of my health to ensure I was able to function and honour this commitment. It meant the world to me. My colleagues were also very grateful to you too! ( I have told them all about my new on line friends on this site). Thank you all so much.
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