What to do about work

[Fozzes]

I’m a 57 year old man. My job is a gardener, 3 days a week. I’ve just been diagnosed after suffering aches and pains and then losing the use of my arms, severe shoulder and hip pain. I’ve been signed off work initially for 1 week and started on 15mg prednisone last Thursday. I’m sleeping better and have less pain but really not sure about going back to work. Anyone in a similar situation?

[Hidden]

Welcome Fozzes

The first thing is to say you will certainly need a period of rest & possibly a week may not be long enough to assess how you are feeling.

The issue is that although Pred dampens down the symptoms it does not actually do anything for the disease which unfortunately has a mind of its own.

A physical job such as gardening may be difficult to manage as our muscles tend to react badly to being over worked, it’s more of a time will tell to be honest.

Men on the whole seem to recover better than us gals again a bit of a mystery as to why.

You’ll get some more replies in due course & hopefully from guys who actually do physical work as they can offer you further advice.

For now though l think it’s a case of wait & see how the first few weeks/month play out for you.

Once again Welcome

Kind Regards

MrsN

[Fozzes in reply to Hidden]

Thank so much for taking the time to reply, much appreciated. I’m speaking to my doctor tomorrow so we’ll see what she says.

[PMRpro Ambassador]

We have had someone before who worked as a gardener but I'm afraid I can't remember the name to find his posts.

15mg is the bottom end of the range for PMR - you may need a tad more to get a good result. It is difficult to say how you will get on - your muscles will remain intolerant of exercise despite the pred and heavy lifting and similar activities may be difficult - you will develop more muscle soreness than usual that will probably take longer than you expect to resolve.

We do suggest keeping up with a level of exercise you can manage but that varies from person to person. Often men do better than women - probably because they have more muscle bulk in the first place - and also people who have a good level of fitness to start with and are diagnosed and treated quickly do better.

Are the 3 days in a row or can you choose the days so you could have rest days? Are you self-employed? I think you might be better with a bit longer off to start with so you can see how you go.

[Fozzes in reply to PMRpro]

Thank you, good advice, much appreciated

[PMRpro Ambassador in reply to Fozzes]

Forgot to ask - is this landscape gardening or normal stuff?

[Fozzes in reply to PMRpro]

Bit of everything. Grounds maintenance and handyman stuff too. Employed.

[PMRpro Ambassador in reply to Fozzes]

It may depend on how helpful your employer is prepared to be - I think PMR does come under legal protection in that there should be some accommodation for disability. Others will know far better than me though.

[Hidden]

If you are asking the question you know you are not quite ready for work. But do try and stay active so you don't lose your muscle bulk. My brother in law does a similar job and I have seen the physicality of autumn on him when he is getting the gardens sorted for winter into spring. So start thing now if you can do something like Mon/weds/Fri or similar to give your body a rest. You may have to stop for a rest every 30mins or something too. So cram your rest with gentle activity while you can and see how you feel. The main thing is not to push too hard. As others have said many men have a better time if it so fingers crossed that's the case for you too. Especially with a physical job.

[Fozzes in reply to Hidden]

Thank you Poopadoop! Good advice

[piglette]

There is a lady with PMR who does the garden for my next door neighbour. She says that she does need to rest, but she is a very knowledgable gardener and has done lots of training. She tends not to do heavy spadework.

[Raven1955]

It's a real balancing act but hopefully you should be able to continue working within the confines of your "new normal". You're just getting started with living with PMR and that alone has its own set of challenges, even without the complications of a job.

I worked full time 40-50 hours/week, was diagnosed with PMR at age 61 and am just hitting the 3 year mark of living with it. My work was 30% office and 70% deliveries, heavy lifting and lighter lifting but dealing with 100's of boxes that had to be loaded and unloaded. The initial prednisone treatment was working wonders and after a week I dove back in to my work full blast...........and got knocked back down. Enough about myself.......

I think you'll want to feel pain-free or fairly close to it before hitting the physical work too hard. It's a real balancing act. Work hard for too many hours and you'll find the pain and fatigue crippling you once again. I am continually looking for the level that allows me to get my work done, but without going at it too hard. Fatigue is just as big an issue. You can sail along quite well for a while but if you're doing more than the PMR will allow you'll find the pain and fatigue knocking you down - sometimes worse than it originally was.

Don't expect to do everything at the level you USED to be able to. That was your old life. Now you need to closely listen to your body and adjust you work to what you can reasonably tolerate. It's a lot of trial and error. Unfortunately the error part involves fatigue worse than I've ever known and a revisit of the PMR pain. Overdo it and you will get knocked down sooner or later. Trust me on that one. I learned the hard way before I ever found these forums.

You should be able to do what you've done before at work but not at the same speed and probably not as easily as before. It is a real balancing act but listen to your body and you'll find that balance - although it constantly changes.

I just finished a good week of work - 40+ hours but pushed it a bit too much and the fatigue laid me out for most of this weekend. Feeling good again but lost the weekend because of it. I wish you the best.

[Raven1955]

Forgot to say, NOW my work is 70% office and 30% deliveries. Part of the balancing act I had to do.

[Fozzes in reply to Raven1955]

Thank you, really helpful to hear another working mans point of view. All the best to you

[Blearyeyed]

I think that you will definitely need to take extra time off from work , get used to your medication level , then try some experimentation with some of the jobs you do as a gardener to assess if it is possible for you to continue or if you need to change what parts of the job you can regularly do.

Depending on the size of gardens and types of the gardening you have to do as part of your job , that activity can be a trigger to new PMR pain or Flares and increase the days of Fatigue you suffer unfortunately.

I am a Nature and Land Artist by profession , which involved alot of the more heavy activity jobs of a Gardener .

I am probably in a different position to you , all of us are hit with different levels of severity and can have other conditions adding to the symptoms, I have other health issues that also cause me joint pain and stiffness apart from GCA/ PMR , but I found the PMR/ GCA conditions were the final nails in the coffin for me to continue doing my work consistently each week , let alone each day. At present I'm not able to work at all because of the pain it causes for me.

I know that even when my symptoms aren't severe things like pruning , dealing with trees , heavy ground clearing or even spending alot of time weeding a plot or walking up and down with a full wheelbarrow takes its toll in a way that makes your old post gardening aches and pains pale into insignificance.

I also realise that for many of us we cannot afford to take too much time away from our work if the money is an essential part of our monthly budget so a balance needs to be found.

If you can I'd take a month away , and in the last week try out some jobs and assess how much you can do at a time.

If you find some jobs cause considerable pain or post work Fatigue you might need to take them out of the jobs that you offer to your clients if you are Self Employed , or , if you work in a team , discuss with your boss adapting your duties to ones that your can cope with , passing the more heavy duty jobs to other members and taking over their lighter duties , like mowing or light weeding.

You will also need more rest breaks between your daily jobs and to work in shorter bursts with lots of fluids to help cope with it.

Keeping your vitamin and mineral levels up will also be important , as well as possibly taking an antihistamine even if you don't generally need one ( as long as it doesn't contraindicate with your other meds ) as your immune system is weaker with PMR/ Pred and insect bites or scratches from plants can cause allergic reactions that they didn't before.

You also need to be more careful with Health and Safety with what you handle , dress appropriately for the weather , use sunscreen , and use your gloves all the time and often a mask as you are more prone to getting an infection or injury when taking long term steroids and it takes longer to recover from cuts and bruises too.

Then you should be able to continue your job without pushing it and causing more Flares that will mean more time off work to recover.

It is going to be a case of easy does it and trial and error , as it is with any jobs that people do with PMR that have alot of physical work involved I'm afraid.

Many people find that with physical or high stress jobs that they do need to do part time or half days to be able to continue working and not become ill.

Good luck with it , keep us posted about how you get on , you could end up discovering lots of good tips that you can share with the forum about how to keep gardening that could help us all.

[Fozzes in reply to Blearyeyed]

Thank you, kind of you to reply and helpful advice

[karegodd in reply to Blearyeyed]

So true about the bug bites. I live in Northern Ontario and we are thick with all kinds of biting bugs. Never used to react as a kid but now it’s full blown reactions. The antihistamine is excellent advice.

[Fozzes in reply to karegodd]

Thank you

[squashie]

As always PMRPro has said it all very concisely.

What worked for me was to carefully read all of the very helpful advice, and then apply it to my situation.

When dxd last October I was a very fit 78 year old squash player and gym junkie. 15mg of pred brought almost instant relief of my symptoms - bilateral stiffness in the hips and shoulders. But I understood that the PMR was still chugging along in the background.

It appeared from the advice that men often have an easier time with PMR.

Most of the advice was to back off strenuous exercise, but knowing how quickly I lose fitness and muscle tone, I decided to continue with virtually the same regime as before. I reasoned that if this led to delayed onset muscle soreness or other problems I could back off a bit.

Now down to 5mg and still OK - although I suspect that the next few drops could be the hardest. Only physical setback has been a couple of hamstring strains - couldn't determine whether this was doing things a now 79 year old shouldn't be doing, or whether it was pred related - now think it's the former. After a 2 month break from squash (1 due to the hamstring and the other for a walking holiday) I'm now back on court and actually won a Masters tournament at the weekend.

My conclusion - if you can, steadily go back to what you were doing pre dx. Listen to what your body is telling you. Back off if you need to.

[Fozzes in reply to squashie]

Wow, congratulations on your recent win and thanks for the advice

[CSMM]

Maybe another week off . I’m 53 full time carer for my Dad I never stop Just have to keep going I’m very active gardening cutting grass power washing painting etc keeping my own home lists as you know are endless. My advice keep doing everything you can do and get plenty early nights I certainly have to I’ve come from 20 mg to 15mg since March I’m aching but trying to just keep going we are Youngish for this and hopefully many years ahead so try to keep fit as long as we can .

[Fozzes in reply to CSMM]

Thank you

[alangg]

I was diagnosed at 59 after thinking that I would have to give up my physical job - a freelance Live Event Technician; rigging lights, PA systems, building stages, etc. This was in December 2017 and I started on 15mg of Pred; I've reduced carefully and slowly using the DSNS system and am now down to 2mg.

The Prednisolone worked for me and enabled me to carry on working but I am probably a little slower and think more carefully about climbing ladders etc.

Contrary to other people's experiences, I find that after a spell of work; 3 days maybe or a week, the aches, pain and stiffness are not as bad as when I am not working. If I've had a few quiet days at home then I begin to hurt.

But this condition affects us all differently and only you will know what you can or can't do on the dose of pred that enables you to function.

Good luck.

[Fozzes in reply to alangg]

Thank you

[Waterfeature]

Hi Fozzes, I too suffered the very same pains as you, I couldn’t function without prednisone. I do not go out to work but am now on my own after the loss of my husband from cancer. There are many extra chores I now have to do. I have to pace myself otherwise I get extremely tired and have to rest. Sometimes for the rest of the day and often the next day.

Maybe if you spread your three day workload over the week it might help or if you can maybe only do two days.

I have flare ups if I try and do too much or am under stress.

Good luck

[Fozzes in reply to Waterfeature]

Thank you

[daworm]

I had a similar situation but I was able to take a few months off with pay, not full pay but sick leave type pay which was enough to pay bills, when I went back, I realized it wouldn't be easy as I was still getting sore and painful after work...millwright type repair work, so they put me on lighter duty for awhile...not everyone has a company that will do that though....its tough when you first get back...pace yourself...

[Fozzes]

Thanks for the advice

[karegodd]

Good morning. I was 56 when my pmr hit and tried to keep working. Prednisone treatment started when I was 57 and I lasted about two more months of work on the prednisone but then had to stop due to fatigue pain and short of breath. I have not been able to return to work to this day. I just know I can’t do it. My job was physical as I am a physiotherapist. I am now 59 and have resigned myself to the fact that I can’t return. My body is telling me that and i have to put my health as a priority. All journeys are different but that has been my experience.

[Fozzes in reply to karegodd]

Sorry to hear that