Should I apply sick day rules following a foot operation?

[Mfaepink1973]

I had an operation yesterday to remove osteophyte ring from around my big toe. I’m home now and it’s very painful despite taking the codeine 30mg they prescribed. My PMR is no different and I’m on 6mg prednisolone but am I supposed to apply sick day rules or do I only do that if PMR gets worse?

[PMRpro Ambassador]

If the codeine alone isn't doing the job - ask for something more, you can take paracetamol if it is just codeine they gave you, not if it is cocodamol. Pain relief post op is crucial.

According to this,

addisonsdisease.org.uk/newl...

they say to apply SDRs under 5mg so just be wary I think. Though a couple of days at 10mg wouldn't hurt really. SDRs aren't anything to do with the PMR - increasing for a flare is a separate factor and both could apply here - the increase for illness is to give your body a better chance of dealing with it despite poor adrenal function which under normal circumstances would provide a spike of cortisol to help the body heal and recover.

[Mfaepink1973 in reply to PMRpro]

Thanks PMRpro for clarifying things for me. I was just prescribed the codeine so will try paracetamol as well and will increase my pred to 10mg for a few days. The anaesthetist came to see me after the op and emphasised that because I have PMR I am more at risk of infection and to contact the hospital or GP immediately if I have any signs of infection no matter how insignificant I think it may be

[PMRpro Ambassador in reply to Mfaepink1973]

In that case - since you have the contact, I'd call the hospital and ask about pain relief, Whatever you do, with the codeine for goodness sake avoid getting constipated!!! Prevention is better than cure!

[Mfaepink1973 in reply to PMRpro]

Yes the prescription label has a warning in capital letters that it may cause constipation. I’d better find that Tin of prunes that was lurking at the back of a cupboard🤣

[PMRpro Ambassador in reply to Mfaepink1973]

Personally, I thoroughly disapprove of codeine being handed out without an accompanying script for a suitable laxative!

[Mfaepink1973 in reply to PMRpro]

Yes that would be handy as I can’t nip out to the chemist so will have to wait for a son/daughter/ grandchild to visit and get me some. Meanwhile it’ll have to be the prunes!🫤

[PMRpro Ambassador in reply to Mfaepink1973]

I don't think they think of the logistics! I was discharged from hospital last week with a script for pantoprazole. It never occured to me to ask at the hospital pharmacy and the pharmacy here is the other end of the village, hadn't got the oomph by the time I got home under my own steam to go and fetch it there. Got me out of the door the next day though but I had had a lower dose at home already so it was fine.

Some chemists deliver - and I'm pretty sure had I rung ours someone would have called by with it on their way home.

[Mfaepink1973 in reply to PMRpro]

They must all assume we’ve got someone at home who will deal with getting prescriptions filled or buying laxatives etc. Chemist here is closed until Monday morning so will try to use paracetamol instead of codeine unless the pain in my foot gets intolerable. Thanks so much for your advice

[PMRpro Ambassador in reply to Mfaepink1973]

If it is plain codeine, you can take paracetamol too, otherwise codeine is a better painkiller than paracetamol for most people if you want to take only one. If they gave you cocodamol, that is already a mix of codeine and paracetamol and you must not exceed the max daily dose of paracetamol.

Is your family far away? I would expect mine to appear on the doorstep if they weren't too far. Mine are well over a 1000 miles away though!

nhs.uk/medicines/codeine/ta...

[Mfaepink1973 in reply to PMRpro]

My youngest son lives with me but is at work when the chemist is open, my other 3 live less than 70 miles away but youngest daughter has just phoned to say she is on her way so I’ll get her to go into Asda in the nearest town tomorrow. Like you I live in a village and it’s 24 miles to the nearest town. Thanks again for all your sound advice

[PMRpro Ambassador in reply to Mfaepink1973]

Ah yes - but my village has a chemist, shop, baker, butcher, PO and a couple of doctors despite being only 2,500 people in the main bit. We are also only a short distance to town by train or bus!

[Mfaepink1973 in reply to PMRpro]

Sounds idyllic!

[PMRpro Ambassador in reply to Mfaepink1973]

It is most of the time - tad parky this morning at minus 18C though!

[Mfaepink1973 in reply to PMRpro]

Brrrrr🥶

[Karenjaninaz in reply to PMRpro]

“Codeine is a better painkiller than codeine”?

[Mfaepink1973 in reply to Karenjaninaz]

I’d assumed it was a mistype and Pro meant codeine is better than paracetamol

[PMRpro Ambassador in reply to Karenjaninaz]

TA - did no-one else notice????

[DorsetLady PMRGCAuk volunteer in reply to PMRpro]

😉.. but then I can read your mind….

[Mfaepink1973 in reply to PMRpro]

I knew what you meant!🤣