Teacher - Off work with AF

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Teacher - Off work with AF

Postby Zodiak » 26 Nov 2013, 09:03

Hello I am a Science teacher in the UK, and have been off work for three months now with a Fissure.
It still hurts but I can move around at home and most days are bearable, but I couldn't teach.
One problem at school is that we can only go to the toilet during break and lunchtime, which makes it really difficult if yo get desperate.
The other issue is that when it hurts, it really hurts and I can't concentrate on keeping the class busy and on target. Its a boys high school and once you loose class discipline it is a nightmare to tray and get it back.
I can have two or three good days, but then a really bad morning where my BM is huge and it hurts like mad for the rest of the day and I feel like I have been kicked up the butt for days after, including the ever present burning sensation.
I had no idea that this forum existed and have already been inspired by some of the posts.
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Re: Teacher - Off work with AF

Postby MarathonGirl » 26 Nov 2013, 09:47

I am a teacher in Canada and you're right, it's very tough to be able to go to the bathroom when you need to. I was in a desperate situation yesterday at one point, but thankfully it was a really well-behaved, small class; they were very busy and I wasn't gone for long. I teach instrumental music and English, and spend little time sitting down, thankfully, because some days I can't sit because of the pain. I have read about people who had desk jobs, or jobs where they needed their car a lot, and had to quit their job.

I've had my fissure for 6 weeks and am already thinking about getting the LIS, even though I would have to miss 2-3 weeks of work. Have you thought about this as well?
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Re: Teacher - Off work with AF

Postby Zodiak » 26 Nov 2013, 10:43

Thanks, the medical system in the UK is different. Personal medical insurance is rare, we have the national health service, where your local GP refers you to a consultant and you can wait months to be seen.
I saw him last week, he asked me to describe the pain, and said without even looking, that I would be better off not having the operation and if I want it I would have to pay, but as I don't have insurance that is not really an option.
My school didn't want me there if I could not function properly but I have been off since September and I think I will have to go back soon and just try to cope.
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Re: Teacher - Off work with AF

Postby Ever the Optimist » 26 Nov 2013, 16:35

Zodiak,
I'm from the UK and I'm a little shocked - Who on earth did you see, who didn't even bother checking you properly? and then suggested you didn't need the op but could have it if you paid for it? Was this an NHS consultation because if so, that's terrible?!...........
Have you been prescribed Diltiazem or Nitro?? Was Botox suggested? What is the next plan?
If nothing has really been done, I would suggest going back to your GP to ask for another referral if you can to another CRS - because that didn't seem too helpful?
LIS is available on the NHS, but will always be offered as a last resort because of the expense & also not to women of child-bearing age due to a risk of increased incontinence.
If you haven't been prescribed anything just yet, you could try going back to your GP for Diltiazem or Nitro, which might help you a lot at this stage....
I assume your school are aware that you have a medical issue - because of the time you have had off already, but have they discussed making workplace adjustments for you? (i.e. ensuring that you are as comfortable as possible when teaching) or bringing you back in on a phased return/ part time hours? They have a legal duty to do these things and if they can't make your RTW as easy as possible, you really have rights to complain.
If you don't feel happy you have been offered proper treatment, please go back and sort it out and as for school, there really are things that should be done to support you more, so go back and ask some questions.
I hope it all works out for you and things resolve quickly soon :)
Chronic Fissure diagnosed December 2011
Healed by Diltiazem around Feb 2013
Anal Fistula followed burst abscess in June 2012
2 internal troublesome piles remain & suspected, but undiagnosed, ongoing Levator Ani type symptoms & flare-ups
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Re: Teacher - Off work with AF

Postby Zodiak » 26 Nov 2013, 16:53

ETO, thanks for the reply.
It was one of those privately run NHS treatment centers, he asked questions about frequency and pain etc, then when I mentioned IBS he went on to talk about that.
In fairness when I saw him I had just had 4 days with almost no problems so when I asked about an OP he said that as I was feeling OK at that moment then a natural recovery was possible and preferable. I don't know if that was patient care or money talking.
Child bearing is not an issue. I am a bloke :-)
I mentioned it to my GP, who has been terrific, he diagnosed the problem very quickly, prescribed Nitro and actually made me feel like he cared. He wasn't too happy about the consultant and is going to "have a conversation" in the mean time he said that I could be referred to another consultant but that would mean a 60 mile trip to London.
Alternatively I could pay at another local private hospital, but guess what, its the same consultant as the other one!
School have been terrific, and have agreed to help how they can, but the practicality is that teaching teenage boys is a full on job and you need to be at the top of your game of they will walk all over you.
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Re: Teacher - Off work with AF

Postby Scientist2516 » 26 Nov 2013, 17:42

Hi Zodiak,
Good that you have nitro to use. I just want to give you some words of encouragement - it does take time, but when I started to use nitro I started to improve almost immediately, and am now cured. (It's a bit more complicated than that and if you are interested look at my topic a-one-person-experiment-on-af-drugs-t7231.html).

You probably know a lot of this already, but curing an anal fissure is a multi-faceted process.

1) relaxing the anal sphincter to increase blood supply and ease the spasms. Nitroglycerine or other medications (diltiazem and nifedipine) can also be used, so if nitro doesn't work for you or gives you bad headaches, you can switch. Heat is another great way to ease the spasms and increase blood supply. Some people use baths, sitz or full baths. I used a hot water bottle.
2) keeping your stools soft, to reduce pain and trauma to the fissure. First, drink lots and lots of water. Second, increase the soluble fibre in your diet (lots of diet tips and advice on this forum). Third, there are stool softeners and laxatives galore. Some will work better for you than others.
3) Other pain management. Unfortunately, not many pain killers seem to touch an anal fissure. I found ibuprofen to help a bit (not much but enough to keep me sane). Again, a hot water bottle can be a life saver. You can't sit in a hot bath for ever, but you can spend hours on a bottle. Very warm rather than hot.

I'm sure there are other things, and you are probably already doing lots already. If I had to say what helped me the most, I'd say water, hot bottle, nitro.
And rest. You've got to take care of yourself.

It's really good that your school is being understanding. I have a teenage boy, and yes, he's a handful just by himself.
Nifedipine/lidocaine, no help
Diltiazem, effective, but caused major rash
Nitroglycerine, effective.
Topical estrogen for final healing.
Gentle heat to bottom - pain relief, muscle relaxant
Kondremul mineral oil
Time - lots of time.
Status - Healed!
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Re: Teacher - Off work with AF

Postby Zodiak » 26 Nov 2013, 18:23

Thanks Scientist2516.
The nitro was OK at first, but now it stings like mad and I have had to stop using it.
1 - Bath is not an option, we converted it to a walk in shower as my wife had a back problem.
2 - Yup, I am onto the lots of water thing and am using "Fybogel" as as softener, which seems to work.
3 - Due to other medication I can't take any pain relief apart from paracetamol, and that doesn't seem to help at all.

I guess my problems are normally with the first BM of the day, about 5 minutes after I get up. If it is soft and not too much I will probably have a good day, but if it is too much or starts too hard then if feels like I am trying to pass a road cone and it hurts like heck for the next 48 hours or so.
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Re: Teacher - Off work with AF

Postby Scientist2516 » 26 Nov 2013, 20:15

Wow, that sounds really rough.
If you can't have a full bath, you can still do the sitz bath - it's a basin that fits over the toilet. I didn't like it and much prefer sitting on a hot water bottle, but lots of people here swear by their sitz bath.
If nitro is causing you problems, definitely try diltiazem or nifedipine. I had to try all three before finding out what worked. It's terribly discouraging, especially as you have to deal with these problems on top of being in lots of pain, but don't give up! You may have to experiment quite a bit to find out what will work for you.

I'm sorry you are going through this, but believe me, you will get better. It can take a long time. It took me three months, and it felt like MUCH longer, but now it's over. There were set-backs, and every time I'd be plunged into depression again, but each set back was easier than the one before and over time I did heal. You can do the same. Keep venting here if it helps - we all know what it's like.
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Nifedipine/lidocaine, no help
Diltiazem, effective, but caused major rash
Nitroglycerine, effective.
Topical estrogen for final healing.
Gentle heat to bottom - pain relief, muscle relaxant
Kondremul mineral oil
Time - lots of time.
Status - Healed!
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Re: Teacher - Off work with AF

Postby Zodiak » 26 Nov 2013, 20:37

Thanks.
It seems that if I can produce a BM last thing at night the following day will be fine, but that's not always possible :-(
(That's why I am still awake at 1:30, hoping that something will happen)
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Re: Teacher - Off work with AF

Postby MarathonGirl » 26 Nov 2013, 22:03

UK teacher: I thought about your story all day today. Today was a "bad day" pain-wise for me, meaning sitting/moving was very painful all day. Getting to the end of the day teaching grades 7-9, in agony but pretending nothing is wrong, is starting to take a toll on me. I am so relieved when the students go home for the day, so I can come home and lay down with my hot water bottle. Today at work I wondered why the f**k I am putting myself through this torture, but if I stayed home, I would't have anything to take my mind off the pain, and before this all happened, I didn't realize how much I truly *love* my job.

I am really depressed right now - and I never get sad!!! PLEASE tell me how you got through such a dark time!
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