Time flies when your a mum!

Hi there!! Just a quick update…

So, firstly… My how times flies!! I don’t know how mums do anything other than cuddle, feed and socialise with their yummy babies!! 🙂

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Update on my post partum flare… I got back to my clean eating and have stuck to it since getting back from hospital!! It has most definitely helped, the aches and pains have eased, but I am still managing a certain amount of pain.

It’s so difficult to be able to balance all the variables… Last weekend I did lots of dog walks with Seb and Andrew… And my knees blew up like balloons. Epsom salt baths sorted those in 2-3 days.
Over this week aches and stiffness have crept up on me in the neck and shoulders – from lots of lifting an ever increasingly heavy chunky monkey (Seb.. Not Andrew!!), and broken/disturbed sleep.
And this weekend I did some silly stretching of my right wrist to try to avoid it stiffening up at a Christmas party… But instead, just flared up my Oarsman’s Wrist!!! This I have managed with mag oil, avoiding aggravating it, and today my friend did some acupuncture… So fingers crossed… Although not, as that hurts!!

My new addition to my natural management of my RA is magnesium… In the Epsom salt baths and mag oil (homemade!)… I’ve only started this week, and there is SOOOOO much to learn about minerals and their balancing! I haven’t done any testing yet to see what my levels are, but since a huge proportion of the population is deficient in magnesium, it’s my first port if call!!

Next on my list to add are: fish oils, essential oils, kefir/kombucha, fermented veg… (Bought my mum a book on fermenting and going to set her the task of keeping me stocked up!!! I just don’t have the time or the wrist strength for all that veg prep yet…!!).

There’s lots to consider adding to my routine, it’s quite overwhelming… But I remember how overwhelmed I was before changing my diet… So as long as I take things one at a time, surely I’ll get there… I could just do with a good straight 10 hours of sleep…..!!!! Ha!! Never again I suspect!! (But I don’t mind, because my little boy is perfect!)

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Why I’m not a food blogger…!

Since starting my food exploration I have had to get a bit creative with ideas for dinner/lunch. It’s handy because Andrew really doesn’t mind from Monday to Friday if he just receives protein source and veg… it’s what he grew up with (however the protein sources are VERY different from his childhood… and so are the veg for that matter!! And it’s not now topped up with an enormous portion of potatoes and bisto gravy!! Much to his pleasure thankfully), but for me, my parents were always a little adventurous in their food endeavours, and variation was key… so I do get a bit bored… or if not bored, I just feel the need to create a variety of dinners and food…

Now, I feel that on the days when I try to get creative I have on the whole been quite successful (even if I do say so myself!!), and I have been really quite proud of the taste sensations!! But, before I can show off to anyone about how great meals on this restricted, but gradually increasing elimination diet can be… I’ve eaten it!! Mmmmmm!!

Plus, despite being totally in love with photography… food photography just has never inspired me! Can I really be bothered to get out my lovely camera, just to take a few photos of my dinner… nah!! The light in my kitchen is all wrong, plus it’s October, annd England… there is no natural light at tea time round here!!
So the few… well two things that I have managed to take photos of before they became an empty plate are: A cherry ‘cheese cake’ made for my birthday so that I could enjoy a little (modified) AIP treat:

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And last night’s Prawn and Squid coconut curry:

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As you can see… I’m no food blogger! Things I do wrong:
1) The cake was already half eaten
2) The crockery is OLD!! And chipped!!
3) The background isn’t clear
4) The lighting is all wrong
5) The angles are all wrong
6) The presentation of the food is not considered
7) The photos are taken by my iPhone or iPad.. Not even a compact camera!

To name just a few… but, mmm they didn’t half taste good 🙂

And at the end of a day, that is the main thing I care about! Cooking good healthy food that is helping my body heal itself…

So… what’s for tea tonight?

A lesson in over doing it!

I’m planning a proper blog about how my elimination diet has gone/is going… But for now just a quick note on that. It seems to be going pretty well!! And I couldn’t be more pleased!!

Now… A little reminder to listen to your body!! Yesterday, joints felt good, but generally I woke feeling pretty tired, at 6am and I had had a busy week so far… But once I was up and dressed… I ended up mowing the lawn, doing a big shop (to Costco for baking ingredients, and farm shop for special stuff), then when I got home I spent nearly 3 hours stood in the kitchen preparing lots of fruit and meat for the days ahead… In an attempt to make life easier for the following few days… Forgetting about today!! 17.00 came, and I finally sat down…. Uh oh! Swollen knees, fingers and a very painful right shoulder and neck… Off to bed at 21.00!!

I think my knees were down to 1) being on my feet ALL day! 2) wearing shoes that I’ve not worn for years due to my feet being to swollen!!

My shoulder and neck was due to lifting the mower tub into the compost bin… The lawn seriously needed a mow, so I did this A LOT!! and the grass was a bit damp!

And hands just down to everything, the mowing, the chopping, the kneading etc…

I’m pleased that I felt capable of all the above, but I knew I was tired, and I didn’t rest, I certainly didn’t pace myself… And I paid for it! Today my knees are much easier, but still sore right on my patella’s. Hands gradually easing, shoulder gradually easing….. Today’s to do list….. Well, it’s long, but I will just get what I can do done!

Priorities… Baking (which I am trying as we speak)… As it’s my birthday tomorrow!!! And as much as I’m loving my new diet… I need something delish to celebrate with!!

Things I can do…!

Here’s a little list of things I can do since changing my diet, that 2-3 weeks ago I couldn’t:

Sleep through (despite being 32 weeks pregnant!)

Roll over in bed without yelping/crying

Pull my own covers over me in the night

Get out of bed on my own without help

Sit onto the toilet without ‘dropping’ onto it or using the radiator and bath either side to lower myself

Squeeze toothpaste onto my brush

Stand for the whole time I brush my teeth

Put on my own socks – quickly!!

Do up buttons and zips

Pull up own trousers… Even maternity ones

Put up my own hair

Walk down stairs one foot In front of the other without using the banister

Make breakfast including lifting pans

Open some jars and bottles

Empty the dishwasher

Squeeze pegs enough to hang out the washing

Walk without a waddle or a limp (despite being 32weeks!!)

Walk dogs (2 big ones at that) about 3 miles most days

Get in/out of the car without help

Chop veg, even squash and swede

Spend the day in the Lake District without wanting to go to bed immediately on return home

Mow lawn

Swim 20 lengths plus without repercussions

Get on/off the settee without help, even at the end of the day

Get up stairs one foot in front of the other without the banister

I’m sure there are other little things that I manage and think ‘whoop!!’, but my memory fails me!! I am growing a baby! 🙂

On balance just to add…

I still don’t have any bounce!! So I can’t jog, run up stairs (tried yesterday in a moment of exuberance!), and I can’t squat/crouch, or get on off the floor…. But hey!! I’m working on it!! 😉

Feeling good!!

Just felt the urge to post a little yippee!!

It’s 10pm on Thursday evening, and today I have: fed the house their breakfast (AIP elimination friendly), been swimming (20 lengths plus exercises and stretches), gone shopping (food plus a pair of slippers – essential!), mowed the lawn, done some agility training with the dogs, made tonight’s tea and half of tomorrow’s tea (AIP elimination friendly) done a very small bit of hallway decorating (Andrew has done 95% – but I like to feel I’ve helped!!), had a bath, and still I’m able to walk up the stairs one foot in front of the other… With minimal use of the wall for stability!!!

Now, don’t get me wrong, I’m by no means pain free… my main complaint today is a right elbow that won’t straighten! (And sore knees getting off the toilet!!).

But to manage all of the above in one day…?! It certainly wouldn’t have happened two weeks ago… There certainly is something in the water (or should I say food!!).

I’m so glad I took the plunge to eliminate and scrutinise my diet… Here’s to a healthy future!!! 😀

Back to work – day one!

Hooray!! I did my first day back to work yesterday!!

It was non clinical and only 9-3.30, but it was great to be back in the world of the living!!

I love my dogs to pieces, and the conversations I have with them keep me amused and in company all day… But it is quite nice to have conversations with a variety of humans from time to time too!

I’m just doing 2 days a week, with a rest day in between which I am thankful for as today I am struggling to straighten my right elbow. I wonder if this is due to the use of the phone, mouse and pen on that side… I am VERY right handed!

Any hoo… Today the plan is to get a few more bits for tea tonight and tomorrow, to go swimming, and to do a bit of dog training… And maybe a nap!

A new start with the diet…. So far so good!

Something I have been considering for quite some time now is a change in diet in an attempt to reduce my RA symptoms… I wrote about it in Food Glorious Food, I’d been sceptical and also scared… I love food, I also love eating healthy, but I’ve always enjoyed a treat, a beer, a brew, a steak… The list goes on.

But the pain remained and as I draw closer and closer to my due date I worry… Will I be able to function as mum?! How will I cope? So since being off work (sine the 25th July, going back on Wednesday 3rd though!!) I have looked further into this option, I’ve read around quite a few places (by no means all… But I’d still be reading if that were the case!), and I decided to take the plunge. A few weeks back I had swapped from milk to soya for my brews and cereal, and had noticed a bit of an improvement, but after some serious consideration, I decided to go the whole hog and start an elimination diet…!

One of the main reasons I had felt sceptical was that I struggled to find the information I was looking for, but just kept coming back to the Paddison Programme, I’m sure he has a huge amount of information to provide, but I some how feel uneasy about paying online to get advice…. Especially since I couldn’t find anything else… Then one day I was on a RA Facebook group and someone mentioned Rheumatoid Arthritis Managed Naturally, so on I went and found so many answers to so many of my questions. Plus lots of files and resources, and information about where to look. AWSOME!! I straight away bought the Paleo Approach and the cookbook, and The Gerson Therapy book (there are LOADS of other resources out there, not just those two books, it’s just they are the ones I’ve started with!)…. I know… Why am I happy to pay for advice via a book, but not online, well 1) the information in the book is available else where, it’s just easier to read all in one place in a book. 2) I like books, and they are full of references, 3) my studies taught me to be sceptical of web based information! (Despite more and more information these days being web based!). Plus I’ve found some blogs that give me recipe ideas, such as Paleo Mom, and I’ve got myself back onto Pintrest in an attempt to scrap book together recipe ideas and inspiration. Planning planning planning, because it’s going to be so easy to pick up a Danish if I’m out and haven’t planned something ‘elimination’ friendly!

On august 21st I started a brief food diary of what I was eating,with the view to starting my elimination diet on the Tuesday 26th. In the run up to starting my diet I ate RUBBISH!! Not overly intentionally, but I kept thinking if this is the last time I get to eat a Danish pastry, I’m going to have it!! I’m sure that’s human nature….?!

Tuesday 26th came around, and the diet began…. I have eliminated: dairy, gluten, nightshades, legumes, citrus, seeds and nuts, meat (except Turkey, fish and wild game), certain cooking fats (currently using avocado oil, coconut oil and a little olive oil), alcohol (not hard being 7 months preggers!!), caffeine, sugar…. They are the main things I think!

I’m aiming to stick to this for about 3-4 weeks, then start some very gradual re-introductions, with a view to finding out what, if any are triggering my flares and making me feel so rubbish.

When you look at what I’ve cut out, it looks like there’d be nothing left to eat, but… In fact there is plenty to feed a hungry pregnant woman, and thankfully due to the fish and wild game, I don’t feel like I’m depriving ‘bump’! Yes…I have to prepare it ALL, no convenience any more (thank god I’m off work at the moment!), but it feels good to be eating nutritionally!

After my re introductions, I really hope to be able to follow something along the lines of the Paleo Approach, as it makes since to me, and it is pretty much all the foods I love to eat… It’s just I have to make them, rather than buying from a supermarket! Which again, is no bad thing, especially if it means I’m healthy! But I’m willing to accept a more vegetarian diet if needs be to keep me well.

So…. How has the first nearly week gone I hear you ask….? Well, a hell of a lot better than the acupuncture and hydrotherapy!!

In the last 6 days, the swelling in my right knee and left ankle has reduced, including the pain (although not gone!), I am sleeping through the night, maybe waking briefly for the odd position change, pain in my hands and feet is still present in the mornings, but it’s only lasting about an hour, and instead of it taking 4 minutes to put on my socks (yes, I timed it!), it now takes me seconds :-D. my hands look wasted, which they might be… My grip certainly isn’t what it once was, but it could also be they they aren’t fat puffy mits anymore! My fingers still have thick joints, swell a bit and are stiff… But I have had RA for 7 years! This weekend, I have been able to go up and down stairs one foot in front of the other (not every time, but I’m still chuffed!), and I don’t always have to hang on to the banister rail. I’ve been on more dog walks, some even on consecutive days, and yesterday managed a lovely 3+ miles walk in the woods (furthest, and most undulating walk I’ve done since being pregnant!). And I am even able to clean the kitchen whilst the dinner is cooking, including un-stacking and re-stacking the dishwasher!!

Now don’t get me wrong… I still have pain, I still have stiffness, I still feel fatigue… But it is all much less, and considering this is all in 6 days… I’m pretty chuffed!

Of course, I’m aware, it could be many variables leading to these changes…. 1) the rest from work is finally giving me some benefit 2) placebo? Is it the positive mental attitude from the reading around of something I believe should work (only after reading the science!)? 3) maybe baby is finally kicking out some steroids like all my midwives and consultants kept telling me it would…. Or is it the diet?! I guess time will tell!

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Acupuncture… Wish I’d had my tutor as a clinician!

In a previous blog I planned to do a blog about acupuncture and/or hydrotherapy, adding in some research, and I did start looking into the papers… but for some reason my heart just wasn’t in it! And if you have ever tried to read a research paper when your hearts not in it you will know that they are the perfect antidote to insomnia!!

 

So instead I will just give you a run down of my personal experience! I’ll try and give you a brief history of acupuncture first from my notes taken whilst training in acupuncture earlier this year, unfortunately I haven’t really had the opportunity to practice my acupuncture since the course… and you certainly can’t acupuncture yourself effectively!

 

There are two recognised types of acupuncture TCM (Traditional Chinese Medicine), and the western approach.

TCM is known to stretch back as far as 3000 years, it is a holistic concept of treatment and a recognition that the body has the ability to return to a balanced state of health/repair itself given the correct stimulus. TCM aims to balance ying and yang (two opposing energies), takes into account the 5 elements (Fire, Earth, Metal, Water and Wood), and along with assessing the pulse, and tongue (and a few other bits and bobs) TCM practitioners try to gain access to the energy that circulates in the body to restore balance and subsequently healing.

 

However, the NHS can’t really work to those guidelines!!! Western medicine needs evidence based practice, it needs proof that what it delivers is backed by clinical evidence and is cost effective. Practitioners have had a good idea that acupuncture works in certain situations, and therefore it has been dabbled in in western medical literature since the 17th Century, but only really has there been any western systemised clinical trials since 1950… so we are a touch behind the Chinese with this one! Sadly western medicine tends to ignore the wealth of evidence from China, to do it’s own. Evidence has been looking into the science behind how acupuncture works, the science behind pain, and how we can modulate pain, and has yet to look into how acupuncture can be used for asthma, gastric motility, mood, addiction, etc. etc. etc. in any great length.

 

What we do know is that acupuncture can have a strong analgesic effect… I’m not going into the science of pain and how acupuncture effects pain… that is was too much for my baby brain to take at the moment ***

 

Ok… back to my recent experience… As I said there are two approaches, I was trained by a western practicing physiotherapist who happened to be Chinese, and after learning the western way, has been to China to learn the TCM method also… He looks at papers from both sides of the globe for his evidence and teaching, and therefore stepped away from the rigid teachings of some western acupuncture societies to pass on his wealth of knowledge to hopefully produce good practitioners that get results, whilst still are able to backup their practice with evidence.

One of the main aspects of his teaching was that acupuncture needs at least 6 sessions (3 weeks getting treatment twice a week), plus there needs to be progression, so start with 6-10 needles (consider if this is unilateral or bilateral – so may need for example 6 needles per hand if treating hand pain) but increase number of or change points of needles as required, aim for 30 minutes treatment time, and make sure you stimulate the needles initially every 5 minutes until Deqi (energy – generally felt like a numbing heavy sensation – this is the sensation that enables people to undergo surgery with only acupuncture as analgesia!!) is achieved.

This is how both the western and TCM have shown that acupuncture gets results….

 

My acupuncture consisted of (despite my pain being widespread) once a week sessions of 30 minutes for 4 weeks, two needles in each wrist (this didn’t vary or change at all despite little help from the first couple of sessions), stimulated once per session, with no Deqi achieved, and a huge amount of discomfort 1) in the positioning of myself – have you ever tried to sit in one position for 30 minutes without moving an inch because you have needles sticking into your very sensitive skin, and 2) in the needle sites them selves as they were in so shallowly that they waved around in the breeze from an open window.

Acupuncture, although not a painless procedure – someone is sticking needles into you – is on the whole a very comfortable treatment. Most of your bodies pain receptors are in your skin, once the needle has passes through these into the tissues below there is very little to be felt. Acupuncture needles are sooooo much thinner than when you get an injection, and therefore are far less painful than any injection…. unless they are left in the superficial layers of the skin!!!

 

So all in all… I’m afraid despite how lovely my clinician was, my acupuncture was a huge failure, however this lady wasn’t used to treating ladies with RA, she’s used to treating pregnant ladies with low back pain and pelvic pain, and all the girls at hydro that I spoke to that were getting acupuncture for their pain were getting great relief, therefore I feel it was probably a lack of experience of treating other areas of the body!!!

I think probably my background knowledge also put me at a disadvantage as I was sitting there thinking… ‘this isn’t enough needles, there are better points around the hand and arm that could be used, the needles aren’t in enough, they haven’t been stimulated enough, I’m not getting that nice warm heavy numbing sensation’.

As they say, ‘if you believe something is going to work it probably will…. if you don’t believe in it it probably wont!’. I do believe in the benefit of acupuncture, wholeheartedly, just not my recent exposure to it!!

 

So, my advice to anyone who is considering acupuncture for RA… I’m sure it has it’s uses, but if your looking for a practitioner do your research!! Either TCM or Western I believe both have value, I think it is more important the level of experience that that practitioner has in treating YOUR condition or problem! Ask them how many people have they treated with these problems, what is their success rate, ideally get some recommendations from people who have been to them before, and check out their registration to professional bodies – anyone can do a couple of weeks course and pop a certificate up on their wall, but if they are registered with a professional body then they will be regulated!!

 

*** Pain is a really fascinating thing, and how the body and brain connect to signal pain or block pain is very interesting, so if you ever decide to look into it, there are thousands of books and websites and papers that go into it in varying amounts of detail!! Just be prepared to get your thinking cap on and give yourself plenty of time!

Embracing Research

One of my aims when starting out on this blog was to provide information regarding research into Rheumatoid Arthritis, and other related topics, and to encourage more participation in research. Plus help broaden my own and others knowledge on the subject of Rheumatoid Arthritis.

My rheumatologist is based in Leeds, at Chapel Allerton Hospital. They do a huge amount of research, and my initial experience of Enbral (Etanercept) was through a research study they were conducting at the time (EMPIRE study). The research arm of the hospital is the Leeds Musculoskeletal Biomedical Research Unit (LMBRU), and they have Patient and Public Involvement (PPI) groups meetings every two months or so. Go and have a look at their page, and check out their Useful Links for Patients.

Their next ‘Ask The Researcher’ PPI meeting will be held on Tuesday 12th November at 1 pm on Polymyalgia Rheumatica and Giant Cell Arteritis  presented by Dr Sarah Mackie and ‘ An Update on Scleroderma’ presented by Dr Francesco Del Galdo.

I personally don’t live particularly near Leeds (about a 2 hour drive!), and whilst I’ve been at work I have been unable to attend any of the meetings, but this is something I hope to change now I have a little more time on my hands… unfortunately it’ll be unlikely that I’ll be able to attend the above meeting as my due date is the 8th November!! I know many of you will also not be physically able to get to Leeds, UK, for these types of meetings however, my aim is to bring attention to this sort of thing happening, and that it may be going on at your hospitals too, so keep an eye out!!

And in the meantime, I will do my best to bring you any useful snippets from any meetings/groups etc. I get to attend!!

A Tough and Emotional Week…

It’s the Friday afternoon, of a very tiring and emotional week. My last post stated ‘but it will get better’… The toughness and emotion have been present all week, neither better nor worse, the outcome of the week, I think all though a hard one for me to accept initially, is probably the right outcome… So I think things will get better!

Last week I self-certified a few days off sick because my joints just wouldn’t let me keep going. Back to work on Monday… a difficult decision in some ways as my very supportive boss said as I left mid-morning on Wednesday, ‘take all the time you need and make sure your right before you come back, don’t rush back’. I appreciate the sentiment, but when every morning you wake up and feel rubbish, work or no work, how do you tell which morning is the right morning to go back? However, Monday came around, and I felt I should try a new week.

Tuesday morning I had a Women’s Health physiotherapy appointment that I had arranged whilst off, she was supportive, but as I know too, there is little she can really do. She can’t cure my RA, but she did offer hydrotherapy and acupuncture, which I have accepted. I’m happy to try anything that might help ease the pain or stiffness. I have been doing my own hydro of a fashion when going swimming, but it’s also nice to get other therapists ideas on exercises/rehab.

Wednesday was a day off (using my annual leave to break up the weeks), which worked well as I was exhausted after Monday and Tuesday, and hydro is on a Wednesday at 13.30 which would have been really awkward if I had been at work.
Hydro was lovely, very gentle, and a lot less than I would do on my visits to the pool (but at the cost of £3.80 per swim I’m afraid I feel I have to get my money’s worth!!), but it was great in the warm water to take my joints through their full range of motion with very little pain. Plus as there were ladies there with pelvic girdle pain there were core exercises as well which you can never do too many of!! Now granted… getting out the pool did suddenly make my body feel twice as heavy, but it had worked wonders on the lovely water retention that has come to fruition over the last week (Just to add a little extra size to my already fat feet…!! To think I once wanted to be a foot model!).
The physio is going to add acupuncture to my treatment plan for next week as she didn’t want to overdo it in the first session. So that will be interesting, having never had acupuncture as a treatment!!

Thursday, back at work, feeling some benefit from having the Wednesday off, but still, as every morning is proving to be, a difficult and tired start to the day.
For the last week I have been sleeping in the spare bed, it has a memory foam mattress, and space! Which in this beautiful English summer weather, is worth its weight in gold!! Because by ‘eck this little baby is making me warm!! Plus the fact that I am trying my best to sleep on my side, which is very uncomfortable for my shoulders and hips no matter how many hot sweaty pillows I use in all manner of places to prop myself up! So every night without fail, I will wake up several times to sit up and turn onto the other side (rolling is impossible at the moment). This swap of beds has made for better night’s sleep for both of us… but it is weird. We don’t quite feel in the right age range to be having separate bedrooms just yet… so hopefully this won’t be a permanent thing!!
Anyway, back to work… I had a very minimal case load in comparison to my heavily burdened colleagues, which is due to their lovely support, but it does make me feel pretty useless and quite guilty. Although I do understand that if I wasn’t there at all those patients would be added to an ever growing list of patients for my long suffering colleagues to deal with. So I’m not totally useless… By the by, I got through the day. Exhausted, wiped out, fog brained, done in. The drive home was weary, and I was finding it difficult to keep my eyes open.
At home, I vegetated on the settee, despite the most beautiful summer evening (we bought out first set of garden furniture this spring – I was so excited – but I have barely used it as every evening all I want to do is go to bed!! Last year we had had barbeques coming out of our ears, using dog crates and camping chairs as furniture!!). I had a weep and a chat with Andrew about how I was feeling, and at 8.30pm we went outside to watch the dogs in the garden… that cheered me up.

This morning arrived, and I knew I had my 25 week midwife appointment. So after I had eaten my breakfast I wrote down the main things that were making my life hard (picture below). I felt I had to do this, as I knew I’d either forget (fog brain/baby brain… it’s a wonder I know how to spell!), or I’d be too upset to get the words out. For me at the moment, the worst feeling is that I don’t have the mental strength to keep going in to work and focusing. The physical side is hard, but as anyone who has RA or any other chronic pain problem will say, the pain is a given so you just keep going, working through it. But once the mental toughness has slipped, the pain becomes too much to manage.
The mid wife was lovely (I’ve not seen the same one twice yet and some have been better than others!), and very supportive, (yes I did get teary and upset). Everything baby wise is going swimmingly. But she immediately made me an appointment with the GP so I could discuss taking some time off. The GP (a very well dressed, highly made up, hard faced, slim woman) was less supportive and comforting. Very matter of fact and (I felt) suspicious. But after some rather hard questioning she signed me off for 2 weeks, and prescribed me some ibuprofen gel (10%).
I felt emotionally drained. So after letting work know, and again getting a lovely response from my boss who has been nothing but supportive the whole time I’ve been pregnant, I went home and slept!
So let’s see how the next fortnight goes… I worry I’ll have the same dilemma as I did this Monday. Every morning is tough, how will I know if I have enough strength in me mentally as well as physically to go back to work, and how will work feel if I keep popping back for one or two weeks here and there?
I’m not 100% sure about using the gel… especially not if I’m off work. I prefer to manage my pain in other ways if I can. Any thoughts on using Ibuprofen gel during pregnancy?

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