Before I have the operation, I am of course in quite a lot of pain with the affected shoulder and arm. As there are bony overgrowths where the cartilage should be in the shoulder, I have inflamed tendons which send pain shooting down my arm to my thumb, but mostly the pain is just above the elbow and around the shoulder joint. This is worse at night and so I get painsomnia, the inability to sleep because of pain.

A typical night: I go to bed about 10pm, slather my affected arm in Fenbid gel, take a Zapain, and hopefully I will get to sleep. I will wake up about 4 hours later because the painkillers have worn off, get up, go to the loo, take a dose of my levothyroxine and some more painkillers, and get back to sleep for about another 3 - 4 hours.

That's the plan anyway.

You see the trouble with Zapain is that I get brain fog. It's cracking as a painkiller/sleeping tablet, but if I take more than one per night, then I have great trouble operating mentally the day after. And as I teach on Fridays and Saturday mornings, then if I want to take a painkiller during the night, I can't take Zapain.

If I use Fenbid, which is a 10% ibuprofen gel, I can't take Naproxen but I can take Ibuprofen, just not at the same time as the Fenbid.

I have some "High strength" painkillers available from the shelves at the supermarkets, but they contain caffeine, which isn't recommended to take at 2am.

I can take paracetamol, but I have to be very careful as it's easy to overdose on paracetamol - over 8 tablets in 24 hours and you risk liver failure. Which is a bit drastic as it needs a transplant to cure it, otherwise you die a very nasty death in 3 days. (My sister-in-law did a stint on the liver ward in her nursing training)

So what can I do on teaching nights? 2 doses of Fenbid, maybe a lower dose of co-codamol which you can get over the counter, and some paracetamol should do it.

Except on Thursday night it didn't. This means I didn't get back to sleep after 3am, which made teaching on Friday a real struggle.

Now the point of this blog is to tell you how I manage things using complementary therapies. How did I manage the insomnia on Thursday night? By getting up for a couple of hours, then going back to bed and dozing for a while until the cat woke me up.

On Friday night I decided to do something called Autogenic Training, which is a mild form of self-hypnosis and works at a very deep subconscious level. I find that this really helps with all sorts of things, so tonight the affirmation I used was "It sleeps me". Well that worked. I did get back to sleep without having to take Zapain or co-codamol, in fact I don't think I finished the meditation I used!

Things to tick off on the list of therapies to use: Autogenic Training. The book by Dr Kai Kermani is the one I recommend.