Twitter Chat – Back to Work and School On Saturday 5th September, from 3pm we settled in for another #AddisonsQA Twitter chat. This time we set out to get everyone talking about that first week at school or work that many are facing this month. Once again we were really pleased to have an excellent expert panel consisting of consultant endocrinologists, specialist endocrine nurses, education professionals and ADSHG members, ready to answer our #AddisonsQA questions! With the #InternationalDayofCharity hashtag also whizzing around Twitter our Addison's theme chat was lively, supportive and informative. Thank you to everyone who joined in and shared their views and questions. Below we’ve included the 6 questions we asked our experts and some of the great advice and tips sent in by medics and people living with Addison’s. The key pieces of advice we took away were: School: Keep in close contact with your school and communicate regularly. Make sure the school is fully aware of the needs of the pupil and their Individual Health Plan (IHP) is up-to-date. Read more here. Work & Employment: Your workplace should be 'COVID-secure' and you can request a personal risk assessment. Read more here. NHS Steroid-Card: print a copy or keep electronically on your phone to keep the card with you at all times. Knowing you are prepared can help reduce any anxiety. Precautions: wash your hands for at least 20 seconds making it part of your daily behaviour, keep hand sanitiser handy with your medication, wear a face covering, keep rooms well ventilated (keep those windows and doors open!) and keep 2 metres apart where possible. Up-to-date medications & injections: Check your emergency kit is in date and you have all essential components (needles and syringes). Read more here. Emotional Impact of COVID-19: Take your time. Many people are anxious but being steroid-dependent adds to the complexity. The world is very different and we're all learning. Reach out for support, share concerns and speak with people in similar situations on our private online forum. Follow us on Twitter at @AddisonsUK to hear about our next twitter chat. Questions? Please get in touch on [email protected] The conversation is continuing on our online forum under our dedicated Coronavirus forum. Log on to speak to others in the same situation to offer mutual support and help. Q1. Are there any precautions a steroid dependent person needs to take to keep safe if returning to the office or school, on top of the official Government guidelines? A1. Have extra hydrocortisone tablets & your IM injection kit for emergency use. Always carry your steroid alert card on you. Tell friends/colleagues that you are steroid-dependent if you feel you can #AddisonsQA https://t.co/ZiCkAXo8YU — Anna Mitchell (@Anna_L_Mitchell) September 5, 2020 A1 I find this difficult one - you can try and make sure that you take as much care of your own health and risks as you can. Remember that its likely to be a bit stressful and listen to your body to possibly increase your steriods as required#AddisonsQA — ⚫️Clare Fenwick (@csf0961) September 5, 2020 ❗️ A1 ❗️Great advice from @SofiaLlahana. Being prepared is key. The new @NHSuk @Soc_Endo Steroid Emergency card is available now! For more info on how to order one or to keep electronically on your phone, please visit 👉 https://t.co/guIYPIhPYf #AddisonsQA https://t.co/fIG4lzkbYB — Addison's Disease (@AddisonsUK) September 5, 2020 Q1 It can be stressful and cause anxiety going back into workplace or school for some. Try have support systems and use methods that help you if feel getting anxious. Lots of online resources.#addisonsQA https://t.co/rKGrTwrkAR — Helen Simpson (@hormone_doc) September 5, 2020 A1: #AddisonsQA https://t.co/jnaNZbs9Zf — Addison's Disease (@AddisonsUK) September 5, 2020 Q2. What's the one thing you'd advise a steroid dependent person to do before returning to school or work to minimise risks? A2 Get advice from your endocrinologist. If you're comfortable let your work team know, so they can be stringent and supportive too #AddisonsQA https://t.co/Ig1B9ecWkB — Dr. Pippa Little (@PippaLittle3) September 5, 2020 A2 Think through your day door to door. Plan commute, have masks, hand gel, drugs handy. Don’t worry if it feels different. It is! The world very different and we’re all learning. #addisonsQA https://t.co/BjVojp6pyL — Helen Simpson (@hormone_doc) September 5, 2020 A2: Great advice - you should only be going back to work if your workplace is 'COVID-secure'. See the employment section of our website for a link to the https://t.co/XFgZ9hLSal’s coronavirus employee risk assessment tool.✒️https://t.co/PbUZrx9ick #AddisonsQA https://t.co/fJ3JSkkq8k — Addison's Disease (@AddisonsUK) September 5, 2020 Q3. What can parents/carers do to help the steroid dependent person minimise any risks of infection or exposure? A3. Ensure upto date with seasonal vaccinations, get them to eat healthy, exercise regular, good sleep hygiene, thorough regular hand washing...things relevant to all people https://t.co/AElKUmZ7eH — Lisa shepherd (@lisashepherdcl1) September 5, 2020 A3: Yes, communication is key! If you're worried about the safety of your child returning #BackToSchool if they have Addison’s or adrenal insufficiency, speak to the school and to your child’s endocrine team about your concerns.🚸More info 👉 https://t.co/9UK2xoE6d6 #AddisonsQA https://t.co/lu4H01jtgO — Addison's Disease (@AddisonsUK) September 5, 2020 A3. Common sense precautions which keep us all well. Hand washing, wearing a face covering in public places, avoid crowded places etc #AddisonsQA https://t.co/kBZkiS0afi — Anna Mitchell (@Anna_L_Mitchell) September 5, 2020 A3. Make handwashing part of daily behaviour, rather than an extra chore, as nurses we find this very natural, like taking your shoes/coat off when walking in the house - add washing hands... #AddisonsQA — Sofia Llahana (@SofiaLlahana) September 5, 2020 Q4. Is there anything colleagues and managers can do to help keep people who are steroid dependent (and need to be physically in the office) safe? A4 If colleagues are willing...get them taught how to give an emergency hydrocortisone injection — Lisa shepherd (@lisashepherdcl1) September 5, 2020 Q5. What are the signs a person with Addison's/adrenal insufficiency may need emergency care? A5. Adjusting is tiring & takes time. If you have been away for some time or are starting somewhere new, cut yourself some slack: things may look different or not be as you imagined. Remember you've adjusted & adapted before...you will adjust & adapt again. pic.twitter.com/siBATCg9vY — Stephen Ball (@sball_endo) September 5, 2020 A5 Retain usual routine of medication timings; note and keep to hand contacts of neighbours, family or friends if needed. Take sufficient breaks if working at home, and try to work in a separate room so you can ‘cut off’ from living rooms in house #AddisonsQA — The Pituitary Foundation (@Pituitary_org) September 5, 2020 A5 listen to your body and recognise potential triggers that may precipitate an adrenal crisis #AddisonsQA https://t.co/nLEcf81LsD — Lisa shepherd (@lisashepherdcl1) September 5, 2020 Q6. Apart from the potential physical risks of going back to work, many people will also be feeling anxious. Is there anything steroid dependent people in particular can do to help manage their mental wellbeing at this time? A6: Take time out if you can. #addisonsQA pic.twitter.com/tOIu7my3vh — Helen Simpson (@hormone_doc) September 5, 2020 A6. Finally, it’s really important to keep things in perspective. The vast majority of people who catch COVID-19 live to tell the tale. #AddisonsQA https://t.co/jyb4k8014v — Anna Mitchell (@Anna_L_Mitchell) September 5, 2020 A6. Knowing that you are prepared helps to reduce anxiety. Ensure you have an extra supply of hydrocortisone handy, check your hydrocortisone injection is in date & you have the right kit, invest in hand sanitiser if you use public transport #AddisonsQA https://t.co/jyb4k8014v — Anna Mitchell (@Anna_L_Mitchell) September 5, 2020 A6: Yes shared experiences & mutual help & support are so important.💜 You can join the @AddisonsUK online forum here 👉https://t.co/KTniMMXgXu💙 You can join the @Pituitary_org support groups here 👉https://t.co/XQUlSrwzTG#WorkingTogether #AddisonsQA #SteroidDependant https://t.co/sSiVglwU9V — Addison's Disease (@AddisonsUK) September 5, 2020 #AddisonsQA https://t.co/gpLWjr1G0C — Addison's Disease (@AddisonsUK) September 5, 2020 A big thank you to our expert panel: Lisa Shepherd, UK, Endocrinology Advanced Nurse Practitioner, Heart of England NHS Foundation Trust. Birmingham. Anna Mitchell, UK, Consultant Endocrinologist at the Newcastle upon Tyne NHS Hospitals Foundation Trust Helen Simpson, UK, Consultant Endocrinologist at University College Hospital London Stephen Ball, UK, Professor of Medicine & Endocrinology, Manchester Sofia Llahana, UK, Senior Lecturer, Consultant Nurse, University College Hospital London Miranda Payne, UK, Pituitary Foundation Juliet Edwards, UK, SENDCO in Education. Juliet and her daughter have Addison's. And to all our wonderful members who fed in their experiences and encouraged new friends to share their thoughts.