Ah OP, I could have written your post two years ago. First of all, I've taken biologics: both Humira and Stelara. After the first dose, where they show you how to administer it in hospital, you do your injections at home, so no need for time off to take it.
I'm no longer on biologics despite having been in flare when we moved house earlier this year, because I inadvertently put myself in remission by going on a ketogenic diet to lose some weight. Turns out that the main ketone released has been discovered to reduce inflammation, and there is a current clinical study into RA patients to see if it helps. I have psoriatic arthritis, so we get the studies and the treatment later, but it's made a big difference. I still have osteo from the damage done to my joints while the inflammation was active, however.
This time last year I was running my own business and had been for some years. The work was often physical, and I also felt unable to stop work, or give up work, or even attend appointments at certain times because I had a business to run, staff who depended on me and a child to raise. I was self-employed and had no safety net, which no health professional I've ever met has truly understood.
I was also referred to pain management. The consultant reviewed my pain meds and sent my GP a letter with prescription recommendations - I take a lot of morphine, now, but it helps - as well as signing me up for psychological therapy.
I was sceptical about the psychological stuff, but fortunate that I was sent for individual sessions because it meant I could have a more in-depth conversation. As I was told, recent studies have shown that when you've been in pain so long, your body gets really good at telling you you're in pain, often to a greater degree than you might actually be. The way the mindfulness etc works is to retrain your brain into deprioritising pain signals.
In the end, I had to close my business, because I simply wasn't physically well enough to keep going, and the physical side of it meant I was still making my physical condition worse. It meant we would lose our home, which came with the shop. We moved 200 miles north of London and started again. I had always sworn this was impossible for me to do. And I won't lie, it wasn't easy.
What I have learned is that running a business or just doing a job with a chunk of responsibility is stressful. It is doubly so when you add in the chronic pain, because the pain acts as an amplifier. And the stress amplifies the pain. It's a vicious circle.
I've had no choice but to just look after myself. Between the back, the arthritis and my fibromyalgia I can't work reliably enough to even take on freelance work. And so I've been spending time on trying to get well. Swimming, light gym work, walking what little I can. 20m slowly on crutches to the village shop is still 20m.
I've also signed up for the Curable app, which takes you through a lot of the mindfulness stuff, but in your own time so you don't have to miss work. And this time I have found it effective. It's not that I don't feel pain any more, it's just that I feel now that I'm in control again. And that allows me to bear it and feel it less. I still struggle massively with the fatigue from my fibromyalgia and the associated brain fog, and there are still some days where it's all unbearable. And it's the days I feel least like a 10 minute meditation that I actually need it the most, because it takes me out of the stress cycle that amps everything up.
If giving up your job is not an option - and that's fine, I get that - at the very least I would be considering talking to your employer about how your disability can be managed and what can be put in place to help. If they're raising eyebrows about you taking AL to attend appointments, I think it's important to state the disability for your own protection, and talk to them about measures that would help. Explain how often you're likely to need to attend an appointment and arrange to either go in to work for the rest of the day, or work from home so you don't miss the day. Maybe reduce your hours so you can rest more, or ask for access to a quiet space so you can take 15 minutes to get yourself back on track on a bad day. Or for the option to work from home when the commute would cause you to be unproductive because you're in flare. Reasonable adjustments for disability are fine to ask for. And while it's hard to think of yourself as disabled, and I had a major wobble the first time someone suggested I was, it did help me to be able to realise that it wasn't my fault and didn't make me a bad person that I wasn't physically able to do as much any more.
Sorry. I feel like I've waffled on forever here. I'd really recommend Curable, especially if you can't get the time off work to do the pain management course, and if you do have a tool like that you can at least show the medics that you're taking their advice, but in a way that works round your other commitments.
By all means PM me if you've any questions - I'm a bit sporadic in my use of MN because of the brain fog, but I do get notifications for messages and am happy to help if I can 