Twins and Hemorrhoids

Oh. My. Gosh. I'm 27+2 and for the last 36 hours Ive barely been able to move due to sudden horrible hemorrhoids. I got one in the 38th week of my first pregnancy but it went away and I haven't dealt with them since. The pain is making me nauseated. I'm getting some witch hazel later today, hopefully that'll help. I'm a nurse and can't imagine my next shift at work.... Ive been using prep-H but it does nothing. I soaked in an epsom salt bath and it helped, but I cant just sit in there all day. Help!! Recommendations??