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Do you feel guilty about using FMLA to recover from an asthma flare?

Another question: do any of you struggle with feeling guilty about taking time off from work under fmla to recover from your asthma flares? Or otherwise inconveniencing people who have to cover for you in your absence? This was my first asthma hospitalization and it scared the crap out of me. I went to the ED intent on getting methylpred and running away straight back home. But realized things were different when my heart rate was out of control and the labs came back showing dehydration, hyponatremia etc. It’s a lung problem for pete’s sakes … how do you kill someone quick, fast and in a hurry? Go for the lungs or heart. I’m trying to think of similar situations for other chronic conditions (maybe a heart attack, renal injury, small bowel obstruction, crohns flare). One wouldn’t expect those guys to discharge from hospital and be at work the next day. Why should asthma be different? Maybe it’s because I’ve grown used to having albuterol, Flovent, prednisone and advair in my life and my disease had been well controlled/contained to this point … that I’m not more alarmed about how scary last week was, and feel ashamed asking for 14 days to heal. It doesn’t help my work is dumb and keeps bugging me about forms, certifications and date of return (I faxed all that stuff from my hospital room! Grrr).

for myself, rather than toss all of the neb vials and prescription bottles, I’ve been keeping them in a bag as a visual reminder of what a pain in the butt the last week has been. Maybe it’s my own way of telling my stubborn pig headed mind, yes, you got seriously sick, you’re on powerful medications, it’s ok to slow down, get off the carousel of life and focus on self care. Qid nebbing generates a lot of work and wrappers and vials, ugh! I have a bigger bin in my closet with all of the other junk from the last 3 months (steroids, abx, nasal steroids, puffers galore). I’m so sorry greenpeace! I’ll plant 5 trees once the lungs stop being little turds.

Hoping for spring and a better 2019, what a Bear! 

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  • Pljohns

    I'll jump first-YES-at my last job, I knew my boss was gunning for me-had told me so-so when I started having problems I filed for intermittent FMLA-never used it-never had the chance because a week after it was approved, I landed in the hospital for a week and 30 days of medical leave.  I felt really guilty for being out 30 days and using it but I realized how exhausted I was during that time-and used the time wisely to find a new job.

  • K8sMom2002

    Em, I think America as a whole has bought into the "we work even when we shouldn't" mentality. America is behind many countries when it comes to vacation days and parental leave, and I cringe at every OTC flu medication that promises you the ability to pop a pill and make that big presentation. Uh, that's just spreading the flu to me and my poor lungs, thank you very much!

    I've had to take FMLA before — at least three times. It is hard to feel like I felt like I was letting my team down … but I think it's admirable that you are focusing on what your limits are. You're being realistic. 

    Put it like this: an injured athlete on the disabled list doesn't try to play before he's ready because he knows it's not in his best interest OR his team's. If he "played through the pain," he might risk a more serious injury that would take him out of rotation for good, or he might actually prolong his recovery and leave his teammates in the lurch for longer.

    Your team deserves someone who can give 100 percent … and right now, as you recover, you're not able to do that. But you're doing everything right to get back to baseline as quickly as possible.

    If you feel guilty about taking FMLA, let its inconveniences and issues remind you that it's not all sunshine and roses. When you're on FMLA:

    • you don't get paid unless you have sick or paid time off built up.
    • you have to pay both your employer contribution and your own contribution to all insurance plans.
    • you're eating up your limit of 12 weeks' total of a year.
    • you're only guaranteed an equivalent job at the company, and not your old position at your old location.

    But FMLA can be a life-saver because it can help you retain your employment. It also protects your insurance — before FMLA, if you took leave, companies weren't required to provide health insurance for you.

    You can also request intermittent FMLA in the event you run out of sick leave. So keep that in mind as well.

  • Emelina

    Cynthia and Lynn, thanks for sharing your experiences. Good to know I’m not alone in filling out the forms and asking for time to recover. I love the perspective of treating this like a sports injury and the risk of charging back onto the field still injured (both for the individual and team). Good point too about fmla; there are pitfalls too. I’m so grateful it exists to protect workers and especially our insurance. That would be absolutely mortifying to be in hospital and worrying about being dropped from insurance with an active medical condition! 

  • K8sMom2002

    I'm SO glad that our insight has helped! Lynn in particular has really overcome workplace challenges. 

    And being without insurance while managing a life-threatening disorder is terrifying, but never anything to be ashamed of. Many people could find themselves without insurance through no fault of their own, since insurance depends (for the most part) on being able-bodied enough to work at a job that offers it.

    Sending good that your HR folks will get all those forms filled out properly! 

  • Emelina

    Cynthia, all great points. Insurance is such a difficult but essential thing. It makes me sad to read about how much we pay in healthcare expenses and treatments here in the US but have worse health outcomes. I got curious about the cost of some of my meds without insurance and my jaw dropped. $430 for combivent! $400 for advair $360 for Flovent. It’s so unreal and awful. Even nebulized corticosteroids are so expensive. 

    Thanks for the good vibes. Looks like HR is happy now and I’ve got work coverage for the full 2 weeks. What a relief. Now to focus on the real task: rest, sleep, eat, get moving again and get well! 

  • Shea

    Transitions in any situation can be a struggle. I feel that companies should always give themselves enough cushion to deal with employee vacations, illness, maternity leave, family leave– if they dont then that is a company problem and fault– not yours. You just gotta have players on the bench. 

  • LK

    Em,  Actually we have very good outcomes here in the USA compared to some other countries, but don't want to get into an argument here!    Glad to hear that you have the two weeks' coverage!  

    Shea,  I agree that companies should be able to handle things like that but not all companies are equipped to do it either because of the size of the company or they are just not financially able to have that many employees.

  • Emelina

    Ah, Lisa you are right. I should clarify, our outcomes can be incredible (premature babies, advanced heart failure, liver transplant). I was thinking more in relation to spending and outcomes and health disparities. I took a cool health policy class and they showed some interesting us vs international comparisons and it was stunning. It was also interesting to look at other factors in overall health. With asthma it was interesting too, one’s socioeconomic standing can have direct impact on the disease. Example, poorer families not only have reduced access to doctors & medicines but are more likely to live in cities, older buildings and exposed to more allergens/triggers thus leading to more missed school/work, more hospitalizations and worse quality of life. 

    This isn’t the exact picture I was looking for, but it is interesting. 

  • LK

    Em,  Those are some very valid points to consider!  Thanks!!  

  • Pljohns

    Em-I hear you on the cost of the meds without insurance.  One-just ONE of my maintenance meds is $1200 month and the steroid is another $800-that's why I work where I do and why I put up with crap from bossman-we have AMAZING insurance that costs me $250 month for full family coverage-$100 deductible and covers my meds with a small copay.  By comparison, DH's insurance (if we were on that) would apply EVERYTHING-even the cost of meds-to the deductible until EACH PERSON paid out $6700 and then it only drops to 80%.  I couldn't afford my meds if we were on his plan.  We are a small company and really the only benefit is the company pays for 80% of the cost of our insurance.  i can put up with a lot of crap to keep that good insurance.

  • Emelina

    Lynn, ugh it’s so scary and terrifying. Sometimes I wonder if health insurance is really there to help or just make money for itself! That high deductible plan offered by DH’s company sounds awful. The think that drives me insane is we pay $250 every 2 weeks for insurance and employer pays the rest of the premium. So these turkeys are making like $1600-$2000/month, and still you have to fight to get them to cover things with prior authorizations, etc. The medication costs are just astronomical. I found this picture to help me be more cost conscious at work, check out the price per dose! There is so much price escalation/inflation. I cheer every time a medication becomes generic. I think advair and humalog insulin were the most recent to go generic. There is no reason why insulin which used to cost $130 in 1996 should cost $400 today. It is not 3-4x more effective. There is just corporate greed and patents that are lining pockets on the wrong people and hurting patients and our country. Don’t even get me started on the epi pen insanity … it’s so crazy and wrong. People deserve access to medicines and healthcare … for me it’s part and parcel with our right to life, liberty and pursuit of happiness. 

  • Dar007

    I work in a ED, and I hear what you are saying. It is hard to take time for yourself to heal and get well, and not every work environment is open and considerate to that. For us, it is just that sick time or notes from a doctor are often used when the person is in fact not sick. An example is a co worker of mine has three months vacation every year, because of her seniority, she chooses which days she will take off before anyone else – so she takes June, July, and August. BUT every year, (in May), she gets a note from her GP giving her three weeks off…which then bumps her three months vacay. So she is off May, June, July, and August. Too “sick” to move, but then we see Facebook posts of her living it up on vacations backpacking in Arizona and dancing up a storm in Vegas! Not the only one who does that and gets away with it all. So nobody believes you and gets really angry if anyone calls in sick. Nobody believes you. It is so hard to take time when a I really really need it. 

  • Pljohns

    My current employer has 3 "floaters" to cover 32 clinics for my position-you can imagine how hard it is to get a day off-and calling in sick usually means you will have no coverage so you will have twice the work when you get back because no one did it.  I can't even schedule vacation ahead of time-the boss says "I'll see what I can do but i can't make promises"-sure you can-you control who has help and who doesn't.  I need 2 days off in May-one for DS graduation and one to take him to college orientation-neither of which are optional-and I got the "I'll see if I have coverage"-if not, I'll just be behind when I get back because I'm taking off.  I ask off for time around Christmas 2 YEARS ago and still didn't have coverage for it this year!  It is my biggest gripe with the current employer.  

  • Emelina

    Dar007, ugh! That’s awful. It’s miserable when someone abuses the sick leave system and ruins it for everything else. Especially for people who work in healthcare! Since we are around those who really can’t afford to get our infection/cough/cold plus whatever else they have going on. I’m surprised that wouldn’t trigger some sort of review claiming too sick to move and dancing/living life up. 🤮

    Lynn, that coverage system sounds terrible! 3 Floaters to cover 32 clinics, wow! Though, how much you wanna bet the admin has no trouble at all being off for graduations, illness, holidays. Grrrrr. Grumble. One of these days I’m going to dislocate an eyeball from rolling them so hard.

  • Shea

    My former employers tried to cut corners because they are a mom and pop business but they bought new cars, a new fancier building, had some spendy impractical policy changes, and they upped their prices to cover all those things–  were basically treating employees very poorly. We had no insurance benefits.. I was lucky when Obama expanded the age kids can be on parents insurance, or I wouldnt have had insurance during Tommys birth and my health crises. No maternity leave– I worked until 3 days before I gave birth and I was at work, with my infant breastfeeding in my office– 2 weeks after of which I had used my vacation time. We had no extra staff or floaters, and if my midnight shift or any shift called out last minute– I was there to cover… And just would leave ezrly other days in tbe offi e as I could so I dudnt get OT. But after I had a kid that option was out to me, so I used OT pay basically to bribe other people to cover a last minute shift change… and that was effective, but the owners didnt like it. I always nade sure my staff was able to get off when needed– we worked as a team and really tried to help cover eachothers shifts…. But– We should have just had an extra staff or position so that if one called out or went on vacation, we had another one there. We could have afforded that and we rrally needed it. Instead after my heart attack when I needed 2 weeks to recover they told me that was too much time off– even though I had talked to my staff and agreed to a pay cut and to use that money to promote some of them to cover certain duties which they were capable of and give raises– and me to be there part-time and by phone for training and transition. Nope– they just said we dont need you anymore. They gave duties to others with no raise and no training. My employees were furious and the place went into chaos. People left. The company closed down not long after. I dont think they knew how much I actually did there. It was good I left, because I needed to care for my son and myself and was lucky enough to qualify and be approved for disability (and that my parents saved my butt during the 2 year transition where I had unemployment income only for a tiny bit then nothing). But I couldve made it work there, if the owners hadnt been so greedy and stupid. And we were doing such good work there– it was a non-12step residential treatment center for substance abuse and mental health, we had some amazing therapists, a great doctor and nurse, and a crew that included nutritionist, massage therapist, art therapist– I loved my staff of behavioral health technicuabs that I managed and we really helped make a difference in our clients lives. Just basically the owners were the falling point, as they did not treat employees right. I wasnt the only person they mistreated, but I guess karma got them. Anyways, my thoughts are if you cant affird to treat your employees right then you shouldnt be in business. Its not healthy. And its not doing anyone any favors. People first. Health first. Family first. Then buy new cars abd bigger buildings and koi fish and Budfha statues in your lobby. Ugh. These people. Ill never get over it. 

  • Emelina

    Gosh Shea, that’s incredible what your team was able to do and support each other despite an unsupportive employer with warped priorities. I’m sure your patients at the treatment center were grateful for everything that the team provided. You sound like a strong soul who could move mountains. No maternity leave, working up until days before delivery and bringing your baby to work to breastfeed, and not getting full time off to recover after a heart attack – wow! Thanks for sharing your experience. 

  • LK

    Oh, my goodness, Shea!  Those former employers were unbelievable!!  I am sorry you and the other employees had to deal with all that nonsense.  You are a smart lady who can figure out ways to handle so many unacceptable situations.  

  • Shea

    I guess we all just have to play the best we can with the cards we are handed, and hope you pick some good ones from the draw pile. Life is so much like a game of cards. 

  • Emelina

    Just a little update for anyone who happens to read this in the future. With the advantage now of hindsight, I’d tell everyone considering FMLA use after a bad flare to take it if they need it with no regret, shame or second thoughts. 

    I took 2 weeks of FMLA after a flare that landed me in the hospital; the crowning event to several months of deteriorating control. I struggled with leaving my team behind and guilt that I didn’t look that outwardly sick.

    The pearls that I learned are:

    1) who cares what others think. Even mild asthma can rapidly progress to a fatal attack. Think of a severe flare like a badly broken leg. You need time to rest your body, mind and gain control of your symptoms and deal with the sometimes very troubling side effects of the medicines we take (high dose steroids, anticholinergics).

    2) work life will carry on without you. A friend told me bluntly in the hospital, stop killing yourself for your job. If you dropped dead, your workplace would replace you within 2 days. If you are sick enough to need FMLA, please use it. Don’t push before you are ready to return, or push through the pain. Your life is precious and invaluable. Your workplace will be ok while you mend; it may be hard but they will be ok without you. 

    3) be patient with yourself and your recovery. Diseases of the lungs have a profound on the rest of the body; let’s face it, we are aerobic organisms. We like to breathe. Poorly functioning lungs stresses every other system. Don’t be surprised if basic tasks like dressing, eating, keeping up with medicine regimens are all you can handle for a few days. And please don’t be ashamed to ask and accept for help from family and friends. 

    4) give yourself adequate time off. I pushed my recovery and didn’t think through post fmla work accommodations and got very ill within 1 week of returning to work, and felt even worse after the second bout of illness. Now I have filed for 4 additional weeks of fmla to get the care I need to fully recover. Please give yourself adequate time and space to heal your body before jumping back into the fray of life. 

     

  • LK

    Very well thought out Em!!  You say it very succinctly.  Those points should be written on a second page of our Asthma Action Plans!

  • Shea

    I love it too Em! This is great advice, and like Lisa said, succinct and organized. Thank you for sharing your experience with others.

  • K8sMom2002

    Em, what great wisdom you have shared! Thank you, and I hope you get the accommodations you need in order to be able to go back to work. They're missing a wonderfully wise staff member … and I hope they appreciate you!

  • Emelina

    Just a little thought and another tip for anyone reading this in the future and walking a similar path: while you are on leave, don’t worry about others think or what activities you do. Once I recovered enough to get out of bed and venture out, I worried about what others (work colleagues, I live in a very small town) would think if they saw me grocery shopping, or going for a walk around the neighborhood or dropping off my kids. So I stayed in my house and was a hermit crab, until I realized this is ridiculous. You’re not under house arrest (yes, you should take it slow and listen to your body) but no need to seclude yourself. Your fmla leave, the determination of if you can work and your recovery is between you and your medical team, no one else.

    The invisible Illness definitely has its pros and cons, but don’t worry about anyone’s judgments or assessments of if you are sick or not. People will always talk and gossip, but rise above it. Your recovery and rehabilitation is the most important thing! 

  • K8sMom2002

    Emelina, so true! But also it's important to start making those trips out of the house so you can judge for yourself how much endurance and stamina you have. A grocery trip will be a much higher demand of energy than staying at home … but kind of a midway point between that and a full day at work.

    It's good to see where you are and to treat going out for errands or shopping or a walk as occupational rehab. Plus, as you say, connections can help you heal better!