“Do people with chronic health problems have different challenges from those who are healthy in keeping their jobs?”    This question came from a journalist who had told me he didn’t personally know anyone with a chronic illness.  (Really?)

Not sure where to start,  I gave him examples.

Let’s imagine  Susie Q.  A  healthy 30 year old,  she woke  one morning and was blindsided by an unexpected physical problem.  Could be  she felt extreme fatigue (the flu).   Or maybe it was disabling pain (she’d injured a muscle working out or sprained her ankle ).   Susie’s day wasn’t going to be what she’d expected.  It might mean she’d miss a key meeting, fail to deliver her quarterly report or not finish the memo her boss was waiting for.  Naturally, this would create disappointment and/or a momentary problem.   But it’s highly unlikely it would be a game changer for Susie.

A virus or an injury, although unpredictable, are acute problems that resolve and are gone for good.  Chronic health problems are also unpredictable.  But where the acute health incident is unusual, the chronic problem is frequent.   The chronic problem doesn’t ever go away  (that’s why it’s chronic).  Also chronic symptoms are typically invisible and  rarely objective (as in fever or broken leg).  They can also be difficult or uncomfortable to describe  (try explaining poor bowel control, spastic limbs  or pelvic inflammatory disease).

Now, let’s look at  Tim, who lives with ankylosing spondilitis.  On Monday, Tim was a  ‘busy beaver’ at work.   On Tuesday, he woke  with dragging fatigue  and pain that creates brain fog.   The challenges Tim faces?

  1. When you feel poorly and that means that you’re not getting something done or don’t show up to work,  you not only have to experience the lousy feelings but you also face a tough conversation explaining yourself to others.
  2. These conversations are particularly difficult  because you have to explain your situation to someone who most likely is unfamiliar with this kind of issue and your problem could be an added burden on them.
  3. Finally, unlike the Flu or recovering from surgery, you can’t reassure anyone this won’t happen again.

The conversations that this requires is something that most of my clients struggle with.   For detailed suggestions , check out  “Are You Talking” (Career Thrive Series) .  I can’t promise it’s ever easy but it can get smoother.

For many of us, however, the toughest part is what we say to ourselves and how we manage that internal conversation.  As a client said to me just yesterday,  “…even if  no one questions my absence to my face, I’m constantly worrying about what they’re thinking”.   Negative thoughts like these can be very distracting and damaging.

Still wondering about  my response to the reporter’s question?

Yes, people with chronic health problems face the same challenges as healthy people.   But for us,  life’s challenges include an additional layer  that requires a carefully honed skill set.   People with chronic illness confront this question on a daily basis:  Am I able to do this today?  If not, what then?

What would you have said to this reporter? Anything to add?  Do you agree with me?



11 Responses to “Is it harder to keep a job with a chronic illness?”  

  1. 1 Melissa Marsh

    I probably would have laughed at the reporter’s question since I would, at first, think he was joking. Then I would tell him the truth – that there are days when I feel fantastic and have no problems whatsoever. Then I will tell him that, with little to no warning, I will wake up with a flare of my rheumatoid arthritis and have no energy to move, yet I drag myself to work anyway because I don’t want to take a sick day AGAIN and have other people cover for me because I am a responsible person and hate having anyone else have to do my work for me just because I’m sick. Then I will tell him how guilty I feel over this, despite the fact that I have a very good reason to be gone from work, and how I struggle with trying to ration my paid sick leave so I don’t end up financially stressed. Worse, I try to tell myself, is this a really bad day, bad enough to stay home? Or can you make it through the day? I hate making that choice, but that’s what it comes down to.

    I’m praying that I will be able to cut down to part-time as soon as my husband graduates from college in June. I am the sole breadwinner right now and that adds additional stress.

  2. 2 Rosalind

    Dear Melissa — Your story is so familiar — it’s mine and so many others I talk to. I have to tell you, though, that after 35 years of living with bad health, I don’t think that working, per se, is the problem. People tell me and I’ve found, that when you feel most horrible, work and interacting with others takes your focus off of your body’s distress. The challenge, I think, is to find the right kind of work that you can do more times than not. And work that allows you to take good care of your body. Hard to do this. But worth it – especially when you’ve got so many years ahead. You might ask yourself what it would be like to rely on your husband’s income and have no other options? I wish you sound thinking and the best possible health as you think about this. Thank you for writing your thoughts.

  3. 3 Debra

    I would say that only during the industrial revoluation did people work 40+ hours a week; at no other time in history did people work as long as we do now. If we had good-paying flex-time, part-time, and work-from-home options in this society, then everyone’s chronic health (or family) situations would be a nonissue. The same goes for reducing the number of hours in the workweek for full-time employees. There is nothing wrong with us with health problems; what’s wrong is the belief that everyone can sit at a desk 40-60 hours a week for their entire adult lives. According to the Social Security Administration, 1/3 of Americans are disabled before age 65! The workplace needs to get real!

  4. 4 Melissa Marsh

    I actually want to make as much money as I’m making now, only working a part-time job and writing (I do freelance writing). I certainly don’t want to just rely on hubby’s income. Just having the option to work from home on the days I don’t feel good would be fantastic. I do agree, though, that distraction is a must with my RA. Sometimes, though, my body just can’t handle the physical stress of going to the office.

  5. 5 Kim

    Working through a migraine is like trying to work through labor pains. After 15 yrs of labor, lol, working through them. I have finally resigned to living off disability. Just to clarify. I had 16 days of migraines in January. There is some pain you can keep yourself busy to avoid or keep your mind off of, but there is other pain, like labor, that you just can’t pretend your okay, or strong enough to make it through the day. Looking back, I worked too many days when I just should have stayed home. Why? I would have been fired. But in reality, as an employer, you need someone who is dependable. And no matter how determined and hard working your are on “Good” days, can not make up for the days you stay home or “should ” have stayed home. I am struggling now, going through a divorce (someone who refuses to acknowledge my condition, despite witnessing it for 18 yrs) single mother of two, and trying to make ends meet with a check that doesn’t even cover half. I would love to be able to work on the Good Days, but what kind of work is there? What’s worse, is that you have NO CONTROL of when or where or how long or how bad an attack can be.

  6. 6 Nikki

    I have Fibromyalgia and chronic migraines. I’ve had FM for a very long time and your response is quite accurate for FM… although I often hesitated to mention it to co-workers due to the stigma which has gotten slightly better over time. You develop coping skills and tricks to dealing with pain, fatigue, memory issues… all the symptoms really. And certainly it is challenging and certainly when I was younger I discovered there simply are jobs I am not capable of (like those that require standing for 8 hours, those that require repetitive motions or lifting too much weight, those that require shift work). So.. desk job it is… as long as I move about once in a while. And certainly flare ups of pain are difficult because they can cause severe pain in whatever area that can make it hard to walk or write, but slow and steady and all that. I always feel unwell, sleep deprived and get sick often and recover slowly but I’m very used to this states of affairs. So I would use the term challenging for FM. Chronic migraines are quite different. I think the term I ended up using was ‘suicidal’. That is not the sort of pain you can think through or cope with for long in a workplace environment that makes it that much worse… not without it driving you mad, which it will because you have to go to work, but you miss too many days, which the employer does not like, which you feel insanely guilty for, but even all the days you don’t miss are filled with acute migraines it is only Some days with acute migraines that are beyond severe with symptoms that distort your perceptions too much or give you something very much like the worst stomach flu ever that you miss… then repeat over and over and over. FM I can cope with, chronic migraines I just survive. So, yes, I had different challenges than a healthy person in keeping my job. As in keeping my job. As in being threatened with demotion, being fired, suggested I should quit, being made to feel guilty for being ill and for missing work. I could not sustain full time employment which was self evident by how many days I was unable to work… yet my employer would not offer any alternatives to compromise due to my health. So it was a lot of short term leaves for disability then back to full time. The tension was emotionally and mentally draining over the years. The challenge is simply trying to hold onto employment because you must even though you know you should not.

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  8. 8 Lily brinson

    My boyfriend of 7 years just found out that he has an autoimmune disorder where he gets sick allot especially around the cold seasons…..he recently got demoted from his job being a delivery truck drive for a water piping company to work in the warehouse because he is always getting sick and he has type

  9. 9 Debra

    Enlightened companies encourage their employees to work from home when they are sick. Most office work can be done remotely, so employers should give their employees laptops to take home. A friend of mine works at a company where everyone works at home one day a week and employees can simply call in and say “I’m working at home today.” As long as the work gets done on time, this system is very effective. For those of us with chronic health problems, this would allow us to get some work done, as much as possible, when we are sick.

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