Professional Patient

Going Back to Work after Medical Leave - My First Year in Review

Time flies when you are working hard. I am surprised that I have been back at work for just over one year now - and they still want me to be there! When I went back to work, I wasn't sure my body was ever going to be able to handle any kind of work routine ever again. I thought there was at least a 25% chance that after a few weeks or months, I would realize the whole work thing just wasn't going to be possible.

Now that I've been at it for a year, how's it going? What lessons has my return to work continued to teach me?

1. You will continue to see improvements in your physical strength and mental stamina. My body has very quietly continued to improve - more muscle tone, less pain, more mental focus. These steady, subtle changes add up over time... I am doing so much better than I was 12 months ago. I'm not sure when my body will finally be "done" (I am 2.5 years post-surgery now), but until then, I am very grateful for every little drop of improvement.

2. You need to feed your mind and body to stay on the right path. I have a tendency to stop exercising when my life gets busy. And I'm one of those people whose mind stays revved long after the workday is over. I also skimp on cooking time, returning to eating easier and more processed alternatives (premade garlic bread, chicken nuggets, fish sticks, tortellini...). I've learned the hard way (when I arrive home, crash-on-the-couch tired) that I must exercise to some degree at least once every two to three days. It helps clear and calm my mind, improves my sleep, and ensures that my neck continues to get well (strong muscles help hold my neck up for me... I can't let them melt away from neglect). I also have to re-commit to healthier snacking (green pepper strips instead of Pringles) and eating, even if it means I spend a few hours during the weekend pre-chopping ingredients for use in meals and snacks throughout the week. I also have to make sure that my nonwork time includes activities that are restorative rather than purely rest. I feel mentally clearer and have more energy after tai chi or a short swim, a walk with my dog, or a half-hour spent in the kitchen. These activities take more energy than laying on the couch (which I do my fair share of anyway), but they give me energy back, too. 

3. You need to address any new health problems that might creep up - don't develop tunnel vision around your major medical issue. I am developing osteoarthritis in my hands, my knees are killing me (probably because I can't reach down to pick things up any longer... I have to squat down), and I am battling brain fog and fatigue on an ongoing basis. Take the time to get new issues checked out and dealt with... before one of them gets the upper hand and prevents you from working. 

4. Recognize how much hard work it takes to even arrive at work each day. Do you remember those t-shirts from college that said things like "chemical engineering students get more done before 9 am than other students get done all week"? Make yourself a mental t-shirt to wear that affirms how hard you are working... "return-to-work employees have overcome more hurdles by the time they arrive at work each morning than healthy people overcome all week." Just getting to your office takes tremendous effort and dedication. You are the only one who knows that, so be sure to pat yourself on the back.

5. At work, expect to not see the beginning or end of things. I often get asked work on pieces of larger projects - I'm not often there when a project kicks off, and I'm almost never there when a project is finished and we send it to our client. Trust that your teammates are giving you enough context about an assignment to help you do it effectively (press for more information if you think they are not), and that they will apply the finishing touches and deliver the final product. It's unnerving to work in this "every day is a surprise," and "hey, whatever happened with that project?" kind of mindset, but you do get used to it over time. 

6. When you start to really, truly yearn for more in your life (at work and at home), that's the sign that it's time to go ahead and go for it - to increase your work hours and/or add some commitments in your life outside of work. This can't be a yearning drawn from self-pity (I want to do more at work because I feel so left out!) or from external expectations (my mother-in-law thinks I need to do more for the commmunity/my house/my family). It has to be a genuine dissatisfaction with the content of your life, paired with the sense that you have what it takes (energy, etc.) to get more out of your life. I have recently increased my work hours from 12 hours per week to 15 hours per week (it's a HUGE deal to me, but not to much of anyone else!), and also began a new volunteer activity visiting senior centers and other group homes with my dog. I picked the volunteer activity with reality in mind - I can volunteer at a senior center down the street, and the organization only expects 1 hour of volunteering per month (as a minimum). 

7. If you are considering an increase in work hours, but aren't 100% sure you are up for it, try adding hours for a week or two (or four) to see how it goes before committing to the schedule for real. I recently did this... I worked 15 hours per week for about three weeks without officially telling my boss I was doing it (my boss has made it clear he would be happy for me to work as many hours per week as I can handle, assuming there's work for me to do). Once I started to get the hang of the new schedule (consistently getting to work at the right time, understanding how to dial down what I do on my days off so I can recuperate, etc.), I officially notified my boss that I would be working this 15-hour schedule from now on.

8. Keep up with reporting income to SSDI and any private long-term disability plan you may have. I now make enough money that (1) SSDI is about to stop sending me SSDI money, and (2) my private long-term disability plan is reducing monthly payments to me. In this environment, where everyone is watching how much I make in a given week to figure out what (if anything) they need to continue to pay me, I CAN'T GET BENEFIT PAYMENTS until I fax in my biweekly pay stubs! Yikes.

9. Think about your career as a marathon, not a sprint. You will have more responsibilities and more conventionally-accepted forms of success at work... eventually. You will be a boss again, win awards again, lead projects again, etc. Just work on getting there... gradually. Don't take on so much that you burn out, or put yourself under massive pressure to be your old self at work. That old self is no more... pieces of that person come with you to work every day, but you are bringing new experiences and interests to the table, too. Work at a pace that you think you can sustain for the next 30 years! Be the proverbial tortoise. 

10. Celebrate, celebrate, celebrate, and keep fighting the good fight. You can do it! I know it, you know it, but other people may not appreciate what a success you are in going back to work (and staying back at work) after medical leave. Dance a little. Be happy about it. You have, as my family likes to say "done real good." 

Going Back to Work After Medical Leave - 6 Month Update

I've been back at work for six months now. And I keep learning things that I would like to share with anyone else who has recently returned to work after medical leave (or is starting to consider doing so).

Enjoy Feeling Better

Six months into working again, my body is getting used to the physical demands of being at work. My muscles don't start to ache half-way into each workday anymore. My neck pain is nearly gone (unless I do something that I know will set it off). My mental energy is strong and steady. My body is ready and willing to wake up at the same (early) time each day (I may be tired and achy, but at least I'm awake). I'm still exhausted by the end of each shift. I'm still not ready to work a full 8-hour day. But I'm making progress. Gradually, working is getting a little bit easier. 

If you're noticing similar improvements, don't forget to celebrate and appreciate them. It may not be a big deal to my friends or family that I'm making gradual progress, but to me it's like Christmas every day. I'm sure your modest improvements are a big deal to you, too. Be glad. Appreciate your body's determination and success. 

Be Certain Before Increasing Your Work Hours

Since returning to work, I have increased my work hours by 50% - instead of working two half-day shifts per week, I work three half-day shifts (M, W, F). But I didn't jump right into that change. 

I've had two basic ideas at play as I consider adding more work hours to my schedule: (1) I want to keep moving forward without risking a backward step, and (2) I want to be sure I can handle the work schedule even on my very worst week. Why (1)? Because people come to rely on you being at work on certain days, at certain times. The last thing you (well, I) want to do is add so many hours to my week that I can't keep up and have to cut back. I don't want to tell someone that I'm going to be less available in the future rather than more available. It's confusing and could turn people off. Why (2)? Because my energy and symptoms ebb and flow over the course of weeks or months. But I am still expected to show up to work during bad and good days alike. Especially as a part-timer. I need to be able to grunt through work even on a bad day. (Yes, it's possible to take sick days, but again, it could send the wrong message if I call in sick repeatedly.)

I gave myself 60 days, minimum, to get used to 8 hours per week, before I even considered increasing to 12. And when I thought I was ready, I delayed the change for another full month. I just wanted to be sure I was up to the change.

Report Your Income

If you are receiving short-term or long-term disability payments from a private insurance plan, and/or receiving federal Social Security Disability Income (SSDI) payments from the U.S. government, you are obligated to notify these organizations about your earnings. [Typically, you can work a certain number of hours per week while receiving full payments, then there's a period of time in which you work and get partial payments, then there's a period of time in which you work and no longer receive any payments at all. The Disability Benefits 101 website has excellent information about SSDI work rules in the article SSDI and Work, and a beautiful visual example of how the rules work in the linked SSDI Work Rules Closeup.]

Be Patient with the Present Moment

You won't be your boss's pet. You will probably be lowest on the totem pole. You may still have trouble concentrating or holding onto things or whatever else you need to do each day. You will have bad days. You may have more work to do than you can handle, or none at all. I have the latter problem... I have to remind people over, and over, and over, that I am lacking something to do and would like to help someone with any assignment. (I still, every Monday, wind up coming in to work and telling my entire team "I have nothing on my plate this week, so if you have an assignment you need help with, please let me know.")

This is not forever. You can still do good work and be helpful to your team or employer. Just be patient with whatever frustrations may exist in the here and now at work.

Set Boundaries 

Arrive to work at your established start time, leave work at your established departure time, work while you're at work, and rest while you're at home. Easy, right? Not for me! I have found myself over and over again wanting to stay late or to work from home so I can make more of a contribution to some large assignment that's behind schedule or otherwise veering towards danger. Then I remind myself that being healthy is my job... work is just work. And it will be fine without me. There's always going to be an emergency. I can't fix them all. 

I've also wanted to work from home for free... do some research, etc. so I can do a better job the next time I'm at work, ready to write. This is the worst madness of all. If I'm working, I might as well do it on the clock and get paid for it! 

Reining myself in and walking away from needy projects has made me go berserk. I hate leaving loose ends in general, and hate even more that someone else has to finish things for me. When I get in this state of mind, I tell myself "You are crazy," and then I go home, on time, and let it go. 

Walk Before You Can Fly

This goes with the idea of reining yourself in. You may have big, big ideas for what you want to do at work... ideas that are bigger than your ability to execute them right now. I want to bring in some new customers at work... but I don't have any time or energy to go out there and find them, write proposals, negotiate contracts, etc. It's on my long-term plan, but I just can't pursue it wholeheartedly yet. So I keep a long-term to-do list posted on a bulletin board in my workspace, and jot these kinds of projects onto the list, then go back to focusing on whatever small assignment is right there waiting for my love and attention. I may not be thrilled about writing fact sheets all the time, but I can do a good job on them in the time I have at work each week. That's a good match-up and a great way to be useful to my team and company.

Remember That You Deserve to Be There, As Yourself

Sometimes I feel like a shadow at work... no longer invited to sit with the big boys and talk big ideas (strategy, business development, etc.). But that's 90% made-up... all in my head, driven by a little insecurity about how useful I can be as a part-time employee. 

I keep having to remind myself... I deserve to be there. I am not a lesser employee for my time off. I am still that skilled person I was before medical leave. The company hired me for my skills and experience, so I should use them by giving my ideas, having opinions, developing strategies, and correcting problems where I see them. It's what they hired me to do. It doesn't matter that I'm not around all the time... that doesn't mean my job description has changed!

Why Do I Care about My Career?

I have been getting a lot of snotty comments lately (from relatives, no less) about my relationship with my job. "Why do you care so much?" "Why do you try so hard?" "It's not like you're going to get promoted, or ever be given any real responsibility as a part-time employee." "Why are you considering getting a graduate degree? It's not like it will make any difference for you at work."

These people mean well, but their implications about life with disability are horrifying. People with disability are supposed to give up, and if they can work at all, they should expect to do nothing but unimportant grunt work for the rest of their working lives. To be the last on the list for anything... raises, promotions, big assignments, training courses, etc. To be willing to accept a career that has stalled out and never seek to broaden their horizons educationally or professionally.

I'm not buying it. And people think I'm nuts. Every now and then, you can feel life and possibility calling to you. You have a sense that you're on the threshold of something great... some opportunity is going to waltz into your life soon. I have a lot of things calling to me right now. Work is going well, and more people are recognizing that I do good work, and asking me to do more of it. So I'm committed to keeping up the good work... I love my job and my workplace and want to make the best I can out of my employment there. I also have an opportunity to design a book memorializing my Dad's life. This project appeals to me on so many levels that if it goes well, I might want to make a career out of it. I also want to get a graduate degree in health policy, health education, or public health so I can bring my unique experiences to bear in helping others survive illness and better navigate our labyrinthine health system. And I love cooking, and have this creeping desire to either teach cooking classes to kids or run a for-profit business providing meals to elderly people living at home alone. 

Yes, that is a massively full plate of ideas, potential future directions, etc. And yes, I barely have the energy to tackle my current job, let alone take on graduate school and/or starting a new business. But, much like people say "don't dress for the job you have, dress for the job you want," I want to position myself for the possibility that I could run a new business, get promoted at work, or successfully complete some kind of grad degree. I want to act as if all these goals are realistic and possible... because that in itself helps make them possible. If I act like I want to be a mindless grunt at work, that's all people will ever ask of me. If I don't at least try applying for a grad degree and taking a test course, I will never have an MS/MA on my resume. I may not achieve any of these goals for years (or decades). But I want to "risk my significance," and reach for goals that matter to me and to the world around me. As one of my favorite poems says:

I will not die an unlived life.

I will not live in fear 

of falling or catching fire.

I choose to inhabit my days,

to allow my living to open me,

to make me less afraid,

more accessible,

to loosen my heart 

until it becomes a wing,

a torch, a promise.

I choose to risk my significance,

to live so that which came to me as seed,

goes to the next as blossom,

and that which came to me as blossom,

goes on as fruit.

--Dawna Markova

Going Back to Work After Medical Leave - 3 Month Update (part 2)

When you return to work after medical leave, the first major hurdle is sheer fatigue. But there are many other challenges to navigate. Today I would like to focus on two other major issues: awkwardness and feeling rusty. 

Banishing the Awkwardness

It will feel strange to be back at work, regardless of how long you were (or weren't) away. Things will have changed since you left (different faces, different approaches). How do you fit into the new version of your old workplace? It is going to seem awkward. At some point, you are going to feel left out. You are going to feel disconnected, out of sync, and just plain stupid at times. Perhaps many times.

You may have forgotten how to talk with colleagues... about anything! Working involves a learned set of behaviors that don’t come naturally and that don’t get used when you are at home or out volunteering. (Because, let's face it, left to our own devices, we typically spend time with people we like and get along with easily. Only at places like work or school do we have to exercise extreme tact, deference, etc. to get along with people we don't like so much.) I actually found that my voice was raspy from lack of talking (I talk a lot at work, whereas at home, I would just chit-chat every now and then with friends or family). And I had forgotten how to project my voice so that someone could hear me from the far end of a meeting-room table. Yikes.

Also, people aren’t going to know what to do with you. Bosses will want to know how fast you can get back to your old schedule, how much work you think you can take on, etc. You don’t know. You won’t know until you know. And bosses hate answers like that. Also, they may never have had a part-time employee or employee who needed reassignment to a lower-intensity job; they may simply have no idea what work to assign to you.

Peers may pity you (I got some strange looks and awkward hugs)… you have to nip that in the bud. You aren’t a poster child for disabilities. You are someone who deserves to be there. When someone starts the whole "Oh, you poor dear" thing, I don't buy into it. I say as little as possible in response to their questions, and try and stay focused on a positive present moment. "Oh, was it terrible being at home all by yourself all that time?" someone will ask. "I was busy getting well. And now that I am healthy, I'm thrilled to be back at work" I might respond. When you don't warm to the pity, it usually ends. Pitiers are often parent-like in their interest; if you don't respond like a helpless child, they move on. 

Also, people aren't going to quite know how to feel around you because healthy working professionals don't think about illness, and really don't think about recovery from illness… the person who has a stroke isn’t supposed get healthy again. Ditto for cancer, or anything requiring major surgery. In person, you are a reminder that accidents and illness happen… and people don’t like to be reminded of their frailty and mortality. People are frankly more comfortable if the sick person stays that way, out of sight.

I find that in general, when confronted with any kind of awkwardness (I feel weird, a boss feels weird dealing with me, a colleague looks at me like I have risen from the dead), it helps to acknowledge the weird feeling to yourself. Then stay rooted in who you are today, and strive to stay warm and professional in your interactions at work. I still gripe at friends and relatives about awkward moments that have happened at work; but after a little venting, the embarrassment and anxiety diminish, and I go to work the next day feeling calmer and more professional.

Brushing Off Old Skills

You probably didn't do anything like your job while you were at home. So your working skills are going to be rusty. I've had to remember how to manage an overflowing email inbox, how to do my timesheet and request vacation time at work, and how to just do the work itself. Edit an essay in favor of nuclear plant license renewal? Write a fact sheet about a new propane heater for school buses? Divide a massive writing assignment up between multiple team members and track their progress? Doing each task was a real reawakening process for me. I hadn't done anything like that in over two years, so I was pretty slow with my work at first. I did good work, but it took me longer to do it. Now, more than three months into working, I feel like my work brain is turned back on. But there are still days when it is slow going. 

If you find yourself in this position, be patient with yourself. Take your time… and try a little bit of every kind of work you possibly can, even work that might have once been beneath you before you were sick. I used to manage projects and delegate work to other editors; now the roles are reversed and other people assign work to me. But it's important that you think about your career in a broader time frame; you need to get your fundamental skills back if you want to later advance your career and do more exciting or challenging things. Walk before you run. Doing a good job on any kind of assignment (big or little) is a great way to show off your skills (people probably don't remember how good you are) and be a team player. Also, I have found it very useful to remind myself over and over again that "I'm just here to help." I try and take my ego out of it and focus on helping my team succeed.

Going Back to Work After Medical Leave - 3 Month Update

I have been back at work for 3 months now, working two tiny little four-hour days per week. And I'm still at it! I haven't been fired, reprimanded, or gotten too ill to continue working. My neck pain is even mostly under control, thanks to having a very ergonomic computer/desk/copy stand to use at work. So I am THRILLED. 

To celebrate my successful re-entry into the world of work, I will post a series of short articles focusing on the challenges I've faced as I return to work. And the lessons I've learned, mostly the hard way. In this first post, I want to focus on the physical aspects of returning to work.

Prepare for Exhaustion with a Capital E

Going back to work was the biggest shock to the system I have perhaps ever experienced, outside of surgery. Making a drastic change in the pace and complexity of your days is a challenge for anyone, but it's an Everest to someone who is recovering from an illness or injury.

When I first began working, I was so tired by the end of each work shift (four hours) that it took me more than 48 hours of resting and doing almost nothing else to recover. For the first three weeks, I was literally so tired I could cry, and so exhausted by the middle of the day that the muscles in my torso hurt just from the effort of sitting up. I was mentally spent, too. By lunch time, my concentration was gone. (I was seriously out of practice.) This lasted for a solid 4-6 weeks before I noticed any improvement at all. 

My physical therapist warned me that returning to work would be a shock. She suggested I practice my work day at home... get up, shower, dress for work, pack a lunch, drive/ride for the normal length of your morning commute, get back home, put your lunch in the fridge, "work" for a few hours, break for a quick lunch, resume "working," pack up and leave for the day, drive/ride again (for the amount of time you would normally commute), arrive home, and change back to normal clothes. No napping or laying down, unless you can do that at work. 

I wish I had taken her advice. I didn't realize that left to my own devices at home on leave, I was probably automatically taking it easy… sitting down every few hours, laying down for a little nap, etc. Even just closing my eyes for a few minutes or switching from a mentally difficult task to an easier one. So when I started work and suddenly had to be upright for 6-7 hours a day (4 hours of work, 1 hour for lunch, 1-2 hours for breakfast/shower/grooming and commuting), I wasn't ready. I didn't have the stamina or muscles necessary to sit at a desk all day. (Even though a desk job is probably the least physically demanding kind of work I could possibly get.)

Prep Your Life Outside of Work for Ease and Support

Given how physically and mentally tired you might be in your first few weeks or months at work, you need to have a support team ready to help. Hire any help that might make your life easier for a few weeks (dog walker, cat sitter, lawn mower, cleaning lady). Ask friends or neighbors to run errands for you on days when you are just pooped. Have your doctor's office number handy and have extra meds on hand to cope with flare-ups of your physical symptoms. Consider scheduling a massage or physical therapy session weekly to help with pain and ease tired muscles. 

Plan ahead in the areas of cooking, cleaning, and laundry. Make a huge batch of something, divide it into individual portions, and throw those in the freezer. Stock up on pantry staples like ready-to-eat soups and microwaveable frozen vegetables. Clean your house before you return to work, so you don't have to worry about it for a while. If you have to dress up for work, this is the time to break out your drycleanable clothes. You can usually wear dryclean-only clothes at least twice before they need a cleaning, which saves you a lot of work as compared to washing and ironing an outfit after each single day of wear. If your work wardrobe is filled with clothes that require washing and ironing, go to the effort of having a full week's outfits (or more) ready by your first day of work. It's also a good time to reach for any clothes (like knit jersey dresses) that wash well without needing to be ironed.

You might also want to ramp up or slow down your social calendar, depending on what works for you. Ask friends to call you (if hearing from them gives you a boost), or warn them that you might be out of touch for a while (if you're someone who gets too tired sometimes for social contact). Clear your appointment calendar of anything unnecessary (a doctor's appointment that can easily wait a month or two) or overwhelming (like a road trip to visit friends or family). For my first three weeks of work, I didn't go to a single doctor's appointment (they were too far away, and I was too tired to drive), and I think I might have talked to one or two friends/family members. I didn't go to parties or any other social events. I was a hermit. I needed to be. You might need to be, too.

***

In the next week or so, I hope to continue this series with a new post about getting over the awkwardness of returning to work.

 

Negotiating a Return To Work, Step Three (Visiting)

When you decide you are nearly ready to return to work after medical leave, first you need to start the conversation, and second, you need to make sure your workspace is ergonomically correct for your new and improved body.

Step 3 involves visiting your workplace, ideally when other people are there (not at the height of lunch hour or the tail end of a Friday). Why? You want to accomplish three things on these visits: 1) clear up/set up your workspace, 2) raise your visibility in the company, and 3) work out the emotional buzz (positive or negative) you feel when you step back into the office.

Clearing Out/Setting Up

I went on medical leave nearly two years ago, and at the time, I was there one day, and gone the next. I was in the midst of a major project and had piles of papers strewn around my office (even on the floor... yikes). I had no idea I would go home on a Wednesday and be unable to return for weeks after that.

Now my office space belongs to someone else, and those piles of paper (and everything else in my office... awards, pictures, plants, etc.) have been hastily dumped into storage boxes and moved into an "empty" office down the hall. I say "empty" because the person who worked in it before me left her own piles of mess behind. So I've visited the office twice (for an hour or two, once a week for two weeks) to recycle all of my now-irrelevant paper files, chuck the previous tenant's stuff, and unpack my treasured personal belongings. I've also wiped down my desk, windowsill, and bookcase to remove months' worth of dust, decaying plant leaves, etc. It will feel better to spend my first day in a nice, fresh office than in one weighed down with everything I left behind.

I used two small, short visits to limit the physical strain involved in this kind of cleaning up and clearing out. Paper is heavy! Reaching down to dust surfaces is still painful for me. So getting this physical task done before my first day not only gives me a nice, sparkling clean office to feel good about, it allows me to space out the pain and fatigue now, while I have more free time to recover. My first day back will be physically demanding no matter what... I don't need to make it worse by starting it with an hour or two of cleaning.

Raising Visibility/Feeling the Vibe

My visits to the office have given me a nice way to quietly announce to the world "Hey, I'm coming back." People have passed my office, seen the light on (and me there), and stopped mid-stride. "I didn't know you were back! Oh good!" has been the general comment. And these encounters have given me a chance to clarify timelines ("I'm not back yet... but will be in two weeks") and essentially market myself to the bosses. If they know I'm coming back soon, they can start lining up projects for me. And being seen in person is still a much more effective way of marketing myself than trying to promote myself through email.

Visiting has also given me a chance to feel out what colleagues think about my part-time schedule... before we're trying to work together on a real project. Most people have been nothing but enthusiastic, but some have been a little apprehensive. I've also picked up a thread of pity and awkwardness from a few people ("Oh, bless your heart, you poor dear"). I like knowing these things ahead of time... it leaves me with fewer surprises on my first day back. And it gives me some time to consider how to persuade the apprehensive and get the pity people to snap out of it.

Releasing the Emotional Buzz of Being Back at Work

The first time I visited my office (to get my ergo assessment done), I was an over-excited nut-job. It was really thrilling to realize my long-held vision of being well enough to get back to work. I had worked so hard and come so far. I was also a little embarrassed and uncomfortable... it is weird, after all, to disappear overnight with health issues, and leave others to pick up the slack. Excitement, embarrassment, and other intense emotions wear me out. By the time I had visited and returned home, I was so tired and in so much pain that it took me two days to recover.

The second time I visited my job (to start cleaning my office), I was much calmer, but still excited. I got a few hugs from old friends, which revved up the excitement even more. So again, by the time I got home, I was a wreck and spent more than a day getting myself back together.

The third time I visited my job (to finish cleaning up my office), it was almost business as usual. My car resumed its ability to auto-pilot me to work. I knew where to park, which door to open, how to use the new security badge. I knew where to find things in the supply cabinet, where the recycling bins are, and how to open the super-heavy bathroom door without killing myself. And my office was starting to feel like mine. I was still excited, but managed to get to work and back without wearing myself out.

By the time I do return to work for real, the embarrassment, excitement, and awkwardness will be nearly gone, and I will be able to concentrate on working. I don't want to be riding an emotional roller-coaster while trying to convince people that I'm reliable and professional!

Going Back to School After Medical Leave?

An important footnote for anyone trying to resume school after medical leave: Your process is probably going to be similar. You have old papers/notebooks to clean out, almost certainly, and a new "office" to set up (a dorm room to move into or quiet corner of your house/apartment to establish). And you could certainly stand to visit campus before you re-enroll. You could visit your academic advisor/counselor, check up on old friends, reacquaint yourself with campus (new buildings seem to pop up overnight, don't they?), touch base with favorite professors, go to the student union and smell the terrible food again, etc. Setting foot on campus and seeing old friends/faves could release a wave of pent-up emotion, too. You should probably ease back into things, giving yourself time to physically and emotionally prepare to be a student again. Perhaps you don't even want to return to your former school right away; would a semester at a local community college give you a chance to test the waters and regain confidence? Work with the disabilities office on campus, your parents, your friends and roomies, etc. to make moving back in and getting back to class as easy on you as possible.

Returning to Work: Time to Decide and Go For It

As I prepare to go back to work, a little voice inside me is very, very afraid it's just not going to work out. "What if it's too hard? What if you're in too much pain? Or just too tired?", the little voice says. So I have allowed my application for federal disability income to proceed, in case I need it in a few months (after my attempts at working have blown up in my face.) My logic is that the process takes so damn long to play out... why let my place in line slip if I might need it in a few weeks?

This week I decided it was time to piss or get off the pot. Am I man or mouse? I know I want to go back to work. (The ergonomic equipment vendors are taking their damn time helping me test and order stuff, but that has only firmed my resolve. These people are pissing me off... they are delaying my return to work.) I need to have the confidence to know I can make it work. And I need to get brave and notify my private long-term disability insurance carrier and the woman overseeing my federal disability income application so they can modify my file accordingly. I will only be working on a very part-time basis, so the private long-term disability benefits will continue. The federal disability income application, however, will end (you can't work at all and get federal disability income).

Am I nuts? What if working does not work, and I find myself having to restart my federal disability application all over again? Well, God help me if that hypothetical bad situation comes to be. I'm going to focus on today and see if I can't make working work, one day at a time. IF I can ever order a daggone ergonomic chair. (Hello, vendor, can you hear me?)

Negotiating a Return To Work After Medical Leave, Step Two (Ergonomics)

In my quest to get back to work, I met with an ergonomics specialist last week. This person reviewed my work space and recommended ways to reduce strain on my neck and back. The number one recommendation? Buy a high-backed, supportive chair with neck rest. I thought it would be a snap to get a chair ordered before tomorrow (and the start of my Christmas vacation). I was wrong! If you find yourself in a similar situation, be sure to allow lots of time (weeks, not days) to select your equipment and have it ordered/delivered.

The first thing that slowed me down? Management approval for the purchase. I had no idea it would take a few days to approve a $1,000 expense.

The second thing that slowed me down? Finding sample chairs to try out. Last week, I contacted an ergonomic equipment vendor and asked to test a few chairs. I know I can't start work without a new chair (the one I have causes back pain after 10 minutes), and I know I can't just pick one online (spinal fusion surgery has changed my body quite a bit). I have to sit in a few models and see what works for me.

The ergonomics specialist had previously told me that ergonomic equipment vendors can make things happen in a few days. Man, was that incorrect information. I am a week into the process, and the ergo equipment vendor still can't find any sample chairs for me to test out. He might have some ready when I get back from my Christmas break. But those will only be samples. I will still have to place an order and wait for the chair to arrive.

All of these delays will probably make it impossible for me to start work on Jan. 14 as I had planned. No new chair = no new Valerie working in the chair. Bummer. I can use the extra time to continue PT and pain treatment. But it is frustrating to have to wait.

Negotiating a Return to Work after Medical Leave (Step One)

As I posted earlier, my neurosurgeon finally cleared me to resume working, when I feel ready, for as many hours per week as I can handle. (Or think I can handle.) So today, I started the transition back to work. And it was a bumpy ride.

While I'm not officially back at work, I went to work today to meet with ergonomic consultants. They assess my office and recommended improvements that should take some strain off my neck and back.

Last night, I was terribly excited. I got to say "I need to get ready for work tomorrow" for the first time in 20 months. It was fun... I rounded up some holiday cards that I wanted to give out to my coworkers, an award plaque that I needed to turn over to the company president, and some paperwork for the ergonomics people. I plunked all of that into a lightweight laptop tote that I bought months ago and had been waiting to use. I even picked out what I wanted to wear and set it aside.

This morning, I got up earlier than usual and spent a silly amount of time getting my hair and clothes just right. Then I hopped in the car with my spiffy tote and a bright red trench coat (it was raining), and hummed my way to the office. I felt like it was the first day of school as I marched into the building with my new tote and my cute hair.

The ergonomic evaluation went well, although I know my company may balk at the cost of some of the office improvements the ergo people are likely to recommend. I had hoped my company would have a check ready to pay the consultants, but that did not happen. It was a slightly bad sign. I can't tell how committed the company is to making my workspace work for my new neck.

The really bumpy part came after the ergo evaluation, when my direct supervisor and I sat down to chat about how my return to work would happen. He and I had previously chatted online about me possibly working on Mondays and Thursdays, from 10 to 3 or similar, with a one-hour lunch break. So he wanted to confirm that plan. No big deal.

We also discussed which week I would officially resume working... which is likely to be the week of January 14. I have facet injections scheduled for Jan. 8 to reduce the nerve pain in my arms, so it makes sense to start after the injections have kicked in. This was a little bumpier discussion, because there is a chance that the facet injections will not work, and I will still have enough arm nerve pain on Jan. 14 to want to continue medical leave.

We also discussed what my company lovingly calls "workflow integration". Namely, how I will wind up having work to do when I'm at work. My company consults for other companies, doing planning, analysis, and communications/outreach work. So I don't have a steady assignment to work on (it's not like I'm a reference librarian and know I will be working at the reference desk every day). Our company gets money to write this report or analyze that topic, to conduct this planning session or develop that outreach document. Pieces of these projects get passed on to me, so to stay busy at work, I depend on other people deciding they need my help on a project. (I can attempt to reduce my dependence on others by winning my own contract work, but at this point, I don't have the energy.) If I don't have client work to do, I bill my time to company overhead. And that is very bad indeed... do that often enough, for long enough, and you will get canned. (You're not making any money for the company.)

This "workflow integration" is tricky business for so many reasons. If I'm only available two half-days per week, how much work can I even actually get done? Not too much, and not very quickly (in terms of calendar deadlines). Which makes other people much less likely to give me a piece of their project... it's not worth the hassle if I can only provide such limited help. My boss and I discussed that I could simply serve as a team helper... if someone on my team is overloaded with work, I can take on some of it to give them room to breathe. We also talked about perhaps trying to concoct small, non-urgent projects that I could do by myself for our existing clients. How many of these exist, though? Probably not many. We also talked about how I could contribute to internal team efforts related to marketing our services and such. That would be good... these things have been neglected for so long that no one is in a hurry to finish them. But these projects don't make money for the company, so I can only do so many before I get fired.

Also, if I'm only available two half-days per week, how can I manage client relationships? That used to be part of my job... being the primary point of contact, someone who talks with our clients regularly, solves problems, manages workloads and budgets, tries to get more business with the client, etc. I can't solve a problem that arises at 5 p.m. on a Tuesday evening if I'm not in the office, and there are very few clients in this world who want a part-time project manager. Their businesses move too quickly for that.

Also, my company's business planning model relies on personnel who are available on a full-time schedule. Period. They don't plan for people who work a 20% or even 50% schedule. And this is largely due to time constraints... our clients need things done fairly quickly, so we plan to throw X number of full-timers on the project until it's done. So there are very few assignments available right now that have the kind of long-term deadlines that would allow me to be part of the project work team.

My boss and I also talked about being sensitive to others' feelings. I wasn't a rock star when I left work on medical leave, but I was showing promise and doing good work (good enough to get a decent 6-month raise). Being at work one day and literally out of commission the next left a large gap. An entry-level coworker stepped in and has done a tremendous job while I've been away. She's grown from being a project worker to a project leader and now has client management responsibilities. My boss doesn't want her to feel slighted or eclipsed or in any way undermined by my return. I get that.

I don't plan to be feted upon my return. I don't expect to be handed big important assignments. I don't even expect for many of my coworkers (outside of my immediate team) to know I'm back at work. I do plan to be ignored, underutilized, and a great source of puzzlement to my boss. I represent a challenge he has never faced.

And at the heart of it all, I'm simply so incredibly grateful that my company is willing to take me back and work with me as I gradually increase to a 20- or 30-hour work week. Today, I kept telling my boss "I'm here to help." Period. They could have terminated me after my first 12 weeks of medical leave, but they chose to keep my employment open. They could have refused my request for an ergonomic assessment, but they have promised to pay the fee. I will do whatever work I am asked to do, and cheerfully, too.

The conversations today have raised one unsettling issue. I can't tell if my boss is trying to tell me "Hey, we're going to give this a try, but I don't think it's really going to work for us (the company)." He did tell me that he thinks I have valuable skills and can make good contributions to the team's work. But he does seem profoundly confused about what to do with me as a limited part-time employee.

The concept of this not working out makes me want to vomit. I do not want to have to hunt for a more appropriate job (I have no idea what a more appropriate job would even be, but I'm sure it would involve a pay cut.)

Fingers crossed. Let's hope that my boss and I can be mature enough and open enough to find a way to make this work! I'll post more about my return to work as I get to it and through it.

Finding the Right Job for Yourself and Your Illness

Tips for finding a job with work-life balance, flexibility, time off, and good benefits.

Finding a job -- any job -- is daunting in today's unpredictable job market. Finding one you enjoy is even tougher. And finding one that you (and your illness) can live with is the ultimate challenge. How do you make work work for you?

For many people living with illness, the keys to working include

• energizing work,
• work-life balance,
• good health insurance,
• ample time off, and
• flexibility in work hours and level of responsibility.

Some strategies to get what you need:

Find energizing work. This isn't some self-help mumbo jumbo. You may not notice, but there are certain activities that energize you -- they pick you up on a slow day. You can do them for a long time without noticing that time has passed. They make you feel better. For me, they include talking with others about design issues, and dancing. I can't make a living dancing, but I can make a living working with designers. Realize that two jobs with identical titles could be very different in rhythm, interaction with others, etc. These finer details may make all the difference to your energy level.

Look for jobs where you will be one of many. Working with others in your field is great -- you get moral support, learn from each other, and most importantly, can cover for one another. If you're the only person in the office doing your job, problems may arise if you are out sick unexpectedly. If you're one member of a team, though, your absence won't cause as much drama.

If you're a writer, consider working in the writing department of a major newspaper, a pool of editors at a consulting firm or government institution, or a design firm with multiple copywriters. If you're a system administrator, try working at computer-intensive job sites: national laboratories, government offices, universities, major corporations.

Look for jobs in stable industries or companies. Staying employed is the easiest way to get health insurance when you have acute or chronic health problems. Once you have it, you want to keep it! In most cases, you can join an employer's health plan, no questions asked. There's no health exam to pass, and few (if any) preexisting condition limitations to deal with. And the coverage is often less expensive than coverage you could buy as an individual.

Stable industries are harder and harder to find these days. Government (city, county, state, federal) may be your best bet. You can find stable companies fairly easily -- check company web sites (under the About Us section) to learn how old the company is and how it has grown. Skip working for start-ups, unless you do best in that kind of all-stress, long-hours, all the time jobs. 

Get the time off you need, by hook or by crook. Think creatively -- you may not have to be a standard, full time employee. Consider working part-time, if your finances can handle it. If you're in a high-pay field, consider working as an independent consultant. As an independent consultant, you can take time off without pay. It's a win-win; you get time off, they don't have to pay for it. If you want to work as a standard full-time employee, seek out companies that give more time off. (Again, go to the company's web site, and look for the HR section. Some sites include a link to benefits info.) Nonprofits, government, and universities often give more time off than most.

Consider telecommuting. It's great if you find commuting unbearable. It's great if you need to take a midday nap. It's great if you need to precisely control your physical environment (light, materials, humidity, ventilation, etc.) Telecommuting jobs are hard to find, but some office jobs will at least let you telecommute once in a while.

Be smart about getting benefits information. At your first in-person interview, don't panic about benefits. Just ask for the name of an HR manager or benefits specialist. Call that person the next day and request a summary of benefits programs. Companies often have a one-page summary or small booklet that tells you about time off, health plans, and other benefits offered. By speaking with an HR or benefits manager, you don't tip your hand to the hiring manager. That person doesn't need to know that you are concerned about benefits.

Never take a job sight unseen. You can learn a lot about the mood, attitude, and morale of the workplace just by walking through it. Is there enough light, space, privacy, social interaction, etc.? Do people seem content to be at work? You can also learn about a company's support of ergonomics by seeing what sort of desks, chairs, phones, etc. are in employees' offices.

Pay attention to little off-hand remarks that show the company is interested in having their employees healthy, happy, and relaxed. At the same time, listen for remarks about long hours, high expectations, etc. I've heard a little bit of everything:

• "our ridiculously high standards"
• "our crunch times"
• "paid overtime"
• "unpaid overtime"
• "special events"
• "networking lunches"
• "40-hour weeks"
• "training paid for on company time"
• "this is a safe place to work"
• "this is a happy place to work"
• "the project managers here are penny-pinchers"
• "we like to make sure people are working on assignments they like"

and more.

Listen and watch around you -- do people have hobbies? Photos of their children and pets? Are they maniacally checking email? Have they worked there forever? Are there at least a few people there who are your age and experience level? Do they seem content or overworked?

Best of luck to you. And relax -- you can't figure it all out before you're hired. But many companies prove to be more flexible than you expect, once you're hired.