Michael Smith, MD
While keeping your private life out of your work life is the professional way to go, sometimes, that's not practical -- or healthy. When you have a chronic illness, such as epilepsy, peanut allergies, or diabetes, you need an ally at the office.
Who should that ally be, how does he need to handle himself, and what should he do in case of an emergency? Here are some practical tips experts offer WebMD that will help you balance your health with your career.
Living With a Chronic Illness: Who Needs to Know
"Start by talking to your doctor," says Susan Kerner, director of the Employee Assistance Program for Southern NH Health System in Nashua, N.H. "Your doctor can help you better understand and articulate what your symptoms are, how severe they are, and exactly what you need to be prepared for."
Next, find out if the company you work for has a corporate or employee health department.
"It's sometimes helpful to talk to an occupational health or corporate health representative who can give you words of wisdom," says Kerner. "They are experienced in areas such as helping employees deal with issues like these in the workplace."
You should also ask yourself if your chronic illness will require certain accommodations, like a different work schedule because of medications, or frequent breaks. If that is the case, then a discussion with human resources is warranted.
"Talk to someone from human resources about your health needs at work, especially if you need them to be aware of certain issues that might impact your work schedule," says Kerner.
Then, it's time to talk to the people you spend eight or more hours a day with, and help them better understand how they can help with your chronic illness.
"You need to tell the people who work physically near you, as well as your manager, so practically, if there is an emergency, they can handle the situation," says Kerner.
So what, exactly, do they need to understand about your chronic illness in case of an emergency?
Your Chronic Illness: What They Need to Know
"Be realistic about what they need to know," says Kerner. "Make people aware while not creating excessive concern, and alleviate their fears about what to do when something happens."
Bottom line -- help them understand what they need to do so they don't panic.
"The things that I emphasize are a calm, demeanor, a semblance of order, and the avoidance of panic," says Eric B. Larson, MD, MPH, chair of the board of regents for the American College of Physicians. "This is absolutely the most valuable thing to bring to the situation.
"It's also advanced planning," he tells WebMD. "It's not the person's personality that allows [him or her] to be calm in a frightening situation. It's a sense of mastery, preparedness, and doing what you need to do when it matters."
Your Chronic Illness: What They Need to Do
For chronic illnesses such as epilepsy , diabetes, and severe food allergies, such as peanut allergies, there are specific dos and don'ts. Make sure your co-workers understand what these rules are, so they are fully prepared when it matters most.
What should someone do if you have a seizure? Here's a list of what to do and what not to do. Print out the following and share it with friends and family:
- Loosen clothing around the person's neck.
- Do not try to hold the person down or restrain her; this can result in injury.
- Do not insert any objects in the person's mouth; this can also cause injury.
- Reassure bystanders who may be panicking and ask them to give the person room.
- Remove sharp objects (glasses, furniture, and other objects) from around the person to prevent injury.
- After the seizure, it is helpful to lay the person on his or her side to maintain an open airway and prevent the person from inhaling any secretions.
- After many seizures, there may be confusion for a period of time and the person should not be left alone.
- In many cases, especially if the person is known to have epilepsy, it is not necessary to call an ambulance. If the seizure lasts longer than five minutes, or if another seizure begins soon after the first, or if the person cannot be awakened after the movements have stopped, someone should call an ambulance. If you are concerned that something else may be wrong or the person has heart disease or diabetes you should contact a doctor immediately.
Share this list of symptoms of low blood sugar to help people know what to watch for:
- Pale skin
- Poor coordination
- Passing out
Then be sure your colleagues know how to act quickly in case of hypoglycemia:
- If you suffer from frequent episodes of severe hypoglycemia a glucagon
emergency kit should be prescribed by you doctor. This would be used in case
your reaction is to the degree that you cannot help yourself through the
reaction. Here another person can give you an injection in your muscles of
the glucagon solution that will help bring your sugars up.
Give your friends a few ideas of things they can get for you to help bring your blood sugar up. Also let them know not to try any of these if you have passed out from low blood sugar. They should call 911 immediately in that case.
- Two or three glucose tablets (available at pharmacy)
- One tube of glucose gel (available at pharmacy)
- Chew four to six pieces of hard candy (not sugar-free)
- 1/2 cup fruit juice
- 1 cup skim milk
- 1/2 cup soft drink (not sugar-free)
- 1 tablespoon honey (placed under your tongue for rapid absorption into the bloodstream)
- 1 tablespoon table sugar
- 1 tablespoon corn syrup
While most allergies to foods can cause symptoms, such as hives or stomach cramps, severe food allergies can cause anaphylaxis -- an allergic reaction that can be severe and sometimes deadly. For you and your co-workers, this means recognizing the symptoms of anaphylaxis, which may begin with severe itching of the eyes, but within minutes progresses to more serious symptoms such as those below:
- Swelling, which can cause swallowing and breathing difficulty from swollen tissues in the throat
- Abdominal pain
- Hives, even in the throat
Immediate medical attention is needed -- have someone call 911 -- since the condition can quickly result in an increased heart rate, sudden weakness, a drop in blood pressure, shock, and ultimately unconsciousness or death.
If you have a severe peanut allergy -- or other food allergy -- you should always have an epinephrine injection with you. Epinephrine is adrenaline and it rapidly reverses the effects of anaphylaxis. Be sure your co-workers know where you keep it in your office, and how to use it. Even when the symptoms subside, someone should take you to the emergency room.
Published Oct. 11, 2004.
SOURCES: Suzanne Kerner, CEAP, director, EAP, Southern NH Health System, Nashua, N.H. Eric B. Larson, MD, MPH, FACP, chair, board of regents, American College of Physicians; and director, Center for Health Studies at Group Health Cooperative, Seattle. WebMD Medical Reference provided in collaboration with The Cleveland Clinic: "Epilepsy: First Aid for Seizures." WebMD Medical Reference provided in collaboration with The Cleveland Clinic: "Complications of Diabetes: Hypoglycemia." WebMD Medical Reference provided in collaboration with The Cleveland Clinic: "Anaphylaxis."
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