Tuesday, April 9, 2013

Return to Work Conversations

On January 14, Robin Roberts (host of Good Morning America) made a scheduled announcement about her health status. She's been away on medical leave since August 2012 because of a rare bone marrow disease. With all the brouhaha on January 13 to entice viewers to tune in and learn what the news would be, in addition to the smiles on every face that pronounced the upcoming announcement, it was a foregone conclusion that it involved something with regard to imminent return to work. And it was.

While the news about her return to work was celebratory for all, Robin talked about some of the expected and probably didn't realize she also disclosed unexpected information. Most people diagnosed with and treated for a major illness are put on some degree of disability and remain in that status for the rest of their lives. They become part of the 97% that Romney and Ryan spoke during the 2012 campaign who subsist on entitlements and expect a handout in order to survive in an economy with increasing inflation and little real money. There are few exceptions where there is a discussion about return to work; there are fewer about accommodations in order to make that a possibility.

Robin talked about the partnership of her doctors and care providers had with regard to formulating a plan for how she will transition from being ill to gradually working her way back to the studio and full time work. She outlined the stepped process and the various types of subtle dangers of being in the studio and under the lights. She shared conversations about regaining her energy. She will not be left floundering for answers and searching for what may be appropriate and safe in the way of accommodations during her early days of work resumption and progressing to "normal" life.

Viewing Robin's announcement and the recitation of her recovery and re-entry regimen could cause some with jaded healthcare perspectives to feel she is receiving privileged treatment. Some have the opinion that because she's already in front of the camera as part of her livelihood and career, that there's a foregone conclusion that she will be returning to work, not sidelined as disabled. Her non-visible disability, albeit temporary, does not color her employment opportunities nor her right to work and earn a living.

There are those who suffer from non-visible impairments but they are not counseled in clear and specific terms about what accommodations are required for them to resume full, meaningful employment in their chosen profession. Few are counseled about what to do or what restrictions could apply to them as it relates to their line of work.

My health issue focus of choice is coronary conditions. It could easily be other non-visible conditions such as back injury, emphysema, or venous stasis ulcers. Because the heart is so central to our well being but impairments of the organ are not visible, it is my focus. There are scales for measuring disability and whether a person is still employable. There is a presumption that the disability scale for physical activity is used by doctors in order to determine whether it's feasible for a person to look forward to returning to full time work, with or without restrictions. Does that conversation happen so that the patient is aware of all of the options available to them? If they're well below retirement age, they're not savoring the idea of spending the rest of their life subsisting on social Security Disability Income and restrictions on whether or not they may work. Even if they are able to find various types of employment, they're at a loss when it comes to truthfully responding to the question, "Are you able to satisfactorily perform the principle duties of this position with or without moderate accommodations?" And if they respond that they will probably need some accommodations, the question of which and what types of accommodations should be requested comes into play.

In addition to the activity scale, there is also the disabling conditions scale that covers a large number of issues. Our focus today relates to Cardiovascular Disorders. There are eight subsections of that type of disease and all have different ratings with regard to level of disability of an individual. It is possible for a person to have more than one condition co-existing with others.

How many suffer heart attack

How many people are suffering heart attack in the u.s every year? According to Americanheart.org, there are 1,255,000 heart attacks per year in the United States. This includes new heart attacks as well as recurring heart attacks. In the United States about 1.5 million Americans suffer a heart attack every year, from which as many as 500,000 die. I could not locate information about the number of individuals who survive heart attack and return to work.

What I could find, however, is individuals do return to work after heart attack. In fact, ehealthMD offers a very detailed article about Living After A Heart Attack that includes information about a sensible return, timing, as well as not often covered information about cardiac rehabilitation. What is it like to live every day with Heart Attack? Read real life accounts from people living with this condition can be found in an article on the condition at ThirdAge.com.

So this leads to how many suffer from congestive heart failure (CHF) and the number of those survivors who return to work. According to Staying in Shape, there are approximately 5 million Americans who suffer from the disease. Although their information is quite extensive, they do not answer the question about the number who return to work after being diagnosed with CHF. However, their article is dense with information about various other related matters as well as rehabilitation therapy.

There are guidelines for patients who suffer from heart failure and desire to return to work. The Job Accommodation Network (called JAN) has an accommodation series that includes heart conditions. It would be wise to refer to that resource first when seeking guidance on what to do in order to accommodate a worker with a heart condition. It therefore appers a return to work is not out of the question and in certain conditions can be done with success. Another place where guidelines for restriction and accommodation guidance regarding health condition can be found on MDGuidelines. There is advice available for the patient in regard to the advisability of returning to work full time available in many places. One of them is Heart Failure Matters.

Most of the language relating to heart attack and CHF put the two conditions into the same category of heart failure and heart disease. The information, in most respects, about after care, prognosis, and recommendations is similar.

What is worth noting is the fact that most people are 100% invested in their physician and rely on their professional to tell them what they need to know. Survivors and their families don't ask questions. When they are put on total, 100% disability, there are no questions about returning to work, extent of activities that are acceptable (except for sex), life expectancy, medications and what they do, alternative treatments. The physician takes it for granted that if there are no questions the patient has all of the information they need and will ask if there's something that needs clarification. Additionally, the physician is focused on the condition, not the person, and their focus remains in that area. People are living in a sea of being uneducated and possible risk for another attack that didn't need to happen.

What all of this means is be proactive with regard to your health condition. It may not be visible but it is definitely real and it is mandatory that it be handled and managed properly. A dismissive physician, when it comes to questions about the condition and management of it, is not serving your needs. Form a healthy partnership with your medical practitioners. Find someone who will communicate with you in an understandable fashion. Find someone who will have not only your health condition but also you in the upper parts of their mind and concern.

Resources:
Sponsored Link: Heart Failure: Evaluation and Care of Patients With Left-Ventricular Systolic Dysfunction (Clinical Practice Guideline Number 11)

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