Tuesday, September 01, 2009

How Do We Know?

I've recently been tossling with a strange dilemma...but the full ramifications of my conflict will require a bit of back ground information first. Stay with me here...I'm gonna need your expert input (or humorous responses anyway).

OK, so all y'all know I was diagnosed with Multiple Sclerosis over 6 years ago...duh. That's all I seem to talk about on this blog, aside from the random fart joke thrown in here or there! And y'all know I remain employed in a full time, top secret government job (janitorial really, but I'm still not allowed to discuss it lest I be water-boarded for disobedience). In my full-time, top secret "govmet" job, I am ENTITLED to (I prefer the word *entitled*...seems so very righteous) 16 weeks of Federally sanctioned Family Medical Leave Act (FMLA) time. Well, actually FMLA ENTITLES me to 12 weeks of time away from work in a rolling calendar year...my govmet employer tacks on another 4 weeks for good measure.

Anywhozit...each year, my neurologist, Dr. She Who Will Not Be Named, fills out a formal paper called a "Medical Certificate of Need", which pretty much guarantees my employee right to miss 16 weeks of work BEFORE my govmet employer can legally replace me with a potty-trained chimp and sever my status as THE potty-trained chimp full time. But what my employer/FMLA also requires me to do is fill out a sick leave form for every freakin' fraction of a minute I might be absent from work due to illness (so it can be held against my 16 week allotment of time, should the *other* plan to fire me for bad behavior fall through).

On this sick leave form, I have several choices I can check as to WHY I am needing to use up my employer provided sick leave...my choices range from something as simple as a medical appointment (and oddly, they will NOT allow me to claim getting my nails done as a "medical necessity"...sticklers for rules) to personal illness to the almighty check box for "serious medical condition", AKA, FMLA, AKA, Multiple Sclerosis. Until this past year, I was never aware I HAD a choice which box to check: I was under the assumption I MUST check the "serious medical condition" box for each and every second of sick leave I begged off my employer.

So, a few months ago, I learned a dirty, little secret...I was neither required nor expected to check that "serious medical condition" box UNLESS my reason for illness absence was directly related to my MS! Who KNEW?!? I had been checking that box for 6, long, excruciating years for every sniffle or sneeze of time I missed at work!

Now, granted I have never missed anywhere near 16 weeks of work in any calendar year...but when I discovered this tidbit of information, I felt liberated. Suddenly I no longer had to count every bout of diarrhea or every head cold with fever day I missed and blame it on MS...if it wasn't the fault of MS, it wouldn't count against my 16 weeks...it would just be viewed as *normal* illness...whatever the heck that is/was.

OK, I'm getting to my strange dilemma here...hang on.

This past Friday, I awoke feeling dizzy and nauseated (which I thought would pass in time for me to grace the doors of my employer with my bright, cheerful self at work...LOL) and ended up having to call in sick for the day out of fear of hurling on one of my coworkers or clients. The mystery illness passed as suddenly as it came on and I was able to make it into work on Saturday. So, when I went to fill out my sick leave request, I found myself hovering over the "serious medical condition" box and the "personal illness" box...I couldn't decide. Which WAS it? Had I just come down with a common stomach virus or was it the MS rearing its ugly head and taunting me again? How did I know? How could I tell?

Most normal people would have just checked a stupid box or flipped a coin, or consulted their Magic 8 Ball for an answer...the key word in that previous sentence is "normal". I, on the other hand, ruminated on the appropriate definitions and terms of "serious medical condition" and "personal illness" for quite some time...as a matter of fact, I'm STILL ruminating!

The idea brings up lot's of uneasy questions for me...and the main one is, how do we know when symptoms are directly related to or caused by MS? Who gets to decide this? Our doctors? Our spiritual guru's? Our inner child? What are the criteria we use to judge physical changes in our bodies and what makes one symptom MS-related and another not?

My dearly beloved Always Really Nice Practitioner (ARNP) of neurology once told me, "BrainCheese, not everything is because of MS" as she tried to explain to me the dizziness I was experiencing earlier this year was most likely due to an inner ear disorder...maybe. And I am a firm believer EVERYONE with MS gets "normal" illnesses, too (like the Swine Flu, Ebola, etc...LOL) just like relatively healthy people. Sometimes it can take me a while to really understand a particular symptom has nothing to do with MS and I need to address it from a non-neurological approach. And still other times, it can take me a while to really understand and accept, yes...this IS MS.

So, my question to YOU, my preciouses, is this...how do YOU decide for yourselves what feels like MS and what does not? Which box do YOU metaphorically check (because I know no one else in the entire world is required to fill out such a bizarre form in their workplace!) when feeling ill? I need your thoughts here...how do we know?

And while you're at it, what the heck IS it all about, Alfy?!?!....


Anne said...

No matter what it is, check off the box "Personal Medical Illness" so an employer can't accuse that MS was getting worse and thus jeopardize job performance.

I checked off "serious medical condition" - assuming that anything with my MS would fall into that category. The new administrator of the facility made me go through a company physical to prove that my "serious medical condition" was not a risk or hazard to my patients.

Any more, it seems we have to cover our asses every which way to next Tuesday just so we don't jeopardize our jobs.

After that incident, I started checking off the most mundane of the choices -- anything to put off their assumptions that I might no longer be able to do my job -- and of course to put off that awful company physical (which always finds in favor of the company)!


Glad to read about your wonderful weight loss progress and walking - you go, girl!! I am up to two miles a day and feeling great with it....albeit, no great weight losses like yours to report. But I'm keeping on, keeping on.

Joan said...

With fatigue, it's hard to know if it's MS, menopause, weather, allergies, lack of exercise, older-age, hang-over, or a brain tumor. I've spent the month of August having every orifice in my body probed or scanned to determine if the recent extreme increase in fatigue is or is not related to MS. This medical marathon was exhausting.

As far as that box goes, when I was working and sucking up FMLA hours, I kept a spreadsheet (I was a project manager and control freak - oops that hasn't changed) to let me know if I was getting near the end of either the FMLA pot or my normal sick leave pot. Both came out of my overall leave pot, so it didn't matter. I just wanted to be sure I still got paid. My managers never paid any attention to me anyway unless they needed to yell at someone.

Good luck!

Have Myelin? said...

I blame everything on non-MS disorders cuz it's easier to do that.

Until my Neuro tells me it is MS, I assume not MS until proven wrong. LOL. Now that does not cover symptoms such as water dripping down my legs, or numbness, vision blurring... but everything else, YES!

Jen said...

I've gotten pretty keen at detecting bladder infections (I guess because they are chronic for me?? Because of the MS.) All my MS symptoms rage around them, but I get nauseous and "slightly crampy" and these signs seem to help me figure it out.

It's probably wrong, but anything bizzare --- buzzing, vibrating, tingling, vice-grip tightening, hot/cold sensations, dizziness, numbness--- I end up attributing to the MS, unless clinically proven otherwise. Acute pain I question MUCH more.

Jen said...

PS: I think you need to update your age on your homepage (it's the former scrutinizing tech in me...hehehe...)

Mornin', Creep! :P

Raini said...

I'm with Have Myelin...it's all non-MS unless told specifically it is related, as long as it's not an old symptom (numbness, vertigo that lasts for days, etc.) I suppose if you are taking a lot of sick time, you may need to rethink that. How much sick time is everyone entitled to?

Peace Be With You said...

I assume it's not MS, just in case the MS is paying attention to what I'm thinking and takes the hint to stay away.

Jim said...

I have similar problems. Most of the time, I know what's wrong with me (whether it is MS related or not) like a cold, flu or whatever. Other times, its hard to tell.

I am thankful that my employer understands my frustrations with my own illness. At least my work is current and able to keep up.

I am not missing as much since my employer is not giving me stress or worry over my illnesses.

Webster said...

I would make whatever choice that would hurt me the least in the long run. I'd save "serious medical condition" for a relapse that was really interfering with my mobility or cognitive skills, unless I could work around the symptoms. Anything less than that is "personal illness."

Your vertigo might have been a relapse, might not have. Who knows for sure? Your cold however was definitely a personal illness, and NOT MS related.

I'm glad you're doing so well. I survived the heat of the summer and want more of it - NOW.

Trace said...

I just assume it's not MS, unless it's specifically something that occurred during a previous relapse.