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    The Fibromyalgia Worker
    Mark Pellegrino, MD posted:
    Many of us with FM have to work, and we may be faced with a major dilemma: our fibro interferes with our jobs. This creates stress, often extreme financial stress if the job cannot be performed properly. Whether the FM was caused by a work injury, or whether work is aggravating the pre-existing FM, changes may have to be made in how work is approached to minimize pain and functional impairment.

    Job Considerations: Different factors influence our job abilities. We have a difficult time reaching, using our arms overhead, bending, lifting and being in one position for a long time. We have no business even being in some of the jobs we do since the job duties are so unrealistic for us. Even jobs that involve little or no liftng may not be tolerated if it involves a lot of reaching or repetitions. Some examples of "high risk" jobs for us include assembly line jobs, hairstyling, bus driving, computer work, and cashier jobs. Even sedentary, less physically demanding jobs can be stressful because it's hard to focus, concentrate, and be productive if we hurt all over, have headaches and brain fog etc.

    We can come up with a list of work things to do that's best for our FM. I mean things that we can modify at work to keep us productive and with minimal pain despite our fibro. Here are some examples of things that you, your doctor, and your therapist can try to do.

    -Hours: stay on day shift, avoid ovetime, can you have a flexible schedule? Decrease commute time? Is part-time more feasible? Can you make up missed time?

    -Building: Can you park close? Use elevator instead of stairs?

    -Work environment: Can you control the thermostat? Avoid drafts, bright lights, noise. Minimize interruptions/disruptions. Is your furniture and work station ergonomically efficient?

    -Physical: Can you alternate positions? Sit more? Lie down during breaks? Pace your work?

    -Work load: Can you rotate tasks? Can you prioritize deadlines? Delegate to others? Can you ease pressure on work quotas? Are others depending on your work before they can finish theirs?

    -Insurance: Is it adequate? Paid medical leave? Pharmacy plan?

    Reasonable Accomodations: The employee, the employer, and the doctor can work together to create a safe workplace with minimal pain, hopefully. The Americans with Disabilities Act requires employers tp provide equal employment opportunities for people who are able to do the job but who are limited by physical disibilities. The employee has a right to reasonable accomodations provided by the employer to help overcome any physical limitations.

    Examples of reasonable accomodations for FM workers might include:
    - allowing frequent breaks during the workday
    - rearranging work stations and providing ergonomic tools or furniture to optimize proper body mechanics and use fibronomics.
    - providing phones with headsets
    - using a drop keyboard, wrist bars and arm rests on your computer
    - no direct air conditioning drafts
    - restrictions on repetitive activites

    Family Medical Leave Act: the FMLA was passed to allow workers to take time off work when they (or family members) are incapacitated and require medical treatment for a serious or chronic health condition. I complete these forms often when necessary and will state that FM is a chronic condition that may unpredictably flare-up from time to time resulting in impairment of work ability and may require time off work on a temporary basis. We try to prioritize returning to work and staying at work as much as possible.

    How many of you are working? Please share any helpful strategies. Take the poll too! Next week I'll address disability.

    Dr. P

    Take the Poll

    Are you working?
    • Yes, full time despite my FM
    • Yes, but had to reduce my hours because of FM
    • No, because of my FM
    • No, not because of my FM
    • I'm temporarily on a medical leave of absence
    View Poll Results
    bcbailey1977 responded:
    I work at 2 pharmacy's now. Both same chain just helping out new staff at the 2nd pharmacy, then I go to where I normally work. So I will have worked at least 50 hours when the work week is done. I need the $$$ so I will deal with the pain at night and being slow moving in the morning and going to work 2 1/2 hours early.

    My mom has less than 4 months so I need to start saving and paying off my bills more than I can now.
    annamaria04 responded:
    Yes, I'm working full time but it's getting more and more difficult. By the time I get up, stretch, showered and ready for work I'm exhausted. So as hard as it is, I get up 15 minutes earlier so I'm not rushing and I have a few minutes to sit and read or crochet before I walk out the door. It's hard to get up earlier when I don't get enough sleep already but it's so worth it not to walk out the door rushed and stressed.

    For almost 17 years I have been the Executive Secretary to the President of an airline and used to go in early, work late...whatever it took. For the last year or so I just work 8-5. For the last few months I have been contemplating the idea of asking to work 9-4. By the time 3 or 4 o'clock comes around my body and my brain are so tired I can hardly function. I have a hard time concentrating, staying focused, and comprehending the contracts I have to review. I wonder if this is how someone with ADD feels. It helps to nap in my office on my lunch hour but I can't do that every day. I know my boss would agree to the change in hours; he knows my condition and its such a blessing that he is very accommodating and supportive.

    What's stopping me is how this will appear to everyone else in the office. I know that's crazy. I've gotten over how my handicapped sticker "appears" and I've gotten over how I "appear" in the motorized cart at Walmart, but I can't take this step yet. I know I will, it's just a matter of time. I've stated elsewhere that I think of myself as limited, not disabled. So limiting my hours makes sense.

    Thanks for coming up with such relevant topics Dr. P. They force me to analyze my life and make sure I'm doing all the right things to take care of myself. I can't believe how good it feels to post messages. Very therapeutic!
    Caprice_WebMD_Staff responded:
    Really great post, Dr. Pellegrino. Lots to think about.
    We must let go of the life we have planned, so as to accept the one that is waiting for us. ~Joseph Campbell
    An_199361 responded:
    I figure I am miserable at home anyway, may as well get paid for being miserable...
    hopein2009 responded:
    I am an RN working on an Orthopedic/Joint Replacement Unit for the past 12 yrs. I was on night shift for 9 yrs of this time. About 4 yrs ago is when I began to have symptoms of FM. At this time my doc said all of the yrs of working night shift could have contributed to my FM along with some major life issues going on with my husband. I was able to get onto dayshift 3 yrs ago and I thought this would help me, it did not.

    The added physical and mental stresses of dayshift made me feel even worse. This past year it became harder and harder to get up at 5am and work 12 hr shifts and get to work on time. I was also calling in frequently because I felt so bad all the time. I was working my way towards losing my job and I am the main provider for my family and carry the insurance(very good insurance). So I asked to go back to night shift.

    I have been on night shift for 6 weeks now and it was the best decision. The work is easier and the mental stress is much less. As far as sleeping, I have issues whether it is day or night shift. I also was finally granted FMLA which is such a relief because now if I am feeling bad I can call in without threat of repercussions. I have a wonderful Pain management doc who now has my pain mostly under control, but the fatigue is always there, once again, no matter which shift I work. I have had to modify my lifestyle in every way so that I can continue to work.

    I am also working on my MSNed because I plan to teach nursing which I think will be easier on me physically and allow me to continue to work, thank you for your post. It is very timely and addresses many people's issues with work including me.

    Lisa in WV
    lb707 replied to hopein2009's response:
    Wow it was in print, (the part about bus driver)

    I do not work due to fibro.... but drove school bus for 19 years, 15 in horrible pain. I was an instructor and I found just riding the bus while teaching put me in just as much pain. Then they let me do just the classroom teaching which I loved. The stress of trying to teach adults why the laws are so important took it's toll.

    So I just went back to being just a bus driver and kept working less and less hours. One day my Dr. told me to take a week off and see how I feel after that. I gave my two weeks notice and now at 59 I am on SSD.


    I would rather be working but just taking care of the house and DH and the dogs is more than I can do. I have been known to get someone in occasionally just to vacuum and do bathrooms.

    TCL38 responded:
    Dr. P My situation is not represented in your poll but "Yes, but had to reduce my hours because of FM" is close.

    When FM and my co-conditons hit me and I realized I was going to be playing on a whole new field for the rest of my life. I took a really good and prayerful look at me and my situation. When FM hit me I was managing a women's clothing store (not my ideal job btw) so lifting boxes of jeans weighing over 90 pounds and standing on a concrete floor all day with no breaks was out-of-the-question. My health caused me to be fired not that I was all that disappointed since I hated that job and knew I was hiding out from what I really wanted to do. I also took stock some of the long-held goals I have for myself including a master's degree and then law school or a PhD which included doing dissertation research in China, writing a book and being a professor. I also took an inventory of my family situation including my 16-year old daughter with FM and my 14-year old son who I now suspect also has FM and tried to figure out what would be best for all of us. The deeper I looked into myself, my family and my future with FM I realized there are goals I can hold on to, goals I can change and goals I had to let go.

    What I decided and what my health decided for me is to not work at least not in the traditional sense. Between my kids' and my medical appointments, I realized I would need to take a lot of time off work at a tradtional job. Because of my co-conditons, I also have a lot of restrictions and because of FM I have all the normal FM obstacles so I took a deep breath and spent a lot of time figuring out how I could make all of this work for me and my family. My choice is to continue with many of my goals but at a different pace. I haven't worked a "regular" job since I was fired and I'm not going to try. There is no doubt in my mind that being "normal" in that way is not possible for me or my family. However that still leaves me with needing to do something.

    I gave up my in-residence master's program. This is the first fall since 2002 that I haven't been in school but the classes were at night and by the end of the day I was spent.

    I realized my beloved China, the research and book I'd laid out for my thesis and eventual dissertation are off the table. I can't imagine being in a plane that long.

    In their place, I realized I have some wonderful talents and amazing goals. The talents, I believe, are a gift and also my key to navigating a new life with FM, my co-conditions and all the trappings of them and the rest of my life. I have two great talents: baking pies (you should taste 'em) and writing. Being a professional baker would be not only impossible but ridiculous all things considered. But being a writer is who I am. I have know that my whole life. Fibromyalgia has done a wonderful thing and forced me to practice that which I have known my whole life. You see for as much as I know I am a writer I always felt I needed a "real" job as a back-up/safety net. I am flying without a net. I am a writer and as such I have started my first book--it's about FM. I also do a little freelancing. I used to make up to $40/hour now I make 1.5 cents/word writing for my only client.

    So Doc P, I work everyday at least on the days I am not having the flare from hell. My paycheck has changed for sure. But eventually I do believe it is going to be a good thing. Fibromyalgia has given me the gift of "forcing" me to be who I always knew I should and would be.

    Fibromyalgia has been one of the oddest but best blessings of my life. I'd trade the pain at any moment but I wouldn't trade who I am becoming in spite of it.....

    diannarebecca replied to TCL38's response:
    Hi Tanya! I too am an aspiring writer (I have always felt that's what I would do with my life but have always been to scared/too broke/too busy to get started.) I enjoyed reading your post because I found it so relateable. I have many of the same issues that you do.

    I am currently working 20-30 hours per week & find it more difficutl as time goes on. Aside from the pain the fibro fog is making me horrible at what I do (I am a bookkeeper/office manager for an electrical contractor) & I make a lot of mistakes. I can't stand doing something that I'm not good at & I feel it's only a matter of time before my boss stops being so understanding & fires me.

    I hope in your book you will research & include a lot of the symptoms that we talk about on this website as my first instinct after diagnosis was to buy books & do research on fibro but I continued to be baffled & discouraged by the lack of information on so many things that I was feeling but was not sure if it was attributable to fibro or if I had an additional condition (including but not limited to insanity.) It was not until I found this group that I realized so much of what was not in the books was part of fibromyalgia symptoms. Maybe you can devote a chapter to "Am I crazy or do I feel this" with testimonials from fibro sufferers about some of their less known symptoms.
    Wolfsong452 responded:
    great post Doctor P.

    From what I"ve read on your post, most of the jobs I've had, were totally wrong for me.

    Guess that's the reason I failed the test for driving the school bus.

    You talk about heat-cold-noise etc.

    I have it all working at McDonalds. Definitely not the best job for me.

    Even working at my precious dairy farm, which I loved doing, really wasn't the best job for me. Hot Humid Summers-combined with running in and out of a deep freezer, what with stairs, stress, pressure,

    none of it good for me.

    I'm contemplating going to school, yet, all the things I love, are all hands on.

    or working heavily with my hands.

    I'm also a aspiring writer, yet, can't even make myself write.

    Other than coming on here, and a couple of other places, I do nothing on my computer.

    Would this be called depression?

    I am taking prozac for this, all I can say is 2 tablets once a day.

    I haven't been outside in my back yard in over a month. Even the front yard is a nothing.

    I have a dog door, so no problems there.

    I go to work, come home, if I want to go on the internet, I have to go to the library, or some place like McDonalds, or better, go over and have dinner with my ex-husband and his brother.

    Funny ha ha, get divorce, and still see ex-hubby at least 4 times a week.

    seeing him more than my Boyfriend.


    what would my conseler say about this?

    ooops, got off track there.

    got a call from a Petco (this is pet store for people who don't have one in their area)

    I haven't returned the call yet, but they said something about working on the sales floor.

    not reallly something I think I should be doing, but I'm so far behind in my bills it's crazy. Done the bankrupcy thingy, but, am still behind on the house payment, afraid of losing my house.

    oh, back ln the FM pain again,

    Tell me more about this family leave act? would this work for me if I get the surgery for my torn rotator cuff?

    I'm afraid to talk to any employer about my FM, or even my rototar cuff, thinking they won't let me work for them, or fire me.

    imagine what McDonalds would say, if they knew about my FM, or the rotator cuff, what with the noise, heat, and all the lifting I have to do.


    maybe it's better to be a hermit, homeless, or whatever.
    Wolfsong452 responded:
    forgot to mention, I'm only working about 10-15 hours a week at ole McDonalds,

    trying to get more hours, but even this on top of my little bit of pet sitting, driving 50 plus miles a week to visit my mother in a nursing home, helping my father clean out his storage unit,

    has got me totally wiped out, yet can hardly sleep,, thank goodness for the muscle relaxer, yet, I can't get the prescription refilled, due; to no money, father is on a fixed imcome, so no go.

    tell me more about this Family act thingy
    TCL38 replied to diannarebecca's response:
    Thank you for your reply!

    Actually no I will not be doing a lot of research on or about symptoms. There are literally dozens of those books out there already. But the book will be chock-full of what you describe as testimonials and that's all I'm willing to say about it in a public forum such as this. I have pitched the book to several people with and without FM and I am finding overwhelming support for the concept so I think I'm on to something with it--I'll let you know for sure in about two

    annette030 responded:
    Hospital nursing eliminates the possibility of almost all of the tips for improving the workplace for FMS folks.

    We did always have decent health insurance, so I never had to worry about medical expenses while I was working.

    It is a relief not to be working during the current and continuing nursing shortage though. I have worked through enough of those in the past.

    Even disability has its silver linings, lol. More time, but less money can be okay, too.

    Take care, Annette
    annette030 replied to hopein2009's response:
    I am retired due to disability from FMS as an RN. I agree that working nights probably added to my illness, or worked toward triggering my FMS. I had already switched to day shifts before I was diagnosed, but I worked nights for 15 years and developed symptoms within a year or so of changing to days.

    I would suggest not working 12 hour shifts anymore, but in the city I lived in when I stopped working not a single hospital even had 8 hour shifts, so that is not always feasible. I took six months off to concentrate on improving my health, I then switched to home health in order to curb the total number of hours I worked, but I think it was too late by the time I developed symptoms of FMS. I managed to work about six months part time, then stopped and applied for SSDI.

    Best of luck to you. I hope your change to teaching works for you. I can't believe that you manage to work full time and still work on your Master's Degree, good for you!!!

    Take care, Annette
    lag7662 responded:
    I have worked construction for 25 yrs and I am 48. I have posted all over the place today, my first day. I guess I know that it is not possible for me to continue sonstruction work, but it is a big part of who I am, and I struggle with leaving in behind. My primary doc and husband think I can get the meds right and go back, I even tried it once, made it 4 days. It felt good, I was tired but not in serious pain. That last night I thought I was on fire. I had spent the day on a ladder with a big hammer drill making 4" holes in a double block wall. I just never know what day to day will bring. I was sick for 2 days with a flare and they canned me. In this economy I cannot imagine retraining myself to do another job right now.

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