New England furniture store chain

40 years of silence?  Why?  She didn't have to worry about losing her job or a demotion.  Did she think it would hurt sales?  She's quoted  saying she didn't talk about it because she's a "private" person.  But she's been in the "public eye" for decades.  Why did illness have to be private?

I think there's a problem with the fact that people don't talk about their illness and work in the same breath, don't you?

I know they fear that this will negatively affect how others perceive them.  But as Phyl's husband, Bernie, said, people were noticing that she wasn't the same --  and making incorrect assumptions about her.  When illness becomes debilitating, it's noticeable.

The reality is that the overwhelming majority of people with chronic illness do not disclose their illness at work, which means supervisors and co-workers are unprepared about what to do when it comes up.

I'm not talking about complaining to anyone who will listen that you're sluggish or have some pain. But there's the point when you're having trouble doing the work and your performance is suffering.  There are some who can't understand what chronic illness - unpredictable, waxing and waning, and often invisible - means. You might get negative responses or a subtle (even not so subtle) put down.

You have to be strategic talking about illness when others are depending on your deliverables.   It also takes confidence and clarity.  You can get some tips in my blog post and more  strategies in my booklet, Talking About It.

The fact is that more than 40% of American workers live with at least one chronic illness. But talk with human resource professionals about this issue and they typically say it's not a problem for them.  Of course, not.  No one talks to HR about this - at least not until they file for disability.

Many come to me when they've hit serious roadblocks after disclosing their disease at work.  But when we dig deep, disclosure isn't the root problem.  Sometimes they can no longer do that job -- or in that place.  Sometimes they need to make adjustments.  You can find assessments in the Working With Chronic Illness Workbook .

I don' t have an answer for this but it's clear that saying nothing until you have to leave work altogether isn't it.   It's not easy to let people know how hard your day is when you look fine.   Or more importantly, why you can't meet that deadline or make that meeting.  But unless you do, they'll have no idea what your problem is or what or who might help you.   And you have no chance for improving the situation - - until you leave on disability.  

What do you think?  What have you done about this and how did it go?

Chronic illness, complicated as it is, leaves many searching for a simple answer.

Lately, a tantalizing headline has gotten much press in the social media 'disease' community (yes, I'm on twitter and you can tweet me @WorkWithIllness): "Exercise can Quiet Anxiety that Comes With Illness". 

Help me, please.  What's the news here?   That people who live with illness also experience anxiety?  That exercise can help alleviate that anxiety?

I felt a particular sense of annoyance with this research when a client told me about an email she got from a  co-worker.  The email writer sent a link to this study with a note saying that since my client must feel very anxious about her multiple sclerosis symptoms, this is great news.  Exercise is the cure.

My client lives with symptoms that are periodically difficult to manage and puts in a minimum of 45 hours/week on her job.  She said that although the email writer's a "jerk",  she wanted to talk about her guilt for not exercising and her paranoia that other co-workers would conclude that multiple sclerosis must be her fault.   Can you relate to this?

I read several articles about this research and from what I can tell, the findings say:

• Exercise decreases anxiety for those who had not been exercising at all.
• Exercising at least 30 minutes a day is optimal.

But even if you can carve out that 30 minutes a day, that's not the only challenge.  You've got to figure out what to do and where.  Vigorous exercise is rarely an option with debilitating symptoms  (cross off that spin class).  And with changing symptoms, some days even mild exercise can be a problem.

Additionally, for  those who need a class or  teacher to stay motivated, there's the cost.   True, running or walking outside doesn't cost a dime but weather,  like illness, is unpredictable.  Extremes of any kind - heat or cold - can aggravate many health conditions.  And there's ice.  Nothing like waiting all day to take that long walk after work but icy streets and bitter cold, especially in the dark, present real danger for you.  Not exactly  an anxiety reducer, is it?

Consider this.   When you're given suggestions or "solutions" about your health that you didn't ask for, you've got some choices:

1. You can respond angrily that they don't understand.
2. You can wallow silently in self pity and guilt.
3. You can think about the suggestion, consider the source to decide if you want to respond, and consider the suggestion to see if it fits for you.

For more ideas about talking about chronic illness symptoms at work, check out my Career Thrive When You Live with Chronic Illness Series.

Tell me, what do you do?  How is that going?

On another note, a colleague has asked  me to post this request: Women business owners: Have you experienced a past personal crisis while running your business and lived through it to tell the tale? If you would be willing to share your story, we would like to interview you for an upcoming book, tentatively titled “When Life Happens.” Your experience and lessons learned can help today’s women’s business owners navigate similar life events. If you are interested in being interviewed, email chris@prioritywellness.com.  Put “Share My Story” in the subject line. Chris will respond with an initial questionnaire to assess whether your story is a match for the book. If so, either Chris or her co-author Elli will contact you to schedule a 1 hour phone interview.

If you live with chronic illness, you've probably realized that:

• Symptoms can come and go when you least expect it;
• the intensity and how it impacts you can vary. This can reek havoc on your job.

How do you explain the changes?  Yesterday you were able to get to work and do your job just fine. But today you've got pain,  fatigue or some body part isn't working and you'll be a few hours late or maybe won't be in at all.

One solution is to work "virtually". Virtual work does not guarantee flexible scheduling - unless you work for yourself or it's built into the nature of the job you do (e.g., such as writing, research, web design.)  But it does cut out a commute and in many cases,  it can mean that you have more flexibility to shift your work schedule around your health needs.

I've worked with people who have transitioned their jobs from a brick and mortar office to working at home.  What I've seen is that the  key piece is to  make sure that there are good reporting and communication systems in place. Expectations  about what others can expect and when must be clear to everyone involved. Communication trails have to be documented.   In fact, you have to be more precise than when you were in the office.

One client in my Just In Time Career Coaching program found that her supervisor became really difficult when she stopped coming in.  But when she explored this further, she learned it had nothing to do with her performance.  Her supervisor missed the personal interaction!

I've worked with others who found that after they went "virtual", they were working even longer hours because  systems weren't in place.   You can get some good ideas for communicating while working virtually .

I work virtually but for myself.  For 17 of the 22 years that I worked in large and small operations, I lived with debilitating diseases.  My career skills meant I only had full time and physically demanding options.   With two young children, neither my body nor soul were up to it. To keep working, I had to  "reinvent" myself.  My priority was to work at home.  I didn't intend to work for myself but it happened.   As with everything,  I can see that there have been positive and downsides to working this way.

The upside:

• I  develop relationships and network, market my services,  and work with clients worldwide without leaving my home.
• I don't waste my energy commuting, dealing with bad weather or worrying about finding myself in situations where I'm physically challenged.
• I take the breaks I need when I need them to take care of my body and I don't worry how this might affect how I'm perceived.
• I design and take charge of my time and energy with no one to thank or blame but myself.

The tough stuff:

• Studies show that working promotes health because it gives you a sense of purpose, creates a schedule and gives you social interaction.  But working virtually can be isolating, especially if you're solo. If you're struggling with illness, you can lose your sense of purpose and drive without the support of others.
• When I'm not well,  I'm alone in this body.  Mostly it's a relief but sometimes it's weird and it would be nice to have people contact.
• I miss being around people. Although my days are busy talking on the phone and emailing -  people who work for me,  colleagues with whom I work on projects, and clients,  I often miss having that face-to-face interaction.
• Although I don't miss getting "dressed" for the office, there are days that I'd like a reason to wear a suit.  Go figure.

I'm sure I've missed some points here.   Another perspective is at The Pros and Cons of Working Virtually.  Are you a virtual worker?  What have you found?

Living with chronic illness can leave even the toughest person feeling vulnerable.  You just wish that other people could "get it", don't you?

I know from personal experience how hard this is in a marriage  (How a Marriage Survives When One Person Gets Sick, MORE Magazine) .  And marriage is all about the relationship,  where two people have declared that it's for better or worse, sickness and health, etc.

But what can you expect at work where the goal is to produce products or deliver a service?  No doubt, positive relationships make work go more smoothly.  But we have to remember that no matter what we might wish for, relationships aren't the endgame in the workplace. At best they're a tool for effectiveness and worst, they're a by-product.

I thought about this when I was speaking with my client, Ann (not her name).  Ann, who lives with  Lupus, is a graphic designer. She worked on a team in which, although everyone worked independently, all the parts contributed to the whole on a consistently very tight schedule.  If one person slipped, the ship went down.

Ann's unpredictable and debilitating symptoms meant that the tight deadlines became a disaster.  A few weeks ago, she asked to be 'demoted' to a job with less responsibilities and reduced pay.  Which is why she's in the job hunt.

Ann had created a "needs" assessment  for her next job (using my Working With Chronic Illness Workbook).  In our conversation, she told me that she wanted a supportive environment, where people care about her and how she's doing.  Heading up her "Needs" list was "support".

But when I asked her to describe what support at work means to her, she said, "People who respond positively when I say that I'm unable to meet a tight deadline alone but with some help, could get there. People who pitch in and help if I'm stuck. "

She was surprised when I commented that her description didn't mention illness. Nor did she talk about anything emotional.  I  said that it sounds as if she's looking for a team approach, rather than a gotcha' response.  Again, she was surprised.

As we talked, Ann realized a few things.

First, she has to be clear with language.   What does support at work mean to her?  Do you know what kind of support you need?

Second, Ann  would love it if people would empathize when she doesn't feel well, rather than behave as if she's just a problem for them --  or worse, that she's making it up. But she finds that's hard to predict.   Are there things you say or do that seem to work for you?

Finally, she has to be in a job that she can do.  If you're lucky and you're good at communicating, people can be terrifically empathic.  But if you can't do the job, you're going to be history.  If  Ann needs flex scheduling and/or team support some or all of the time, then she needs a job where that's the nature of the job.

Can you be successful in the job that you're in or does it require support that's simply not there?

But, no matter what the definition is, there's one thing you can count on in unpredictable chronic illness world.

Living with chronic illness will affect your quality of life.

What makes me so sure?  I've seen it daily  -- both  in my  life with illnesses,  and professionally, as a career coach to those with illness.

In  "Mugging Myself", Psychology Today, Alida Brill writes how she "mugs" herself as she lives with MS.   Been there, done that, I say.  How about you?  Do you get in your own way? Are you tripping over your own feet in spite of your best efforts to sail smoothly with illness?

It's easy to understand why. But do you have to accept this?  It's unlikely you can can change the disease course.  But, do you believe that you can change how you live with it?

If you're saying, yes, here's a starting point.  I've seen 3 traps that too many people fall into. And I've worked with  people to think about it differently and seen what works.  Try this.

Ask yourself:

• Am I behaving as if living with a chronic illness is a sprint rather than a marathon? (Even with sprinters, it's a marathon). If you are,  you're bound to run out of steam.  Chronic illness requires patience and planning. It requires endurance.  And, you need to live in a place of hope that you'll make it to the finish line. Even if you can't actually run a marathon, can you behave as if you are?

• Is there some part of me that lives in fear of being "stressed"? Anywhere you turn, the message is that stress is bad for chronic illness.  But according to Dr. Esther Sternberg  (Stress, Chronic Illness and You),  stress can be good for you, too.   Sure, avoid on-going toxic stress, when possible.  But rather than focusing on what to avoid, put your energy toward managing the source of the stress and learning to live with the stress.  Is managing the source and the stress a more pro active, empowering stance for you?

• Do I live life as fully as I can and allow myself to do the things that make me happy? Yes, symptoms can mean that you have to pare down.  But you can still reach for those stars that will bring your fun and fulfillment.  In Lemonade anyone?, I describe how a painful task created new opportunity.   Start with setting desired outcomes - rather than unspecific goals. And  create daily intentions to achieve them. Can you create lemonade for yourself?

But wait, you're saying, I'm too stuck or too busy to think about this now.   Really?  That's why this is the right time.

Unless you only work best on your own, ask for help (or pay for it).   Find someone who will encourage you to get and stay on track.  Yes, a chronic illness career coach is ideal (smile!)   -- or a life coach who knows about illness.  But it can also be someone you know who understands what you're up against.

Have you discovered ways to avoid these mind traps - or others?

When I was young and the only one I knew with bad health, I felt like the rotten apple in a bowl of healthy fruit.  It didn't matter where I was --  at work, with family or with friends.  No one could relate.  I worried that my "bruises"  made me stand out and  unappealing.

But now that I'm older and often in a crowd of 55+ folks,  everyone has a tale of bad health.   I'm no longer alone.  Does it feel easier?  Yes.

The same thing happens to those who are currently unemployed, another "socially difficult" state of being.  One client said that it's easier for her to go to be with other people now that everyone knows someone out of a job.  But being under 40,  she still can't talk easily about her illness.

There's something wrong with this picture.  Are people so unable to empathize with an event outside of their experience?  Do we have to be among others who share our sufferings to feel comfortable?  Or are we unnecessarily paranoid and uselessly isolating ourselves?

I'm going to find a sandbox to play in - - maybe I'll be lucky enough to find someone else in my state of health and employment to play with!

Building on her experience living with chronic illnesses, including multiple sclerosis and ulcerative colitis, Rosalind Joffe founded the executive career coaching practice, cicoach.com. Dedicated to helping others with chronic illness develop the skills they need to succeed in their careers, Rosalind firmly believes that living with chronic illness does not preclude living a full and successful life.

What happens if you’re a world class conductor and health problems prevent you from doing your job?

And this isn’t the first time Maestro Levine has missed work due to poor health. In 2006, he was out for 4 months after falling on stage when he was responding to standing ovations (no kidding!)   In 2008, he was out for the season due to kidney cancer.

The good news for him, though, is that his jobs, at least for now, are apparently not in jeopardy.  Guest conductors have been scheduled to fill in.

Maybe it’s the work I do or the life I’ve led.   But when I hear about physical problems and time missed from work, I’m curious.

I was buying a pillow today and the saleswoman was limping.  Empathizing as I watched her seem to struggle to get around, I commented that it must be hard to be on her feet all day.  She smiled and told me it’s actually a “bad” hip and today was a “good” day.  She’s got rheumatoid arthritis and her hip has been a problem for several years.

Explaining that the doctor says she needs a hip replacement, she asked,  “But who can take the time?”  Obviously not a sales associate in a national department store chain, I thought.

She said that because of the rheumatoid arthritis, she ends up taking a few days off at a time every few months.  Her manager has a sister with rheumatoid arthritis and is very understanding.  She never takes vacation because she takes all her vacation time as sick time!

But surgery and a minimum of 6 weeks of recovery would be unpaid leave. And she can’t afford that.  At least, “Not as long  I can still walk”.

I’m guessing that Maestro Levine doesn’t have those worries – at least not to that degree.  But, after 3 seasons of problems, does he worry what his employers think?  Does he wonder if they question whether he’s a malingerer? That’s a response many of the people I speak with get when they have numerous health problems.  (I really doubt it since you don’t get to his level of achievement without being very driven. )

Maybe he’s worrying they want to replace him for a healthier guy.  I wouldn’t blame him if he is.  But, I doubt this, too.  He’s very very good at what he does and I’d guess, worth the wait. I bet they’re just hoping this headache will resolve itself soon.

But what this must be like for him? To be at the pinnacle of your career only to find that your body is misbehaving!  It’s got to be tremendously frustrating.  It must be jarring after a lifetime of activity and success.

My take away? Illness is never easy to manage when you’re trying to keep living your life. But it is easier to keep your job when you’re at the top or if you’re not easily replaceable.

But no matter how you slice it, it’s always difficult to miss the performance.

Is your employer showing patience with your chronic health problems?

What does this focus on early detection and recovery mean for women? With early detection, most breast cancers now can be successfully treated. There are between 2 and 3 million American women living today who have survived breast cancer and are thriving. Yet, as many survivors have learned, the process of coping with any serious illness can take its toll - emotionally and physically. These 7 tips will help you manage your recovery so you can move forward with your life:

1. Accept your changing emotions as normal and give yourself permission to express them. After a brush with cancer, it's normal to experience many different feelings, such as anger, fear, anxiety, depression or stress. Talk openly with those you trust and acknowledge these feelings to yourself. Only then can you begin to cope with them.

2. Recognize the changes in your body. You may feel that your body has betrayed you, leaving you vulnerable and with a loss of innocence about your own invincibility. Take time to grieve this loss. You may also experience side effects of the treatments - fatigue, weight change, hair loss, or menopausal symptoms. Once you determine how your body is reacting, you can address each of the symptoms in efforts to alleviate them.

3. Enjoy the support you receive from others. Your family and friends can provide a caring network. You may also want to join a breast cancer support group, either in person or on-line. Support is helpful in many ways - it gives you someone to listen to you when you need to talk, someone to give you information and feedback, someone to help you with practical matters such as meals and errands. Support will be there for you if you look for it. It may feel awkward at first to ask, but you'll find friends want to do what they can to help you out.

4. Take care of yourself. Pamper yourself - you deserve it! Set aside time to start or continue an exercise program that includes aerobics, flexibility and strengthening exercises. Enjoy eating a more healthful diet, rich in fruits and vegetables. Schedule relaxation time to decrease the stresses in your life. Learn visualization techniques. Think about what you really enjoy doing and do it. Of course this may be easier said than done, but stick with your decision to make time for yourself. You can make it happen.

5. Redirect yourself toward active goal setting. When a serious illness strikes, you may feel like your life is completely out of control. To regain a sense of direction, reflect on the priorities that are important to you and then set a goal within your reach. Identify your strengths and build on them as you plan how to achieve your objectives. Journaling can help as you consider different strategies and options. Initiate your plan in small steps and review your progress regularly.

6. Make something positive come out of a difficult situation. Women who are able to find some positive meaning in negative circumstances experience growth as well as a sense of control and feelings of confidence and optimism. Think about how you can use the unique perspective you have gained to make the rest of your life richer and more meaningful.

7. Take credit for the challenge you have overcome and the changes you are making. Recognize and accept that you have faced many difficulties in the process of healing. Give yourself credit for the hard work it took to get to this point in your recovery. You have learned a lot about yourself - and made changes in the way you think, feel and react to others and the situation around you.

As women move through the steps of coping with breast cancer and its treatments, staying informed and involved in the process provides a sense of power and resiliency. One breast cancer survivor put it this way after completing a tough charity walk to raise funds for research: "As I crossed the 'finish line' in the pouring cold rain, I felt the exhilaration of my accomplishment, knowing that I had begun to trust myself again. I realized it had taken a long time for me to finally come to terms with the disease that had threatened my life. But now, with the acknowledgement and recognition that I allowed myself to accept from family and friends, I knew, through my tears, that I would have the strength to continue rebuilding myself, body and soul."

 (c) 2009, Her Mentor Center

Rosemary Lichtman, Ph.D. and Phyllis Goldberg, Ph.D. are family relationship experts who have developed a 4-step model for change you can't afford to ignore. It targets women like you, challenged by a family in flux. Whether you're coping with acting-out teenagers, aging parents, boomerang kids or difficult daughters-in-law, we have the solutions - GEMS that will make your family rifts disappear. Visit our website, http://www.HerMentorCenter.com - where you can subscribe to Stepping Stones, a free newsletter - and our blog, http://www.NourishingRelationships.blogspot.com.