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Thursday, August 7, 2008

Breast Cancer and Work

Breast Cancer and Work

Knowing Your Rights, Telling Colleagues, Taking Accommodations

From Betsy Lee-Frye, for About.com

(LifeWire) - A cancer diagnosis can be terrifying on so many levels, not the least of which is how the disease and treatment will affect an individual's ability to work. Not only is income a necessity, but often, so is the health insurance provided by the employer. Before divulging the diagnosis, take the time to research the company's policies, including medical leave and flex time. It may also make sense to find an office mentor who has already navigated the maze of accommodations and disability pay.

Telling the Boss and Colleagues

Typically, sharing life news with those at work isn't difficult, but when talking about a breast cancer diagnosis, the words can get caught in your mouth.

First, don't rush it. There is no reason to talk to the boss or colleagues so soon after receiving the news. Wait until it feels as comfortable as possible.

There is no right or wrong way to divulge a cancer diagnosis. Some people might feel more comfortable talking to their boss or supervisor first, avoiding the miscommunication that can stem from the office gossip mill. Consider setting up a meeting or a lunch, so you can be sure to have his full attention. Also, remember that discussions between a boss and employee are protected. A supervisor has a legal obligation to keep the information private. However, co-workers do not have the same obligation.

Talking to colleagues about a cancer diagnosis isn't a necessity; however, co-workers can be an unexpected source of support. According to a survey of human resources managers conducted by the International Foundation of Employee Benefit Plans, a nonprofit organization based in Brookfield, Wisconsin, colleagues often organized volunteer support for those with breast cancer. Twenty-seven percent of the office managers surveyed said co-workers had provided personal assistance to the woman with breast cancer, 19% organized a fundraising campaign and 15% donated vacation days.

Be prepared for questions. Colleagues might inquire about treatment plans and side effects. Don't feel obligated to share information you'd rather keep private. A supervisor or boss might want to know what accommodations might be necessary. The American Cancer Society suggests having a plan in mind before talking to your boss. But for those who aren't sure yet, don't be afraid to simply say, "I'm don't know yet. Can I get back to you?"

Asking for Accommodations

Employers are required by federal law to provide "reasonable accommodations" for anyone with a disability. According to the Americans with Disabilities Act (ADA), cancer qualifies as a disability when the disease or its effects of treatment hinder an individual's "major life activities." See the following section for more about the qualifications of cancer as a disability.

These accommodations can vary greatly, depending on a person's need. According to the U.S. Equal Employment Opportunity Commission (EEOC), examples of accommodations include:

    * Time off for physician appointments and to recover from treatment
    * Short breaks during the workday to rest and recover
    * An altered work schedule
    * Temporarily assigning some job tasks to another employee
    * Changes to the workplace environment, such as temperature changes or workstation changes to insure comfort
    * A work-from-home arrangement

According to the EEOC, the word reasonable is key. Employees with breast cancer can't make requests of their employer that would cause them "undue hardship." The term "undue hardship" is different for every company. But according to a 2006 survey conducted by the University of Iowa's Law, Health, Policy and Disability Center, nearly 75% of employers reported that accommodations for individuals with any disability, not just cancer, cost them less than $500 per year.

The International Foundation of Employee Benefit Plans' survey, which focused on women working with breast cancer, found that employers were typically more than willing to provide accommodations. With regard to scheduling, the survey reported that about 85% allowed an employee with breast cancer to reduce her hours, 79% permitted a flexible schedule, 47% made telecommuting an option for the employee and 62% agreed to short breaks during the day for resting and recovering.

Employers said they also made arrangements to alter the employee's workload, including assigning different work (58%), altering deadlines or other previously agreed upon schedules (60%) and job sharing (28%).

Legal Rights: Disability and FMLA

Under the ADA, cancer qualifies on a case-by-case basis. The act protects individuals from losing their jobs due to disability and sets guidelines for employers regarding required accommodations. The U.S. EEOC, which enforces the ADA, offers the following example of a woman with breast cancer who would qualify for job protection under the act.

"Following a lumpectomy and radiation for aggressive breast cancer, a computer sales representative experienced extreme nausea and constant fatigue for six months. She continued to work during her treatment, although she frequently had to come in later in the morning, work later in the evening to make up the time, and take breaks when she experienced nausea and vomiting. She was too exhausted when she came home to cook, shop or do household chores and had to rely almost exclusively on her husband and children to do these tasks. This individual's cancer is a disability because it substantially limits her ability to care for herself."

If you feel your rights have been violated or you've been dismissed from a job due to your diagnosis, you need to file a charge "within 180 days of the alleged discriminatory action," according to the EEOC. The EEOC can be reached at (800) 669-4000.

Many companies offer disability pay for seriously ill or injured employees, but often these plans require an employee contribution. Talk to a human resources representative about disability pay and how to collect if your employer offers a plan.

The Family Medical Leave Act (FMLA) of 1993 also protects the jobs of people with a cancer diagnosis. However, not everyone qualifies for FMLA protection. An employee must have worked for the employer for at least 12 months prior to the FMLA request and have worked more than 1,250 hours in that calendar year. In addition, employers who have fewer than 50 employees do not have to follow FMLA regulations.

If protected by the FMLA, you can to take up to 12 weeks of unpaid leave from work. The act allows employees with serious medical illness, such as breast cancer, to use their leave "intermittently." This means an employee could take off 1 day each week or take 2 weeks off to recover from surgery, while saving the remaining weeks to use during radiation or chemotherapy treatments.
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Thursday, January 17, 2008

Hemoptysis

Overview


Hemoptysis (which is pronounced he-MOP-tis-is) is coughing up blood from the respiratory tract. Blood can come from the nose, mouth, throat, the airway passages leading to the lungs, or the lungs. The word "hemoptysis" comes from the Greek "haima," meaning "blood," and "ptysis," which means "a spitting".


Blood-tinged mucus in a healthy nonsmoker usually indicates a mild infection. Indeed, the most common cause for coughing up blood is the least serious—a ruptured small blood vessel caused by coughing and/or a bronchial infection.


In patients with a history of smoking and those who are otherwise at risk for lung disease, however, hemoptysis is often a sign of serious illness. Serious conditions that can cause hemoptysis include bronchiectasis (chronic dilation and infection of the bronchioles and bronchi), pulmonary embolus (a clogged artery in the lungs that can lead to tissue death), pneumonia (a lung infection), and tuberculosis.


Hemoptysis can also result from inhaling a foreign body (e.g., particle of food) that ruptures a blood vessel. Whatever the suspected cause, hemoptysis should always be reported to a physician.


Hemoptysis refers specifically to blood that comes from the respiratory tract. Blood also may come from the nose, the back of the throat, or part of the gastrointestinal tract. When blood originates outside of the respiratory tract, the condition is known as "pseudohemoptysis." Vomiting up blood, medically known as hematemesis, is one type of pseudohemoptysis. Differentiating between hemoptysis and hematemesis is an integral part of diagnosis. Since they involve different parts of the body, treatments and prognose (prospect of recovery) are not the same.


Classifying hemoptysis as mild or massive (some practitioners classify it as trivial, moderate, or massive) is difficult because the amount of blood is often hard to accurately quantify. Life-threatening, "massive" hemoptysis, which requires immediate medical attention, is differentiated from less severe cases.


Massive hemoptysis
Hemoptysis is considered massive, or major, when there is so much blood that it interrupts breathing (generally more than about 200-240 mL, or about 1 cup, in 24 hours). Massive hemoptysis is a medical emergency: the mortality rate for patients with massive hemoptysis can be as high as 75%. Most patients who die from hemoptysis suffer from asphyxiation (lack of oxygen) due to too much blood in the airways.


Mild hemoptysis
If there is a small amount of blood or sputum streaked with blood, the spitting is considered mild hemoptysis. In 60% to 70% of mild hemoptysis cases, the underlying disorder is benign and disappears on its own without causing serious problems or permanent damage.


Even mild hemoptysis can result in critical breathing problems,
depending on the underlying cause for the bleeding. Additionally,
hemoptysis tends to occur intermittently and recur sporadically, and
there is no way to predict if patients with mild hemoptysis are at risk
for massive hemoptysis. Diagnosis is important to prevent a more
serious condition.



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