Welcome to my World - FMLA Paperwork

As a chronic pain patient, at what point should I utilize my Family and Medical Leave Act (FMLA) time and leave work for the day? What is a bad pain day vs what the public considers a bad pain day? Should I use my FMLA time or just “tough” it out? At what level of pain is it acceptable to call in sick to work? It is about time for me to update my FMLA paperwork so these, and many more questions are on my mind right now.

To begin with, my pain management doctor and I have agreed that my base level of pain or a typical day of pain for me is a 5 out 10 on the pain scale. My 10 out of 10 would be the night I fell rock climbing and broke my wrist for which I needed 10 screws and a plate to fix (I also received 6 staples in my head that night too as an FYI). Here is a photo of the X-ray of my left arm:

According to my surgeon, my arm was sticking out 3 inches if I remember right. The radiology department at St. Luke’s told me that the break was probably one of the top 3 worst they had ever seen so they gave me a X-ray as a trophy. Ironically, I guess you would call it, this was my first and only broken bone. Just send it works for broken bones too right?

Thanks to this experience, my pain tolerance is high.

Lets put this in prospective. If you are not a chronic pain patient, or haven’t experience pain from cancer, ask yourself this, at what point on the pain scale would you feel like you would need to go to the emergency room. I did a quick google search and it shows that most patients in an ER are a 6 or 6.5 out of 10. My “normal” pain level is a 5 out of 10, how much do you want to bet that the people in the ER with a 6 or 6.5 on the pain scale consider a 10 a whole lot less than pain that needs 10 screws, plate, and 6 staples in their head in order to stabilize?

So I live in a state that is roughly 1.5 points away from what most people would go to the ER for. What would register as a 1.5 on a pain scale. Lets ask Google again. According to Dr. Google, a 1.5 on the pain scale would be a mosquito bite or rash. To put it another way, a mosquito bite is a big enough event justify me going to the ER since my “normal” or base pain level is so high. A mosquito bite, imagine if I had to use my FMLA time for that. As importantly, imagine what your quality of life would be if a mosquito bite would be enough of an medical event for you to justify going to the ER for pain management. Welcome to my world.

Lets look at another common medical condition, the flu. Almost all of us have had it at least a couple of times in their life. When I say the flu, I don’t mean just a runny nose and fever. I’m talking the intense all body ache the flu causes, the type of ache that makes even your hair hurt. Depending on the severity, most people rate that body ache in the 4 to 6 range. In my world, a milder cause of the flu would mean I’m a 9 out of 10 on the pain scale. A bad case of the flu and I’m at a 11 out of 10 on the pain scale. There isn’t many people that wouldn’t check into the hospital if their pain score was in the 9-11 range. It would take a cold hearted doctor to deny a patient in that much pain heavy duty opiates. Welcome to my world, I would most likely be socially ostracized for going to the hospital for a normal case of the flu, even considering the fact I have rheumatoid arthritis. The good news for me is it would be socially acceptable, both culturally and pride wise, for me to call in FMLA sick.

Lets talk neck issues and computer monitors. I have 8 screws and 2 plates in my neck right now. Working on a computer for 8 hours is not an easy task for me on good days. Currently I have new pain in the area of my occipital nerve and neck area. I’ve had this pain since Thanksgiving and it doesn’t seem to be going away. Since this is new pain, and its at the base of my head/neck, it is cause for concern (even by my high functioning standards). I mention this because the concern alone is probably adding 2 to 3 points to my pain score. That means I’ve been going to work at around 7 or 8 out of 10 on the pain scale since Thanksgiving. Is my “cause for concern” enough for me to justify using my FMLA time? Should I use my FMLA time because its not fair to my work. Is brain fog an acceptable reason to justify using my FMLA time. Again, welcome to my world.

For those of you that don’t know, FMLA provides for up to 12 weeks of unpaid leave job protection. So far if I don’t have any surgeries or major medical procedures, I can earn enough sick leave throughout the year to cover any sick days I might have. That said, in 2019 I ran out of sick and vacation leave due to the 3 major surgeries and 2 significant outpatient procedures I had that year so I was dipping into the unpaid leave category. As far as I can remember, I wasn’t pushing the 12 week limit, but I was getting close. Imagine trying to progress up your professional ladder if you had to constantly miss 3 to 10 weeks worth of work a year, would you even be able too progress. Its hard to finish projects on time, take trainings, attend conferences, brown nose bosses if you are not at work or if the email your boss most oftengets from you is a sick leave request. At the moment I still work full-time, but if my new neck pain is serious I might lose my ability to remain high functions very quickly.

So I ask again, at what point should I utilize my Family and Medical Leave Act (FMLA) time and leave work for the day? What is a bad pain day vs what the public considers a bad pain day? Should I use my FMLA time or just “tough” it out? At what level of pain is it acceptable to call in sick to work? The simple answer is I still do not have a clue how to answer these questions. Not a clue…

One of the benefits of the pandemic is there is now a better understanding of the importance of staying home when one feels sick. It takes a village in order to combat sick. We now know how quickly illnesses like COVID-19 can spread through a business, community, or even a city the size of Boise or even Los Angelas when proper care is not practiced (ie wearing a mask or washing our hands). However, my chronic pain is not considered sick by too many. I’m either not being a true man because I’m showing vulnerability by admitting that I’m constantly hurting or there is no way I can possibly be in this much pain. To many people think pain is an acute condition, not chronic. So until people realize that chronic pain is sick, describing my pain is both sharing a symptom and being vulnerable, and that people can live in chronic pain, my use of FMLA will be different from Lexi’s, whose use will be different than Jacque’s, whose use will be different from Aaron’s, whose use will be different from Justin’s, whose difference will be different than etc, and so on and so on and so on. Welcome to my world…