Need some advice - time off work

Hi all

I am new here. I have had asthma since the age of 7 but it has been (generally) well controlled since I hit 21 or so (I am now 29). While I have had 2-3 moderate attacks requiring nebs in a+e in the last 5 years, I hadn't had a hospital admission since the age of 16 until last week.

Here's some background to my work-related query:

Last Tues, I started with a pretty banging cold and found I wasn't sleeping. I knew that my asthma was likely to flare up so I went to an NHS walk-in-centre for a check up. The nurse examined my lungs and said they were clear enough, advised painkillers/fluids/rest etc.

Friday night I had my first serious attack. Managed to sit it out, but had second attack at 1.30 am and called ambulance who came and gave me double nebuliser. I calmed down and they left me at home. Saturday morning, I had attack no. 3: called out of hours doc and was advised to call ambulance. Ambulance brought me to A&E and I had 4 nebs, then sent home at 12pm. Felt very well all day but woke up again at 2am, struggling seriously and becoming exhausted. Called ambulance AGAIN and was admitted by 3.30 am. Had most serious attacks following am and spent 3 hours in resus while ventilation was debated. IV magnesium did the trick though I had a further two serious attacks the following day, so was put on iv aminophylline etc. Not able to sleep at ALL until the aminophylline taken off yesterday - serious palpitations etc.

Anyway, here's what advice I'm looking for (finally). When do I go back to work? I feel so exhausted and also very drained as I'd forgotten the impact of acute attacks. This is my first serious asthma attack at work but my manager is playing silly beggars and I am stressing about how much time to take out. What would others usually take in these sorts of circumstances?

The regular consultant advised all of next week but the doc who discharged me today said I could go back on Wednesday. I don't want to sound like a sap but I can't imagine I'll have had enough sleep by then, and I don't want to risk a repeat of this attack, which the consultant said was viral. I work with children and want to have my strength back up before I return and get potentially exposed to the same virus!

The reason I am stressing is that my manager has been funny about it. She advised my husband that as I had not submitted a sick note within seven days I would not be paid??? She mentioned something about her own son having an asthma attack and being 'right as rain' in 24 hours... I rang HR and they told me that 'there was some leeway' in cases like mine and not to worry but I feel so anxious and upset about her lack of support. I have missed very little time in my job and only one day in two years in my present post that was asthma related, so I can't understand why it's such a big deal? My poor husband was beside himself with worry and she kept going on and on about how it wasn't good enough that I hadn't submitted a sick note? I don't get it?

The worst thing is that I know in my heart that the level of work I have on at the moment will be too much for me for a little while. I am currently working two posts side by side and in the week or two before the attack I was beginning to fall behind. I think I was probably building up to the attack at that time but due to the stress at work I wasn't really vigilant enough about my symptoms, particularly sleepiness, finding it hard to get up in the morning etc. I don't want a repeat of this.

I keep telling myself that I only feel so anxious and stressed because I am still not sleeping with the steroids (I will be on oral steroids now until end of Oct) and sleep deprived from the aminophylline. Do you think I'll feel better in a few days? I remember when I was younger it seemed to take AGES to recover from acute attacks and I just want some reassurance that I am not mollycoddling myself by thinking I should take more time off than going back next Wednesday?

Thanks,

Fiona

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Hi Fiona,

Welcome to Asthma UK; I'm sorry to hear you've been so poorly, it must have been a very frightening experience for you. I'm sorry too that you are getting such an unsympathetic response from your employers.

Everyone is different, in terms of going back to work, and every attack is different. I have had very severe attacks and been back at work relatively quickly, and I have also had less severe attacks which have taken longer to recover from. It's very difficult for an outsider to say when you will be ready to go back to work, but I would say, please don't rush it - it really is not worth it. The potential consequences of having another severe attack are too grave.

I would think that you need to take it a day at a time, gradually building up your activity levels and seeing how you feel. Hopefully your sleep will improve, too - the pred does make it difficult, but that can get better with time. Once you are sleeping at night and are fairly active during the day, then it is time to think that you may be within a few days of being ready to go back to work.

You will need to see your GP, as you will need sick notes issued, and they will be able to give more guidance about when you are ready to go back to work. Do you measure your peak flows? - you certainly shouldn't think of going back until your peak flows are >80% of predicted.

In terms of the lack of support from your manager - I think you need to take advice. The Citizens Advice Bureau is a good place to start. I am sure that not supplying a sick note at the time is not a valid reason not to pay you - especially as you were in hospital at the time. As for the comment about her son's asthma - I've had that sort of comment from HR in the past - some people simply don't realise what a heterogeneous and variable condition asthma is.

They should certainly consider reducing your work load or letting you come back part time at first. As your asthma is causing you significant problems at the moment, it may qualify as a disability under the Disability Discrimination Act - which means that your employer is obliged to make reasonable changes to your working conditions. More information here: direct.gov.uk/en/DisabledPe... or again, contact the CAB.

I notice from your profile that you are a SALT - do you work in a hospital? I have found that the Occupational Health departments in all the hospitals I have worked in have been very friendly and useful. Basically, if they make a recommendation about the hours you can work, or the way that you can work, your employers *have* to take notice of that. So your first priority when you are feeling a little better might be to make an appointment with Occy Health.

I know it's easier said than done, but please don't let your manager pressurise you into going back sooner than is right for you. If they were considering ventilation, it was obviously a very serious attack, potentially perhaps even a life-threatening attack. It's just not worth risking your health by going back too soon.

Hope this helps, and all the best

Em H

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Just regarding sickness certification - it is statutory that you can self-certify for the first seven days of sickness, and employers cannot demmand an official MED3 (doctor's note) for sickness of less than seven days. After seven days, you will need a sick note - but most employers are understanding if it takes you a few days to get hold of this. Your GP should be able to back-date a note provided you have a discharge note/letter from the hospital to cover your admission.

Hope this helps and good luck.

CathBear

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hi,

welcome, did you ask for a note as you were in hospital, the ward should be able to give you one, if you are now home ring ward and see if they will do one for you, that is at least proof you have been really sick,

then you need sick note from gp as hosp one is only for inpatient stay,

i would take as long as you feel you need . i bounce back quite quickly but some take much longer, ask for cert say for 1 week, if you can go back sooner do, also if you feel you need more time go back and ask for it,

good luck,

george xx

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HI and welcome. this is a quite difficult one as i also work with kids so know how much hard work it actually is. after my last admission of 4/52 the hospital gave me a note for 4/52 to say was in hospital and another for a week b4 needed to go back to work am sure half of doctors seem to think that working with kids is a doddle and you can go back to work almost straight away ( no offence to drs on auk) which sometimes i have but had a further 2 weeks this time and have gone back on reduced hrs. i would say see how u feel if you don't feel ready to go back to work see your gp for another note and go back when u fee; ready which is at diff times for diff people.

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Thanks for your responses. It's really helpful to know what to do. I think that because I'm not originally from here the bureaucratic side of getting a sick note slightly stumped me! At home, you would submit a sick note up to fortnight/month after returning to work and your doc would just send it direct to your workplace so this Med3 lark confused me. I am easily confused post-episode! Though I do feel it was a bit much to be forcing the issue of me needing to fax a Med3 on the seventh day (by 5 o'clock, too). I think it seems a little silly to expect someone to be considering paperwork when they're in hospital after an emergency admission!

I have decided I will go back when my PEFR goes up. It's about 65%-70% on and off now and I'm still wheezing quite a lot, lungs feeling pretty raw. I suppose that may happen Mon or Tue although I will see how it goes in terms of sleep etc - I didn't get off til after 4 last night and was up at 8am this am. I seem to be moving around a lot now, although I need frequent rests. Just glad to be more alert and not palpitating so much!

Just glad to be on the mend..