How to do a medical leave

I’m three-quarters of the way through medical leave. I’m going back to work soon and I feel ready, even though my health still isn’t perfect. I was anxious about going on leave and determined to make the most of it. Going on medical leave isn’t about going on a four-month vacation; it’s about getting better and learning to work around your illness (if it’s chronic) – and that takes work. Here’s my guide to making medical leave a success.

Get your paperwork in order

First, the nuts and bolts. Going on medical leave will likely require several bits of paperwork and you may need to meet with your advisor, department graduate advisor, a graduate studies department, and disability services. Before going into these meetings find your university’s policy for graduate student medical leave and read it forwards and backwards. At every meeting, confirm both the paperwork required for going on leave and the steps necessary for coming back. Start the paperwork for going on leave and off leave as soon as possible – university bureaucracies are very slow, surprisingly disorganized, and prone to not telling you about key paperwork until they realize it’s missing. Keep your advisor in the loop as much as possible if they’re supportive and try to feel out who your best advocates are and lean on them. I’m fortunate to have a very supportive advisor. I informed her first about going on medical leave and the kind of accommodations I’d ask for when coming back. When disability services raised an eyebrow at some of the accommodations I’d asked for, I got them in writing because I had the backing of my supervisor.

Take a vacation

I know I just said that going on leave takes work. Some of that work, however, requires a vacation. If you’re going on medical leave, you’re probably quite sick and have been for quite some time. That takes a serious emotional and physical toll. I was really sick last year and spending so much time in terrible pain exhausted and depressed me. I declared the first month of medical leave a vacation – no work allowed. I kept to an easy schedule. To keep myself busy, I assigned myself two tasks a day: usually one chore and one fun thing. For example, going to the grocery store and spending time on an art project. Once the emotional recovery was about finished, it was time to move on in my plan to get better and live better between bouts of illness. You’ll know you’re done with your vacation when you start getting bored.

Figure out what makes you better

I have a chronic illness. There’s no cure. I will never be well, though I might feel better. How can I get a PhD and have a career while still being taken out unpredictably by illness? The first thing to do is figure out how to be as well as possible.

Routine

I know that for my illness, a strict routine can help. Even if routine isn’t essential for your particular illness, it can help you feel more in control and work around flare ups. But what kind of routine exactly? I experimented, carefully logging what I did each day and when and how I felt. I used the information to build a schedule strict enough to keep my symptoms under control but flexible enough that migraine attacks don’t completely derail me. If you’re curious about the details, I’ve catalogued them on my personal blog here and here.

Fix the small health problems

Most of my doctor’s appointments are related to my chronic illness, but like anyone else, other stuff goes wrong. And when you combine that with chronic illness, small symptoms are much more disabling and can feed back into your illness. I scheduled doctor appointments for every tiny problem to figure out what was related to my illness and what was fixable. This process was really beneficial for me and with the help of my GP, we fixed several small health issues that were having a disproportionately large effect on my life. For example, I had an iron deficiency contributing to my fatigue, which made it hard to maintain a good sleep schedule, exercise, and just generally get stuff done.

I also got more aggressive about treating symptoms of my disease and side effects of medication using medication, supplements, and controlling my environment. When you have a chronic illness, it’s easy to blow off small discomforts, but those small discomforts are distracting and decrease your quality of life. Take them seriously – your life will be better without them.

Find and avoid triggers

Many kinds of chronic illness have triggers. Try to eliminate these from your life. Going into medical leave, I knew that light, sound, movement and temperature extremes were a problem for me. I thought hard and made difficult choices about the things I do in order to minimize my exposure to triggers. I’m more likely now to take a walk on a cloudy day than a sunny day, I gave up swing dancing and other vigorous exercise, I bought special sunglasses, etc.

Medical leave gives you time to slow down. Use that to pay attention to your body and it’s reactions to find new triggers. I realized that small discomfort in my shoulder from using my mouse was causing migraine attacks. I now have a much more ergonomic desk set-up that eliminates the problem.

Live around your illness

There’s a lot of loss and sacrifice with chronic illness. Medical leave gives you a chance to come up with strategies for living well between bouts of illness – and maybe even through it. I gave up activities I loved that tended to make me sicker (swing dancing, late dinners with friends) and added new activities (gardening, brunch with friends). I read a book called How to be Sick that teaches techniques for dealing with the difficulties of being a sick person so you can enjoy the time you’re well instead of being swallowed up by pain and loss and jealousy and rage and grief.

Think about how you want to live your life and what your long-term goals are. Then make your day-to-day life serve those purposes. If I really want to do a PhD in half the time, I have to learn to work more efficiently and a bit longer on days that I’m well. That means cutting back on (but not quitting) some of my hobbies (studying Russian, reading the internet) and cultivating better discipline. Leechblock on my computer and parental control apps like ScreenTime on my phone help. Having a daily schedule with breaks built in also helps.

One of the hardest parts of illness is the way it puts limits on what you can do. It is very tempting to cross those lines, especially when other people are asking. I try to circumvent that temptation by talking to my friends frankly about my limits. Most have been happy to respect them.

Ask for accommodations

Once you’ve figured out how to structure your days and what you need to do to be better, make your university fit your requirements. I asked for accommodations, based largely on the advice of the TSW commenter here (thanks a million!) I went into the meeting determined, but nervous. My initial experience asking for accommodations wasn’t ideal, but this time I went in with a list of things I wanted. They almost immediately agreed to everything I asked for. The only thing I haven’t asked for is extended funding if grad school starts to take me longer due to illness (I’d love advice on the topic or information on funding sources).

Practice

Now that you know what your days need to look like to be healthier and happier, practice. Pretend you’re back at work and make your new knowledge into effortless, automatic habits. You don’t want to be fumbling when you get back or finding out that your perfect schedule isn’t so perfect when you have to account for the bus or meetings. Taking medical leave made me worry I wouldn’t be physically strong enough to do my PhD. Practising the schedule and habits I’ve developed over my medical leave makes me more confident in my abilities and knowledgeable about my limits.

I’m still nervous about going back. I still have fears about my ability to do a PhD. But I also feel healthier, happier, stronger, and ready to go back.

If you’ve ever been on medical leave, what advice do you have for making the most of it? What about going back?