Prevention & Recovery

Am I too sick to go to work?

By: Tammy Sutherland

Author: Canadian Living

Prevention & Recovery

Am I too sick to go to work?

By: Tammy Sutherland
This story was originally titled "Too Sick to Go to Work, School ..."  in the September 2008 issue. Subscribe to Canadian Living today and never miss an issue!

One morning last winter, Meredith Sharpe wasn't sure how she was going to face the day. "I was dizzy, achy, sneezing, coughing, dripping. I almost fell over in the shower from the heat." The 33-year-old public relations manager based in Montreal knew she was suffering from the flu, but got dressed and headed to work anyway. "There was a project that I was responsible for, with an imminent deadline. I was needed and felt pressure to get the job done."

Like Meredith, you might think you're being responsible by showing up for work, even if you're sick. But are you? After all, you may not be doing yourself, or anyone else, a favour. Whether you think the office can't run without you or you're just afraid to ask your boss for a day off, making the decision to take a sick day – or to let your child stay home from school, even though she'll miss an important geography test – can be difficult. Take a look at the following symptoms and risks to help you determine when to stay home and rest.

Aches and pains
An all-over achy feeling can sometimes be the first sign that you're not functioning at 100 per cent. "Generally this is the hallmark of viral, flu-like infections," says Dr. William Milne, a family physician at Seaforth Community Medical Clinic and Hospital in Seaforth, Ont. These symptoms, often accompanied by a low-grade fever, can usually be controlled with acetaminophen or ibuprofen, so you could function in the workplace, but you do risk passing your infection on to your coworkers.

If your children are complaining of aches and pains and showing signs of inactivity, keep them at home where they can rest and you can make sure they get plenty of fluids. However, "If they are feeling well enough to run and play, they are most likely well enough to go to school," says Dr. Marni Hanna, a resident physician in pediatrics at the Winnipeg Children's Hospital.

Cough and congestion

No matter what your age, if you've got a runny nose and a persistent cough, you've also got a great reason to stay home. "Copious nasal discharge and cough will spread infection throughout the work environment quickly, even with the best precautions," says Milne. So stay at home, especially if your job involves interaction with infants or elderly people, who are more susceptible to infection, or if you're continually handing things to others (for instance, if you're serving food or working in a library).

Page 1 of 4He also cautions against reaching for relief too quickly. "All-in-one sniffly, sneezy medicines often turn a minor nasal viral infection into a chest infection by drying out secretions and not allowing the chest to clear itself." Another caution: If you are using those medications and you're dragging yourself through your workday, read the packages carefully. "Medication that has sedation as a side-effect could contribute to danger in the workplace or on the highways," says Milne.

If you are thinking about sending your child to school with the sniffles, Hanna suggests that you take your child's comfort into consideration. "Symptoms could become worse and the teachers may not notice, leading to absolute misery for your child."

Fever and chills
A fever is your body's way of fighting an infection, so staying at home is your best option to avoid passing your germs on to others. Forcing yourself to work through the discomfort might cause you more trouble in the long run. "Depending on your work demands, overextending yourself could prolong or complicate the illness," says Milne.

Any child under the age of six months suffering from a fever should see a doctor, while children older than six months should be kept home to rest and fight the infection. Even if their energy level seems OK, Hanna recommends keeping a close eye on them rather than sending them to day care or school, because they could risk becoming dehydrated if not closely monitored.

Stomach and indigestion
According to Milne, there are several possible causes of a sore stomach, including dietary indiscretion (for instance, overeating or eating foods that are too rich or spicy), side-effects from medications such as ASA and ibuprofen, overconsumption of alcohol, or an early sign of gastroenteritis (inflammation of the stomach and intestines, which can eventually cause loss of appetite, vomiting and sometimes diarrhea). "If you still have your appendix, and you're vomiting and the pain migrates to the right lower abdomen, you need to consider whether or not it's appendicitis," he adds.

Stomach discomfort that feels like heartburn or indigestion may indicate an impending heart attack. If you're also sweating and feeling anxious or have a sense of doom, don't brush the situation aside – seek medical attention right away, says Milne.

If your sore stomach is accompanied by vomiting or diarrhea, heading to work is not necessarily going to make things worse, but you will undoubtedly be more comfortable staying home, says Milne. "Especially if the work environment is prone to causing dehydration or is one where weakness could be dangerous, this is an individual decision."

Page 2 of 4If your child is complaining of a sore tummy on a school day, you may think he's practising a classic avoidance technique, but Hanna cautions against jumping to conclusions. She suggests judging the legitimacy of your child's claim by looking closely for significant changes in his level of activity or appetite. "Some young children will say that their tummy hurts for all kinds of problems – even lung infections – so it is important for caregivers to pay attention to other signs of illness." If children do show signs of lethargy and are also vomiting or have diarrhea, they should be kept home to ensure adequate fluid intake to avoid dehydration, and also to stop them from infecting others.

The unhealthy workplace
Dr. Richard Stanwick, an epidemiologist and chief medical health officer for the Vancouver Island Health Authority in Victoria, cautions that the day you're simply feeling bad – usually the day before symptoms start to show – is when you become infectious. Here's what could happen if you go to work anyway.

• You could infect 10 to 15 per cent of the people you come into contact with during the day, if you're in a service industry (for instance, if you’re a bank teller).

A simple cold can turn into something more serious if you have an underlying chronic disease.

• You may be ignoring your overall health in a significant way. Working when you should be at home could be a sign that your work-life balance is off-kilter.

• Your illness could affect your company's bottom line. You won't be as productive as you normally are, and if you infect some coworkers, they might also have lower productivity.

Precautions and preventions for the elderly
Aches and pains

In elderly people, pain lasting a week or more, particularly in the shoulder, thigh and hip regions, could be the sign of an inflammatory disorder such as polymyalgia rheumatica, says Dr. George Heckman, a geriatrician at Hamilton General Hospital in Hamilton. It can also be a side-effect of certain medications or a complication from a viral infection, so a trip to the doctor is in order.

Cough and congestion
A dry cough on its own shouldn't keep an elderly person at home. "Certain blood pressure medications and heart disease medications, such as ACE inhibitors, can cause persistent dry coughs," says Heckman. "Nothing to keep you at home."

However, a cough and congestion could prove difficult for a frail elderly person. We all develop a stress response when we get sick; in elderly people that response can cause (or increase) weakness or confusion, and can result in falls or incontinence. If these conditions develop, or if the person is simply not himself, he should immediately see a doctor.

Fever and chills
Don't be surprised if an elderly person seems to be ill with fever-like symptoms, but doesn't have a high temperature. The immune system of an elderly person isn't able to mount the protective response that a young person's might, says Heckman, so you can't assume that the absence of a fever means that she's OK. Again, if the person develops signs such as confusion, weakness or loss of mobility, she should see a health-care professional.

Page 3 of 4Stomach and Indigestion
Especially in older people, stomach pains and diarrhea can often be side-effects of medications such as antibiotics, particularly if the antibiotic is new to them. It's important to address this with a doctor, so additional medication isn't mistakenly prescribed.

Elderly people should stay home and be sure to have adequate fluid replacement in the event of vomiting or diarrhea. "Older people tend to be less thirsty and their kidneys are less able to retain water, so severe diarrhea can put them at risk for dehydration," says Heckman.

Relax, you're sick!
Adults: Sometimes staying at home when you're ill can seem more stressful than going to the office, because your undone chores are more noticeable in the light of day. Is it OK to ignore them and retire to the couch? "Always do what you're capable of, keeping up nourishment in small but frequent amounts. But if your body is asking for rest and tranquility – indulge it," says Dr. William Milne, a family physician at Seaforth Community Medical Clinic in Seaforth, Ont.

Children: Dr. Marni Hanna, a resident physician in pediatric medicine at the Winnipeg Children's Hospital, agrees, saying that children will want to do what they feel up to. But she reinforces the notion of taking some downtime. "The idea of keeping your children at home is to allow them to rest and recover faster."

What about that evening music class or baseball game that you or your child can't bear to miss? "Children recover from illness faster than the typical adult, but parents should err on the side of caution," says Hanna. If children no longer have pains or fevers and are breathing well with minimal cough, sitting at an event is likely not a problem. But if they're well enough to run through an entire soccer game, then they can likely make it through a day at school.

Milne echoes that sentiment for adults, and puts forth a wise word of warning: "If you do stay home sick, it doesn't look good if the boss sees you on the tennis court."

Elderly Adults: Dr. George Heckman, a geriatrician at Hamilton General Hospital in Hamilton, says you should stay active as much as possible if you're elderly. "The problem with bed rest, especially for older people, is that they may not have the muscle reserve that a younger person does. They may lose up to five per cent of their muscle strength every day that they are in bed. If they're borderline independent, a couple of days in bed could mean that they can no longer get back out of bed and take care of themselves."

Read more:
• Colds and flu: Symptoms and treatment
• Tips for easing your child's upset stomach
• Foods for a healthy immune system

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Prevention & Recovery

Am I too sick to go to work?