Hiding Your Crohn's Flares from Coworkers

The decision to tell or not to tell is the basis for a ton of anxiety for every patient with Crohn's disease who works outside the home.

The answer: a disappointing "It depends."

Deciding whether to tell coworkers I suffer from inflammatory bowel disease has been the greatest challenge of my many years on this earth. (In a few years, I'll qualify for Social Security.) When the disease flares, I always wonder whether to open my mouth. Why is this such a problem for patients?

If you are fortunate enough to work for a company, organization or educational institution with a mindset that promotes accommodating disabilities, you'll probably get a warm and sympathetic reception to your announcement, provided it's somewhat upbeat. You can tell your coworkers that you've come out of remission, adding a little positive reinforcement about how you can contribute to the office or group. You can back this up by trying hard to show up on days when you don't feel 100 percent great but don't want to let your coworkers down.

Then there are the groups that value only what the employee can contribute to the bottom line, specifically, profit. If you suffer from Crohn's disease and work for one of them, you will immediately sense the expectation to routinely work 10-hour days or weekends without complaint. You will also note required attendance at all social events, including meals where you will be expected to chow down on salads and heavy foods you cannot easily digest.

For these companies, team players aren't the ideal; they're the only ones the company wants. Let your team down by calling in sick when a proposal is due, and you've probably seen your last paycheck. Don't expect anyone to visit if you're in the hospital, either. If you work for a firm like this, plan to place duct tape securely across your mouth as far as referring to any illness, especially during a flare.

Sadly, what we as patients with inflammatory bowel disease choose to reveal has to be determined on a daily basis. If, for example, you're lactose intolerant, you can probably manage to navigate a meal function without announcing that you have to steer clear of anything with cow's milk in it. However, if the published menu has absolutely nothing on it you can safely eat that day, you will have to say something.

The last company for which I worked placed more emphasis on food than any other group I've ever seen. Hardly a week went by without a meeting or other function involving a catered meal. When my disease took a nosedive and I found myself unable to eat enough to remain upright the rest of the day, I had to simply announce that I had a medical issue that precluded me from attending food functions. End of story.

Whether you tell your coworkers that you have Crohn's disease or announce when it waxes and wanes is based on one huge premise. That premise is that you could hide the existence of the disease if you chose to do so.

However, there are several situations in which this would be impossible. If you suffer an acute episode of pain or any type of intestinal obstruction, you will need to leave the workplace immediately to get to an emergency room. You'll also need help getting there.

The second thing you cannot mask is surgery. The simple fact is that the majority of Crohn's patients will have it at some point. It's not same-day surgery. The recovery period has been about six weeks for each of the five operations I've had. Your company will also be well aware of the dollar total of all your health insurance claims.

Third, it's impossible to hide a lot of daily absences from work. It's one thing to come to work with a temperature of 100 degrees and feeling lousy overall. It's another to be at home, bleeding from your digestive tract and so sick you can't keep any food down during a flare.

Also, keep in mind that when your disease is in the active mode, you'll find yourself running to the bathroom many times each day. Do you think your coworkers won't notice your Crohn's "excursions"? They might be too polite to ask, but they'll wonder.

There are no pat answers on how to deal with jobs or coworkers for individuals with this disease. Most of us have both wonderful and terrible experiences in the workplace. What seems to be the lowest common denominator is feeding others only enough information to get through the day. Military members refer to this as "need to know."