Q. As an employer, I am keen to ensure an employee with MS can continue working as a teacher. We are working together to find solutions but can you suggest any changes we can make?
A. If the employee and employer are willing to cooperate in identifying and implementing on-thejob accommodations for workers with MS, effective solutions usually fall into place. The first step is determining which MS symptoms are affecting the worker’s job duties, and which job duties are affected. Where MS symptoms create difficulties with job performance, a reasonable accommodation is warranted. Encouragingly, employers report that accommodating workers with MS is often a nocost or low-cost proposition, often amounting to scheduling modifications or flexible arrangements at the workplace that enable the worker to take full advantage of the abilities he or she has that are not compromised by MS.
Prof Phil Rumrill, Kent State University, Ohio, USA


Q. I need to tell my boss that I have MS as my symptoms are interfering at work, but I am frightened. I can’t afford to lose my job because I am a single parent and my government does not provide any assistance.
What advice can you give?
A. Depending on where you live, it is important to determine whether you have any legal obligation to tell your employer. In many countries, the employer does not have the right to know your diagnosis of MS, only that you are a person with a disability who requires an accommodation to do your job. If MS is not affecting your job performance or your attendance and if there is no law in your country that you must disclose, I generally advise people to keep their health information to themselves. If you do need to disclose something about your health to your employer, I recommend telling only as much as you need to in order to arrange the accommodation you need. Once you relinquish your privacy, you can never get it back, and I try to discourage people from disclosing things that the employer has no right to know.
However, you may want to investigate if your place of employment has a policy regarding accommodations, if there is a personnel office that has a qualified person who can help you or if there are other employees who have had to make changes to their work due a disability/health condition. In any case, it’s important to understand your rights as an employee before making any decision about when, how and what to say to your employer. Your MS society may be able to give you more detailed guidance.
Prof Phil Rumrill, Kent State University, Ohio, USA

Q. I find fatigue a big problem at work. My boss has allowed me to reduce my hours, but I’m still struggling on some days. Are there any medications or therapies that might help?
A. There are medications that can help
(Amantadine and Modafanil are commonly prescribed), but these are never entirely successful if taken in isolation – it is important to integrate some fatigue management strategies into your daily routine as well. The strategies you may want to consider involve pacing yourself. It is important to take breaks at work – we often sit within our work environment during break times, but it is advisable to have a complete break away.

It is also important to build a ten minute break into the morning and the afternoon. If you can’t do this, you may want to consider relaxing for 10 minutes or taking an extra long toilet break.
It is also important that you eat regularly. Foods that are full of slow releasing carbohydrates are particularly good, such as a cereal bar or crackers. You may also want to consider the heat in your work environment – a fan or sitting near an open window can be helpful. Even having ice cold drinks can make a difference.

Finally, fatigue is usually worse as the day goes by so try to plan important activities or meetings in the mornings.
Nicki Ward, Lecturer Practitioner in MS, Birmingham
City University, UK