Maximize your options: an overview from the National MS Society. (A Place In The Work Force)(Cover Story).

Some jobs are compromised by MS symptoms much more quickly or directly than others. If your job is very physical, you'll be concerned about fatigue, balance, or problems walking.

If your job requires planning and problem-solving, you will be more concerned about subtle cognitive changes--problems with thinking, memory, or concentration. Fatigue and cognitive problems, which trigger more unemployment than mobility impairments do, can be hard to accept personally, but they are not automatic bars to holding a job.

The most important point to keep in mind is your personal decision to keep working. The keys will be flexibility and creativity to make adaptations in the way you do your job, and your willingness to seek accommodations available to you through the Americans with Disabilities Act, or ADA. Equally vital in some situations will be your willingness to consider changing the type of work you do and taking on the challenge of training or education for the change.

Identify ways to manage your stress

While research has not been able to identify any causal link between stress and either the onset or the worsening of MS, coping with any unpredictable chronic illness while managing the demands of work is bound to be stressful. We think the reasonable approach to this is to review your stress management techniques. If the things you used to do to escape pressure and tensions no longer provide relaxation or enjoyment, you need to explore new options. Swimming, water aerobics, meditation, yoga, or Tai Chi have all been cited as helpful by other people with MS. You may benefit from the advice of a counselor or recreation therapist.

Plan for the future

Americans commonly change careers; some people do so several times in their working life. If your current job could be compromised by a worsening of your symptoms, start thinking about your next career move. A vocational rehabilitation specialist or career counselor can help. Make sure you understand the sick leave and disability benefits provided by your current employer, and investigate any retraining or continuing education your employer offers.

There is no need to go it alone. The Society office nearest you may have the referrals you need, or a job retention program, or peer counseling.

The office will certainly have Society publications. These include:

Information for Employers

Should I Work? Information for Employees

What Is MS?

Taming Stress in Multiple Sclerosis

ADA and People with MS

"But You Look So Good"--Coping with invisible MS symptoms

Fatigue: What You Should Know

The Win-Win Approach to Reasonable Accommodations

Call 1-800-FIGHT-MS, Option # 1. We want to help you maximize your employment options.

Beverly Noyes has been the director of Health and Independence Programs at the National MS Society since 1996. She joined the Society's National Capital Chapter in Washington, DC, four years earlier, where she managed Operation Job Match, a pioneering employment program for people with MS and other adult-onset disabilities. Dr. Noyes is a certified career counselor and a licensed professional counselor.