Teaching with a
Chronic Illness

How to handle common challenges, what rights you’re protected by under the law, and who to consider telling about your condition.

Last Updated: 08/14/2020

Meet the Expert
McKenna Reitz

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McKenna Reitz’s life forever changed when she lost all her hair due to the autoimmune disease alopecia. Instead of allowing alopecia to define her, McKenna decided to define it. When most would believe that losing your hair would take away your identity, alopecia actually gave McKenna her identity and true purpose in life. As an AP Psychology teacher and varsity volleyball coach at Springfield High School in Ohio, McKenna uses her strength to inspire others to change their perspective on life and others, while understanding that we are all battling something and must support one another unconditionally. A mother of two beautiful little girls and the wife of the most loving, supportive husband, McKenna is heavily involved in many philanthropic projects that have raised thousands of dollars for the National Alopecia Areata Foundation and donated almost forty thousand toys to the Toledo Children’s Hospital over the past five years.

Trying to meet the unique learning needs of every student. Late nights grading mountains of papers. Constant pressure from school administrators. Let’s face it – being a teacher can be a huge challenge. And if you’re part of the 60 percent of adults who live with a chronic illness like diabetes, arthritis or cancer, you know it’s an even bigger one.

How can you overcome the struggles that come with having a chronic illness in the classroom? Who at school should you tell about your condition, if anyone? And what employee rights are you entitled to under the law? These are all critical questions we explore and answer throughout the following guide. You’ll also hear first-hand advice from a teacher with a chronic condition to learn how you can effectively balance managing your classroom with your health and well-being.

Editor’s Note: Any treatment suggestions provided in this guide are not meant to and should not replace expert medical advice. Always consult a licensed medical professional.

Working with a Chronic Condition: A Teacher’s Personal Story and Advice

McKenna-Reitz

McKenna Reitz‘s life forever changed when she lost all her hair due to the autoimmune disease alopecia. Instead of allowing alopecia to define her, McKenna decided to define it. When most would believe that losing your hair would take away your identity, alopecia actually gave McKenna her identity and true purpose in life. As an AP Psychology teacher and varsity volleyball coach at Springfield High School in Ohio, McKenna uses her strength to inspire others to change their perspective on life and others, while understanding that we are all battling something and must support one another unconditionally. A mother of two beautiful little girls and the wife of the most loving, supportive husband, McKenna is heavily involved in many philanthropic projects that have raised thousands of dollars for the National Alopecia Areata Foundation and donated almost forty thousand toys to the Toledo Children’s Hospital over the past five years.

What has your experience been like as a teacher with a chronic illness? How has it impacted your work every day?

The past almost five years have been a total rollercoaster physically, mentally, and emotionally since being diagnosed with alopecia. Being a teacher, I couldn’t hide even though that was all I wanted to do. However, it forced me to be open and honest with my students from the beginning because there truly was no other choice. I am very blessed that I work with such a supporting staff and students who have given me the strength to fight every day. The first year or two were extremely difficult because I was embarrassed of how I looked wearing a wig and everyone knew that I was wearing a wig, or if my eyelashes would start to come off while teaching, or knowing how terrible my eyebrows looked because I had to draw them on every day. I just wanted to cry.

Once I came to terms with having alopecia and where I was at in my life, those things didn’t bother me like they once did. I am now confident in my own skin and I own alopecia. No longer am I allowing alopecia to define me, rather I am defining it! If my eyelashes do start to fall off, then I will just go to my desk, pull out some glue and put it back on where before I would try to hide it completely. I now teach bald. It was extremely difficult at first. My anxiety was through the roof. I was so concerned that I was going to be a distraction to the learning environment, but what I learned is it was me truly holding myself back.  I am 100 percent open and honest about having alopecia with my students and it gives me the platform to show to them that we are all battling something in our lives, mine just happens to be visible and we must support one another unconditionally.

I do have to say that my head is cold a lot though!

How did you handle disclosing your illness to your coworkers and students?

The best thing that I ever did as I started to lose my hair was being open and honest with my students. As my hair started to recede, I started wearing headbands to cover my bald spot and it let me know that I didn’t understand what was happening and I was going to start to look different. I explained to them that I was losing my hair and that I had no idea what the future held for me. I also informed my principal and colleagues aware of my situation from the beginning as well. This enabled me to not feel as though I was hiding and living a lie every day as I stood in front of my classroom.

What challenges have you faced in the workplace because of your condition?

I have faced many challenges throughout my journey of having alopecia. I was so uncomfortable with myself that I didn’t want others to see me bald either because I couldn’t even look at myself bald in the mirror. I didn’t want to wear a scarf on my head because so many people believed that I had cancer. All I wanted to do was wear my baseball hat and feel as comfortable as possible, but of course I couldn’t. No hats allowed in school, so I finally broke down and bought a wig. Do you know how itchy and hot wigs can be? I was constantly scratching my head or terrified what people thought of me knowing that I was wearing a wig. It takes a psychological toll on your mind and body. I remember teaching and my eyelash started to fall off. I wanted to cry. I didn’t want my students to notice because I was embarrassed. I didn’t want to draw attention to it either.

When I finally felt that alopecia gave me my identity, instead of it taking it away from it, I decided to fully embrace alopecia and start this current school year off bald. Now I had to deal with every single student and teacher who didn’t know my story stare at me and wonder if I had cancer. But I took it upon myself to educate others on alopecia and being confident with who are you. However, my head is cold all the time!

How have you been able to overcome those challenges?

I have overcome these challenges through different means: First, by being 100 percent open and honest with my students and colleagues. This allowed me to no longer feel like I am hiding my inadequacies. More importantly, I overcame these challenges by no longer being in denial. I have accepted the fact that I no longer have hair. I allowed alopecia to define me for far too long and consciously made the decision to start to define it.

Every day I try to inspire my students to be strong both mentally and physically by not comparing themselves to others. I want my students to understand that we all have our own story. We all have or are battling something and regardless of the size, we must support one another unconditionally. Since my story is visible, I reference myself to have a greater impact on my students.

What has been the emotional impact of you living with this illness?

The biggest emotional impact for me is been coming to terms with having no hair and understanding it is not about what other people think of me, but what I think of me. I thought I was so concerned with what other people thought of me—Did they think I was dying of cancer? Why do they stare so much? Do they know what alopecia is—but ultimately it has been about me. Being able to look at myself in the mirror, understanding my strength, still trying to be a good mom and a wife while battling my inner demons. I have come a long way. I use to cry at least six out of the seven days of the week and now I am able to stare at myself in the mirror and finally see beauty again. Once I accepted that I have alopecia and that alopecia has truly given me my identity and purpose in life I have experienced so much more happiness in my life. Not to say I still don’t have the random mental breakdown, I am human. But I am so much happier than I was a couple of years ago.

What advice would you give to other teachers living with a chronic illness?

Be vulnerable. The lessons that you will teach to your students are beyond any curriculum you could ever teach.  When you are open and honest to your coworkers and students, you will feel so much more free and have the ability to be yourself instead of being someone you are not. Show your students what true strength looks like.

Understanding Your Rights: 3 Things Teachers with Chronic Conditions Should Know

It’s difficult navigating the physical, psychological, and mental issues associated with a chronic condition. But it’s important to educate yourself about legal issues that can arise in the workplace and understand the rights that are afforded to you. Here are the top things you should know.

1

Teachers with serious chronic conditions are protected under the Americans with Disabilities Act.

The Americans with Disabilities Act of 1990, or ADA, protects people who are living with various types of disabilities from discrimination in workplaces with at least 15 employees. Under this law, people cannot be denied a job or fired because of a disability, and people who need reasonable accommodations to perform the duties of their job are entitled to this help.

The ADA defines a person with a disability as “as a person who has a physical or mental impairment that substantially limits one or more major life activities, has a record of such an impairment, or is regarded as having such an impairment.” Because of this broad definition, those with serious, anyone with a life-altering chronic condition is protected, not just those who are medically considered to have a disability.

2

Teachers with protection under ADA have special rights in the workplace.

According to the Equal Employment Opportunity Commission, some of the rights that are available to workers include:

  • Protection from discrimination in various employment practices, including recruitment, hiring, firing, promotions, and job assignments. The law also prevents discrimination when it comes to pay and benefits.
  • Reasonable accommodations are available to people living with chronic illnesses. These accommodations may include job restructuring, the availability of equipment or devices, and reassignment to another open position.

Under the ADA, some of the workplace accommodations that teachers may be able to receive include, but are not limited to:

  • Accessible communications, like materials in large print
  • Modified workspaces
  • Ramps in the restrooms
  • Screen reader programs
  • Aids to help with writing on a blackboard
  • Computer software
  • Adjusting work schedules to accommodate doctor’s appointments
  • Job reassignment

3

Teachers protected under ADA will have to ask for workplace accommodations.

Teachers with chronic illnesses who need reasonable workplace accommodations are not given this assistance automatically. According to the Equal Employment Opportunity Commission, employees must request accommodations by explaining what the problem is and what they need to make it easier for them to do their job. Although workers are not required to put their request for accommodations in writing, employers may request that the person provide documentation about why the accommodation is necessary if they have a condition that is not obvious.

Disclosing Your Chronic Illness as a Teacher

Deciding whether or not to disclose a chronic illness at work isn’t easy. There are many things to consider before letting your colleagues, as well as students and parents, know about your health issues. The following section addresses this complex dilemma and guides how to make this choice.

FAQs About Disclosing a Medical Condition to Your Employer

Do I have to disclose my medical condition at work?

No. If your illness is not affecting your ability to do your job, you are not obligated to disclose any information about your illness. However, if you need reasonable work accommodations made to make teaching with your condition easier, you will need to disclose it.

If I do disclose, who should I tell?

If you choose to disclose at work, it’s a good idea to start with your direct supervisor. You’ll also want to make the human resources department aware of your illness in case any problems arise in the workplace in the future.

What should I tell people when I disclose my illness?

You can give as much or as little information as you feel comfortable with. However, if you need accommodations at work, you will have to give enough information to explain why they are necessary.

Advice for Disclosing Your Illness to Parents and Fellow Teachers

It can be uncomfortable to disclose an illness to fellow teachers or parents, but in some cases, it may be a good idea to tell them if the illness is impacting your work. If you do decide to share, here are some tips:

  • Think carefully about what information you should give during the conversation and how it will be conveyed.
  • Consider a worst-case scenario and be prepared for it.
  • Communicate in the best way for the specific person, whether that means email, a phone meeting, or a face-to-face conversation.
  • Explain how the illness may affect the way you do your job and what it may mean for other people.
  • Be prepared to answer other people’s questions about the condition, but respectfully decline to answer questions that are too uncomfortable.
  • Reassure the other person that the illness does not mean you won’t be competent at your job.

Should You Talk About Your Illness with Your Students?

In addition to deciding whether or not to disclose an illness to an employer and coworker, teachers have to also consider whether or not to tell their students about the illness. If teachers have absences from work or certain accommodations in the classroom because of their condition, chances are the students will have questions. The following are some ways to best handle disclosing to students.

Do’s

  • Use language that is age and grade-appropriate
  • Be prepared to answer questions
  • Give facts about the illness
  • Expect students to want to help
  • End the conversation on a positive note

Don’ts

  • Tell more than the class can handle or understand
  • Answer questions that are too uncomfortable
  • Present information in a way that will worry students
  • Discourage them from doing things that will make them feel like they’re being helpful, as long as it’s appropriate
  • Discourage students from sharing their feelings about your illness if they need to

Teaching with a Chronic Illness: Solutions to Common Challenges

Chronic illnesses often have side effects that impact teachers’ ability to work—whether the conditions cause them to have difficulty concentrating in class, standing on their feet for long periods, or communicating verbally. This section explores the challenges that teachers with specific illnesses may face and the solutions to these issues.

Asthma, COPD, Cystic Fibrosis & Other Lung Conditions

Condition Overview

Chronic lung diseases—such as chronic obstructive pulmonary disease (COPD), asthma, emphysema, and cystic fibrosis—cause narrowing and blockages of the airways, which make it difficult for the body to transport oxygen and gasses in and out of the lungs. The symptoms of these chronic illnesses include a continuing cough, wheezing, shortness of breath, frequent pain in the chest, and coughing up blood. To manage these symptoms, people may be given oxygen therapy, medication, or pulmonary rehabilitation, and in some cases, surgery may be necessary.

Teaching Challenge Solution
Intense regular coughs throughout classPeople who are smokers are encouraged to quit to help manage their symptoms. Also, they may need to limit their exposure to certain cleaning fluids, perfumes and colognes, and animals.
Feeling tightness in the chest when teaching classesBreathing exercises can help people catch their breath, as well as relieve stress. Also, drinking a hot beverage before teaching a class outside can warm people’s airways. In some cases, carrying an inhaler during these outdoor classes may be necessary.

Arthritis

Condition Overview

Arthritis is a condition that causes inflammation and chronic pain in the joints. The most common type is rheumatoid arthritis, which is an autoimmune disorder that attacks the lining of people’s joints—leading to pain, stiffness, fatigue, and swelling. Another type of arthritis is psoriatic arthritis, which is a relative of psoriasis—a genetic condition that causes people to develop scales and bumps on their skin because of the immune system’s quick production of skin cells. People with this disorder experience back pain, swollen toes and fingers, flaky nails, and foot pain. Treatment for both types of arthritis includes nonsteroidal anti-inflammatory medications, physical therapy, and corticosteroids.

Teaching Challenge Solution
Foot and back pain that makes it difficult to stand up when teachingPlan lessons in such a way so you have periods when you can regularly sit down.
Swollen hands and arms that make it difficult to write or do other activities in the classroomOrganize your classroom in such a way to minimize lifting, carrying, and reaching.
Feeling sudden fatigue during classPrepare backup lesson plans that allow you to sit down.

Cancer

Condition Overview

Cancer, also known as malignancy, is one of the most common chronic illnesses, as well as one of the leading causes of death in the United States. According to the National Cancer Institute, in 2018 alone, there were 1,735,350 new cancer diagnoses around the country and 609,640 people died from the disease. Cancer is an illness that results in changes in the body that cause abnormal growth and division of cells. The disease can affect several parts of the body, from bones to breasts to lungs to kidneys.

Teaching Challenge Solution
Scheduling chemotherapy and radiation treatments around your teaching scheduleConsider scheduling chemotherapy or radiation treatments on days that allow you to take the least amount of time off based on how long you’re sick after treatment. For example, if you’re usually sick for five days after treatment, you may want to schedule appointments on a Wednesday, so you can recover during the weekend and only take two days off.Consider scheduling chemotherapy or radiation treatments on days that allow you to take the least amount of time off based on how long you’re sick after treatment. For example, if you’re usually sick for five days after treatment, you may want to schedule appointments on a Wednesday, so you can recover during the weekend and only take two days off.
Teaching with chemo brainConsult your doctor, as they may be able to provide medication to help alleviate this side effect of chemotherapy.
Having problems getting enough sleep on school nightsConsider doing breathing exercises, practicing meditation, listening to music, or doing yoga at night.

Arrhythmia, Cardiovascular Disease, and Other Heart Conditions

Condition Overview

There are several heart diseases, also known as cardiovascular diseases, which can affect the heart and blood vessels—leading to chest pains, heart attack, or stroke. For example, an arrhythmia is related to an irregular heartbeat, which means the heart can either beat too fast or too slowly. Pulmonary hypertension is a condition that occurs when the arteries that connect the heart and lungs have excess pressure and rheumatic heart disease causes damage to the heart valves after someone has experienced complications of rheumatic fever.

Teaching Challenge Solution
Swelling in the legs that make it difficult to stand at the blackboardPlan out ways to be able to sit down when necessary.
Controlling blood pressure during stressful days in the classroomYou may be able to manage blood pressure through lifestyle changes—like diet and exercise—but medication may be necessary.

Crohn’s Disease, Ulcerative Colitis, and Other Digestive Conditions

Condition Overview

Digestive conditions can impact any part of the digestive tract—the esophagus, stomach, gallbladder, liver, intestines, and pancreas. One type of digestive disorder is Crohn’s disease, which is an inflammatory bowel condition that can affect the digestive tract from the mouth to the anus. People who have this illness experience pain in their lower abdomen, anal fissures, mouth or gut ulcers, and diarrhea. Similarly, ulcerative colitis is an inflammatory disease that creates swelling and ulcers in the bowels. Those who have this illness may experience weight loss, rectal pain, fatigue, and abdominal cramps.

Teaching Challenge Solution
Excessive gas while in the classroomYou may be able to control this by changing your diet. For example, avoiding carbonated beverages may reduce this problem.
Severe diarrhea during the workdayThis side effect may be reduced by avoiding caffeine, which acts as a laxative, as well as spicy foods, and foods that are high in fiber.

Chronic Migraines and Other Types of Ongoing Pain

Condition Overview

Several types of ongoing pain can affect a variety of areas in the body. For example, when people suffer from chronic migraines, it means they have at least 15 migraines each month for more than three months, which can be caused by medical conditions like depression, anxiety, asthma, or nausea—as well as factors such as ingesting caffeine, the overuse of medications, or stressful life problems. Other types of ongoing pain include fibromyalgia—which is a disorder that causes musculoskeletal pain all over the body, as well as fatigue, poor sleep, and depression—and endometriosis, a condition that is caused when there is an abnormal growth of cells outside the uterine cavity. This illness can cause extreme menstrual cramps, back pain, and discomfort during bowel movements.

Teaching Challenge Solution
Feeling sick from the fluorescent lights in the classroom and brightness from the computerTry decreasing the brightness of your computer screen and use light filters in the room.
Feeling nauseous while in the classroomTake sips of water throughout the day.
Sensitivity to the perfumes and body sprays worn by students and other teachersOpen the window to get some fresh air. If that’s not possible, keeping a small fan on the desk to circulate the air may help.

Depression, Anxiety and Other Mental Health Issues

Condition Overview

Mental health issues can be every bit as painful as physical conditions, and oftentimes, mental health conditions can result in physical problems. One of the most common mental health issues is anxiety, which, according to the Anxiety and Depression Association of America, affects 40 million adults around the country. Similarly, depression is another prevalent mental issue that the National Institute of Mental Health reports is experienced by 17.3 million people. Those who have anxiety and depression may experience physical issues such as irregular heartbeat, chest pains, migraines, and weight fluctuations.

Teaching Challenge Solution
Experiencing a panic attack during classAsk another teacher to take over your class for a few minutes to give you time to calm down and collect yourself.
Doubting your teaching abilityPay attention to students’ performance and how they are responding to lessons. This can give you the validation you’re doing a good job.
Poor eating and sleeping habits during the workweek.Create a routine by eating and sleeping at the same time. This helps to make self-care a priority.

Diabetes

Condition Overview

According to the Centers for Disease Control and Prevention’s National Diabetes Statistics Report 2020, 34.1 million Americans are living with diabetes. The disease occurs when the body fails to effectively utilize the hormone insulin, which regulates the way blood glucose moves into cells so it can be used as energy. Common symptoms of diabetes include increased thirst or hunger, frequent urination, sores that take longer than usual to heal, and blurred vision.

Teaching Challenge Solution
Worrying about experiencing low blood sugar in the middle of classKeep candy or other snacks in your classroom so you can quickly get your blood sugar back to normal levels. To make things less disruptive, consider buying extra so you can share with your students. Having a mini-fridge in your classroom stocked with fruit juice or soda is another great option.
Frequent trips to the bathroom because of blood sugars running highCreate lesson plans that where students can do individual work, so you can leave class while keeping your students productive.
Checking blood sugar levels during class without being disruptiveTelling your students about your diabetes can make this easier. Explain why you need to check your blood sugar and may need to take periodic breaks from lecturing.

Epilepsy

Condition Overview

Epilepsy is a neurological disorder that causes abnormal brain activity. As a result, people who have this condition can experience recurring seizures, as well as sensations around the body and loss of awareness. Common causes of the illness include trauma to the head, prenatal injuries, developmental disorders, and infectious diseases.  The Epilepsy Foundation of America reports that 3.4 million people in the United States have epilepsy, with 150,000 new cases diagnosed each year.

Teaching Challenge Solution
Unusual behavior in class or around colleagues at schoolYou may want to disclose your condition to colleagues, administrators, parents, and students so that people understand what’s going on and do not become alarmed. Educating people about your illness can go a long way toward avoiding possible misunderstandings.
Having a seizure during classPeople with epilepsy often experience auras before having a seizure. If you feel the warning signs, you can arrange to have your class go outside before the seizure occurs or get help. Also, it may be a good idea to let your students know about epilepsy so they are not afraid when a seizure occurs and know what to do.
Having trouble breathing while trying to teachDeep breathing techniques can help calm the body and regulate breathing.

Narcolepsy, Insomnia and Other Sleep Disorders

Condition Overview

Sleep disorders can impact people during different stages of the sleep cycle, making it difficult for them to get to sleep or stay asleep. For example, insomnia can prevent people’s ability to initiate or maintain sleep, which can lead to problems with fatigue, mood, and concentration. Another common sleep disorder is narcolepsy, which not only affects the ability to stay asleep at night but can also cause people to suddenly fall asleep during the day—affecting their regular activities like driving.

Teaching Challenge Solution
Irritability with students who are misbehaving in classIn some cases, sleep disorders are related to stress. To avoid becoming irritable and having mood swings, consider using relaxation techniques, like deep breathing exercises, as well as physical activities like yoga.
Sudden muscle weakness or paralysis during the dayLifestyle changes may help here. For example, creating a strict sleep schedule can help train the body to go to sleep at a specific time. Also, you may want to consider avoiding caffeine, alcohol, and tobacco, as well as exposure to lights during the evening hours.

Parkinson’s Disease

Condition Overview

According to the Parkinson’s Foundation, there are 60,000 new Parkinson’s disease diagnoses in the United States each year, which means the total number of people living with the condition is rapidly approaching one million. The illness, which begins gradually and intensifies over time, is a disorder that can affect dopamine levels in the brain—leading to problems with balance, coordination, and memory. Treatment for this condition includes medications that increase dopamine in the brain and surgical procedures that implant electrodes into the brain.

Teaching Challenge Solution
Problems moving in the classroom or balancing when standing in front of the blackboardMedication, along with movement exercises and deep tissue massage, can help alleviate this problem.
Problems speaking when teaching students in class or talking to colleagues during meetingsPeople with Parkinson’s disease may need speech therapy to correct these issues. It may be a good idea to let the people you work with, as well as students and parents, know this is a symptom of your condition.

Additional Resources for Teachers with Chronic Ailments