The Dentist and the Dragon

The Dragon

As many of my readers know, we have a good medical system in New Zealand.  It’s good, but it’s not great.

We also have a very different system when it comes to injuries and medical misadventures.  For a start, in New Zealand we don’t call them Medical Misadventure.  Oh, it’s an adventure.  For some, like Derek, it’s the ride of your life.

But it is, like a broken leg, classed as an injury.  For Derek, it’s a “Treatment” injury.  He was injured because of medical treatment.  But that’s history.  Or should that be “His Story”.

When you suffer at the hands of the medical community, and are injured because of it, you get to have an assessment by the Government’s “Independent” “Insurance” Company.

Set up in the 1970’s, it was designed to stop any form of Litigation.  Stop people having to pay crazy amounts of insurance just in case they suffer an injury.  But like anything new, the concept and the reality can be vastly different.

This great independent organization, that was there for the injured, were under some very strict Insurance type rules.  And like any good insurance company, they change the rules as often they change their pants.  So, you have an injury you don’t know if you will be adequately covered.

When you read back through my blog you will see that Derek was covered for his Treatment Injury.  This injury is his Adrenal Insufficiency.  This impacts all parts of his life.

He had to give up driving because, although there is no obvious brain damage, he can no longer multi-task (Yes!  I was lucky enough to marry a man that could multi-task).  He is also one of the most intelligent men I have ever met.  This is not me saying this, his School History (top 50 in the country) says this.  He has been assessed as being unable to focus on more than one thing, his short-term memory is now not what it was, his ability to manage his stress is nothing compared to what it was.

But we manage.  He still has his job.  That’s thanks to an amazing boss.

So, the New Zealand insurance system, known as the Accident Compensation Corporation (ACC as we all know it) is our Dragon.

His treatment injury is permanent.  It affects many aspects of his life, and if we need help because of that, we have to go into the dragon’s cave, and convince that dragon to stop breathing flames, and let us past, to get to the help we need.

To this end, he has a “Case Manager”.  This is his direct contact in the dragon’s lair.  But this Dragon is very hard on their workers.  They are always being burned to the point the run, screaming from the lair, never to go back.

But on their way out, as the scream ENOUGH, they are supposed to contact all their “clients” and let them know they have reached boiling point, and they have run.

The Dentist

So why the back story?

Earlier this year Derek when for his normal checkup with the Dentist.  She checked his teeth.  They are ok.  He needs more work the longer he is on steroids, but it could also be the fact he has “reached a certain age”.   It comes to us all eventually.

She did x-rays, and then the bad news.  “You need to have your 2 remaining wisdom teeth out.”

“OK can you do it?”  Ah, the naivety of my darling husband.  Hell NO!  No way she will do it.  She doesn’t mind the fact he is on warfarin to stop him clotting.  He can even keep his INR within his designated range.  She isn’t even worried that he has suffered CAPS.  What she is terrified about is the stress it will cause him, and the very real, and high risk of an Adrenal Crisis.

“You need to see an orthodontist.  They will do it under anesthetic, in hospital, where they can keep an eye on you, and monitor you properly.

Here’s where it gets a bit real.  Oral and Maxillofacial Surgeons cost money.  OK, not as much as in the US, but a lot for little old NZ.  And I sure as hell am NOT paying.

I don’t mind paying $1500 to have it done in the local surgery, under local anesthetic.  But an oral surgeon, anesthetist, a hospital bed for the day (or longer).  No way.  We would not have to pay that if he didn’t have AI, so no way am I paying.

Fighting the Dragon

Off to the Dragon’s Leir we go.  Putting on our bravest face.  Derek puts the words on paper, and I then writing them in a firm way.

Please Mr Dragon, can we have the money for the surgery.  We should be covered as it’s due to the treatment injury he needs the high-risk extraction.

I don’t know if it’s the words I use, but we were told “Please, who would you like to assess you.  We have Surgeons on our supplier list.  Use one of them”.

Well, this is going to be a battle then.  And the line has been drawn.  We have to use one of THEIR suppliers.  And anyone who has dealt with ACC know that their “authorized suppliers” are not there to spend ACC money, they are there to reduce that spend.

First blood to us.  The Oral and Maxillofacial Surgeon we wanted to specifically use, is on THEIR list.  We get our choice.  But this is just stage one.  The visit to the Orthodontist to get an assessment.

Does Derek need the extractions: Absolutely, and soon, there is already jaw damage being caused by the teeth.  It will soon become painful, and there is a high risk of infection.

Does it need to be done by a specialist:  Absolutely yes.  These could be done in a standard dental surgery, but if something goes wrong, the teeth break or they are difficult extractions, then it would have to stop, and then it would become an emergency extraction.

Does Derek need General Anesthetic.  Yes.  Due to his complicated situation, a General, even though stressful on the body would be safer in case something goes wrong with the extraction.

We wait for the report to come back from the Oral and Maxillofacial Surgeon.  It didn’t come.  Oh, yes it did, it went to SPAM.

We then draft a very short email to Derek’s Case Manager and forward the report and the quote.

We decide that we will be willing to split the cost.  We pay what it would cost in a normal dental surgery, ACC pay the rest.  Now we wait to see what they decide.

Again, we waited.  The first thing we were expecting was a letter from the Case Manager saying “thanks for your email, I will forward it for decision”.  It never came.  So, a week later we sent it again.  Having fought battles with this Dragon before (and won) we did our usual.

“HI, you haven’t responded to our previous email.  Please tell us what is happening, we are reattaching the documents in case they were stopped at your gateway.”  We sent the email again 6 working days later.  Then we sent one without the attachment.  Still absolutely no response.  So we had one more go.  But this time we sent a copy to their “Complaints” department.  We have learned through the 6 years so far of battling ACC, that we need to do this to make things happen.

We received a very quick response, but NOT from our case manager.   The response included “ Ann has left ACC, this is why you wouldn’t have received a response yet.  We have sent your email to someone else”.  That was it.  Still no idea who.

Apparently, “Ann” ran so fast out the door of the Dragon’s Leir, she didn’t have time to let anyone know she was going.  We were put on to someone else.

We waited until “someone else” then responded to us.

So off to the complaints office we trot.  This time it was a “Formal” complaint, not just a CC.

We want to know who our case manager is, why have we not had a decision on the dental work, why were we not told our case manager had left, oh, and why, after making the first “complain” was his right to have what is called “Driving for Independence” looked at, and why was our GP being asked whether Derek was now able to drive safely, and therefore cancel the driving provided.

Suddenly a swathe of emails from the Dragon’s Leir.

  • SORRY! We have given you TWO case managers so this never happens again.
  • SORRY! Please resend the information and we will get it to our assessment team urgently.
  • SORRY!  I hadn’t read the case file fully, and just saw that your driving was renewed 6 monthly, and that hadn’t happened so was reassessing your need.  I now understand that it is a permanent (lifelong) Driving service we provide.

I guess, if you have to be given a sword to slay a dragon, it’s great when you get the RIGHT sword.

I have mentioned before, and if anyone fighting ACC reads this again, I will repeat.  YOU HAVE RIGHTS!  And for Derek, the key right is that they MUST take his injury into account whenever dealing with him. They had also failed to properly communicate with us, along with other violations.

For someone with a broken leg it’s easy.  They simply say, here, have some crutches and come on in for an assessment.  With a Mental disability due to an accident, it’s not as easy, and the sword they are given is NOT a strong one.  They are disadvantaged as they must fight with all the might of someone fully functional, but who is missing two arms.  And the sword can be taken at any time, just because they can.

But for Derek, they can’t do that.  His covered condition is Adrenal Insufficiency (although the regularly get that wrong, and are currently calling it Adrenal Sufficiency).   But as it is written everywhere that it is the lack of the stress response hormone, it’s a “Gotcha”.  They are not allowed to cause him stress because it will make him sick, and that is not taking his injury into account.

And they have come to the party.  Not quite with the best offer, but it’s a start, they have agreed to pay for the hospital, and the anesthesiologist.  We haven’t finished, but we have time.

So now the preparation begins for the 24 January 2020 (baring anything going wrong in the meantime). Derek is scheduled for the first appointment of the day, in a private hospital, for his tooth extraction, and a day’s monitoring to ensure he doesn’t get sick.

 

 

Worst-Case Scenario

What if I had an accident, not bad enough to require an ambulance, but that required me to go to Hospital?

Since Derek became ill I have had a “worst-case scenario” played over and over in my head.

For two years, I have imagined what would happen if I became incapacitated. For some reason, I couldn’t drive. What sort of impact would that have on the fact that I was the only driver in the house.

I have played it over in my mind many times, thinking “what would I do”, “how would I deal with the problems”. “What if I had to get Derek or Bevan to a medical appointment, or I had to do grocery shopping”.  “What are all the problems I would have to deal with?”

Who could I call.

My worst-case scenario? To break my right leg at home.

 Actual Event

Stepping down off the back lawn onto the steps. I felt my ankle roll to the outside. My mind immediately went to the thought of, “NO, This can’t happen”. So I tried to correct. But to do that I had to put my left foot down on the step. Great, I will be fine.

Imagine my shock when I realised too late that the step I was aiming for wasn’t there. I didn’t stop with both feet on the same level.

I stopped when I was layed out flat on the ground, having landed very heavily on my left knee. It hurt, but not as much as my right foot. That was screaming.

But over riding it all was the thought, “Crap, Derek is going to get a headache, need to go to bed, and I think I should probably go to A&E”.

I lay there for a few minutes, running everything through my mind, tears running down my face. I wasn’t sure if I was crying because of the pain, or because my worst-case scenario might be coming true.

While there, I worked out that I have hurt my left knee. I knew that because I could feel the blood, and I could feel the hole in my jeans. I still hadn’t risked moving my right foot. It was still yellowing for attention, and I was refusing to give it.

The reaslisation that I was the only one with a Drivers Licence, or that could Drive dawned on everyone. Offers of “I’ll call and ambulance”, “Do you want me to call an ambulance?” and other phrases including the word ambulance were used.

No, this was not bad enough for an ambulance. I felt sure I could get to my bed, rest it, and then see what was happening.

All this time I was pumping adrenaline like crazy.

This is a good example of how fast Derek reacts to an emergency. He walked over to me at his normal speed, and just stood there asking if I was ok. Not able to actually react in a normal way. I could tell that, because all he did apart from asking me if I was ok, was to call Bevan, who was already running to my aid from inside the house.

I finally managed to sit up and reassess the situation. My foot hurt, my mind jumped to “crap, broken it”, then moved slightly more slowly to “nah, it’s just going to be a bad sprain”. Ice, rest, and then a trip to A&E to get it strapped, and find some crutches for a couple of days.

I worked out how to stand up, with assistance. I then tried weight bearing. Great, I can stand on my foot.

1 step, 2 steps, that was it. No more. I was NOT able to stand on my own two feet.

Somehow, in that short time, Bevan had come up, assessed the situation, realised I needed help, and went and found my mother-in-law’s walking stick. Well done that son. I hadn’t even noticed he had left before he was back.

Bevan and our Boarder helped me inside (with me sliding down the stairs from the top of our back yard) to my bed, I was given ice.

As I lay there I realised that, even though I knew my eldest son who lived at the other end of town needed to go to bed at a reasonable hour, and that I was about to spend 5-6 hours in A&E, I sucked in my pride, accepted it as a fait accompli, I phoned him and told him the situation. He said he would turn off his dinner (which was almost cooked) and come get me.

No, I wasn’t having that, I wasn’t going to inconvenience him that much for a sprained ankle.

I took pain killers and lay there for an hour waiting for him. At first it was fine, I didn’t mind waiting as I knew it was just a sprain. I had time to go through each plan of how to get to work the next day as spraining my ankle wold mean not being able to drive for 24-48 hours.   I would need crutches but that was it.

By the time my eldest arrived to take me to hospital I was desperate. I couldn’t walk, I was in a lot of pain, even with pain meds,  and shock was setting in.

Derek on the other hand, was laying there, he looked worse than flat but not as bad as he has been some times. He took panadol, and just deal with the headache as best he could.

I worked my way to the car and got in the passenger seat. My instructions to my son was, on arrival at hospital, get me a wheelchair. I was NOT going to try and walk.

We checked in, we could see it would be a 4 hour wait at least. What was a girl to do. Post on facebook of course, where my daughter read about it.

At some point my daughter and her boyfriend (a paramedic in training) turned up. This was a great opportunity to send Derek home. He had taken extra meds, but still looked worse than me.

Finally I am taken out the back and seen, very quickly, by a Dr. Quick exam, “yes, think we might get an x-ray”.

1 found of x-rays and a 5 minute wait later and I get the good news. “Yes, you have sprained the outside of your right foot. But I need another x-ray of it. A slightly different one. That spot you say is the extremely painful, is where you broke it! But there may be another break as well”

Boom!

There it was!

Worst-case scenario now a Reality!

I am cast. Both figuratively and literally.

Oh, and I have to get Bevan to a Medical Appointment tomorrow a long way from home!

Boom! There it is again.

For the next two weeks I will probably be in a plaster case, at which time I have to see an Orthopaedics Specialist to see what they want to do. Even if taken out of the cast and put in a moon boot, I will not be able to drive for another couple of weeks.

Up to 4 weeks of not having a driver in the house.

Yup. My worst scenario is now playing out in real life.

A Small Win Update

I am updating a post I made recently about a small win against ACC over the 4 weeks that Derek’s case manager was saying they did not need to pay his wages because he was incapacitated by surgery.

We received a phone call to say the stand-down had been cancelled, and that he would be paid. We now have documents from ACC which state clearly WHY it was changed.

It is a matter of Law. Do Not let them refuse the cover just because.  The following is from the Policy Department regarding incapacity from injury.

ACC cannot set a stand-down period greater than 1 week from Date of First Incapacity (see Section 97) and ACC cannot set a stand-down period at any time on the basis that we have in this case.  I.e., ACC cannot say “but for the injury you would have been off work because of your surgery for 1 month, so we won’t pay you for that month”.

The whole picture changes once an injury that is covered by ACC causes or contributes to the incapacity.  As soon as a covered injury becomes a substantial contributor to the incapacity, then weekly compensation is payable (provided that the other statutory criteria for eligibility are satisfied), regardless of the presence of the non-covered condition and that conditions contribution to incapacity (unless that condition is the whole cause of the incapacity).

Basically, if you suffer an injury of any type that incapacitates you, even if you are on sick leave at the time, ACC MUST pay you.

If anyone reading this is in this situation, feel free to copy the quoted part of this post to use.

When we were in a face to face meeting with the case manager, we again questioned her decision.  She agreed to go and ask another case manager.  She came back and said she had received conflicting advice (she didn’t say she was told she was wrong) and would have to ask her Technical Claims Manager for further advice.

She then wrote notes of our meeting in which she states:

I met with client F2F.  He was not happy that ACC are trying to find out how long he would have taken to recover from his surgery and take this into consideration in the stand-down period.  This was approved by BMA and TM.  However I have spoken to another CM and appears I received incorrect adivse, referring this to TCM.

Even when told she was wrong, she continued on the path.  Question, and re-question every decision your Case Manager makes.   If it is not in your favour, it may be wrong.

The Case Manager told us that the Technical Claims Manager (TCM) agreed with her even after being told they were wrong.  The TCM was ALSO wrong, but refused to admit it.  His attitude was, I have made a decision, if you don’t agree with it, seek a review and bugger you.  We will be putting a formal complaint in about his attitude.

The parts in italics are direct quotes from the paper work received from ACC.  It is a matter of record that she was told she was wrong but refused to change her mind.

A Small Win

In February this year Derek and I decided that he would apply for a Treatment Injury claim against Accident Compensation Corporation (ACC) for the DIC/CAPS which caused the Adrenal Insufficiency.

Definition of Treatment injury

(1) Treatment injury means personal injury that is—
      (a) suffered by a person—
           (i) seeking treatment from 1 or more registered health professionals; or
           (ii) receiving treatment from, or at the direction of, 1 or more registered health 
                professionals; or
           (iii) referred to in subsection (7); and
      (b) caused by treatment; and
      (c) not a necessary part, or ordinary consequence, of the treatment, taking
            into account all the circumstances of the treatment, including—
           (i) the person's underlying health condition at the time of the treatment; and
           (ii) the clinical knowledge at the time of the treatment.

We were very surprised but very pleased when they accepted, without argument, that he had suffered a treatment injury, and they would cover the costs of his time off work, any treatments for his now permanent condition of adrenal insufficiency, an anything else related to his multiple organ failure.

He had taken sick leave from 28 Sept (the day before surgery, but day of admission to hospital), with the intention of returning to work from home, on 8 October.

On 2 October Derek visited the Dr for the first time due to being unwell after surgery (a very important date).

After the Treatment Injury was accepted, we were told that Derek could get reimbursement for the time he had to take of work between October and January.  This meant that all the leave Derek had had to take so he could lay in a hospital bed dying, or sit at home recovering, would be given back to him by his  boss as ACC would reimburse Derek, and Derek could reimburse work.

The process is that ACC agree the dates to be paid, they calculate how much to pay, based on information from your employer, then they pay you, and you pay your employer back in some way (it is up to  you and your employer how this is done).

The reinstatement of your wages should not disadvantage you or your employer, but ACC are not interested in the details.

Sooooooooooooo………

After much toing and frowing, ACC decided that Derek should have been off work for 4 weeks after surgery, and therefore he was incapacitated from surgery, and so ACC would not reimburse him for those 4 weeks, but would reimburse his wages after that period.  This was regardless of the fact we had given very clear evidence that Derek’s intention was to work.

When you receive reimbursement of wages from ACC, you do not get the first week you are off work, but you get every week after that.

According to our calculation ACC should pay reimbursement from 2 October (legal date set for treatment injury as it was the first date we sought treatment), with a 1 week non payment period, that made first day of payment 10 October.

ACC’s idea was Surgery on 29 Sept, plus a 4 week recovery from that surgery made the date of incapacity from treatment injury the 26 October.  Therefore, no payment until 26 October.  They did allow the 1 week non reimbursement to be during the period from 2 – 10 October.

We argued this point several times, but in the end our Case Manager, and Her manager, made a decision.  We were told very clearly that Derek would have his wages reimbursed from 26 Oct.  IF we didn’t agree with the decision, we could apply for a review.  If the person conducting the review agreed with the initial decision, and we were still unhappy, we could go to court.   We asked for them to produce the case law that supported their decision.  Derek’s Case Manager’s Manager actually told Derek on the phone that his would be a good “Test Case” for reimbursement.

Basically we were told they didn’t have to prove they were right, we had to prove they were wrong.

We deiced that this is what we would do, once we received their letter detailing why they had set the date as 26 October.

We then waited for the payment.  Day after day, we checked our bank account to see if the money had come in.  Derek’s boss was waiting for his reimbursement.  We planned to take a break, believing that Derek would have leave reinstated once the reimbursement was sorted out.

3 weeks later and still no payment.  Derek made phone calls to find out what was happening.

Finally he received a phone call from his case manager.  She was trying to sound like she was happy to be giving him the good news.  His reimbursement had been calculated and approved.  And the really good news…………….

Somebody, somewhere (not in the local office) had basically told Derek’s case manager and her manager, to pull their head’s in.  They were both wrong, and Derek’s reimbursement would be from 10 October (the date WE believed was correct).  His case manager had been over ruled in a major way.

She didn’t sound happy to have been told she was wrong but tried to make it sound as if she was pleased for us.  She may have been.  Ultimately we don’t care.  Somebody at ACC had seen sense, and we had won our argument, without having to fight.

It is a small win, but a matter of principle.  So, if you are on sick/annual leave, or working from home (whether a normal situation, or a special setup) you are entitled to weekly compensation for time off work.

If any one reading this is fighting over their Incapacity date because they were injured on sick/annual leave, make sure you fight for your rights.  ACC seem to work on the idea that, if they fight long enough, you will be too tired to argue, and you will accept what ever they say.

You don’t have to accept it.  You just have to have someone in your corner that can take up the fight when you are too tired.

Accident Compensation Corporation say they are there for you, and most of the people we have dealt with at ACC have been wonderful.  But the Lower Hutt’s Long Term Claims branch appears to be there to drag the chain, and sometimes appear less professional, seeming to spend their time working on reducing your entitlement with little regard for the ACC act. When asked what section of the Act they were using and how it was being applied we were simply told “it was their decision, end of story.

This aspect is the worst from that division.  We have a very long list of problems caused by that department, from reading information from other people’s files to you, to stating dates, and then getting those dates wrong, to making decisions that go completely against their own policy.

For someone who does not have Stress Hormones ACC are making Derek sicker and costing ACC more money as he ends up off work due to his Adrenal Insufficiency and they are legally obliged to pay his sick pay.

A Long Slow Recovery

ON 30th May  the “Experiment in Independence” ended.  At least that’s what we thought.  This weekend is the first weekend since then that Derek has actually felt like he can “do things”.

Wednesday Derek had a meeting with ACC to discuss where they are at to date regarding the reimbursements, wage compensation etc for while he was off work for 15 weeks last year.  I picked him up from work, and drove him to the meeting.  He had just taken his 12 o’clock dose of HC and then met his CM.  By 1. 40 he was starting to rapidly go down hill.  He had to take extra HC.  We put it down to the stress of the meeting.

Thursday he woke feeling OK.  Not as tired has he was the previous week.  The stress of the meeting the previous day had not had a major effect on him because he took the extra HC.  This is how things SHOULD be.

Thursday we went out for 2 hours (in horrible weather) to watch our teenagers perform at a Music Presentation at school.  Friday night Derek stayed up until 9.00 pm (normally bed for him is 7.30).

Saturday Morning he sat in the car while our Learner Driver daughter drove to her job, and he drove back home which is  3KM of driving.  Not far, but the furthest he has driven in over a month.  We went to the Hardware Store (me driving), took my son to band practice (me driving).  He actually felt like coming rather than resting.

Saturday morning, where Derek would normally be tired, and want to rest, he felt like he could go out with me.  I noticed that when 12 o’clock came round, he was surprised when his alarm went off to get his HC.  In the last 4 weeks he was hanging out for 12 o’clock to come.  4pm, again he was happy to wait.

It wasn’t a lot, but it was a great improvement.

The biggest difference this week is that he has been getting a Taxi to work and home again all week.  ACC came to the party, and it has definitely made a difference.

It was suggested at one point by someone, that “If you are too sick to get to work, perhaps you shouldn’t work.”  This is not an option as it is the mental stimulation of working that keeps him alive.  IF he didn’t have that, then I am sure he would not get well.

We have the Taxi for 3 week, then it will be re-assessed and they will see what they can do.  It’s a start.  It has given him a chance to recover from everything.

The weather was terrible this week (a major storm by Friday) but he survived it well and has now reduced his meds back to 10/10/5.  Once he has leveled out some more, he may try going back to the 10/7.5/5 that is recommended.

Sunday morning came and he didn’t feel the need to roll over as soon as he woke to take his HC so he left it for 10 minutes.  He then got a surprise when 12 came again.  He didn’t immediately stop to take his HC, but finished what he was doing.  15 minutes later he was stopped.  Again, he didn’t feel like he was running low.

Fingers crossed he will stay at this level for a while.  We can only put the recovery down to having a lift to and from work in the cold and wet.  It means I have the chance to relax a bit as well.

Getting a basic level of Fitness back is the next challenge.

ACC and the Paper War

In New Zealand we have a Government Department called Accident Compensation Corporation (ACC).  It is based on a “No Fault” insurance system and we pay insurance premiums in our wages, petrol tax, and other revenue system, to be covered by this Government Insurance System.

ACC then kicks in when you have an injury.  They pay your treatment costs, and assist you in your recovery in what ever way they need to.  Their goal, is a quick, successful return to work.

Just before Easter, trying to do some outside chores that Derek would normally do, I strained my back.  It was bad enough to put me off work for 4 weeks.  The first week at my expense, but then ACC paid 80% of my wages for the other weeks I was off, including when I returned to work, but could only work short hours.

When the Dr considered me fit to return to work, I was still unable to drive myself, and taking a train was not practical, so, with 1 swift call, I had someone come to assess me, and agreed that a Train to a particular station, then a Taxi from there, was the best option.

Almost instantly, it was agreed and organised.

We have been asking for the same help with getting Derek to work.  It is Autumn in New Zealand and getting very cold, wet, windy and generally miserable.  We have purchased extra winter clothing (from places like Canada, who know about cold) to help him with the cold weather.

You can see by reading the “An Experiment in Independance” how well that worked (or not).

It is now two weeks on from that experiment.  Derek got a cold, which required extra dosing, he took and extra 20mg for 3 days to try and recover from it.  He went to work last week for 3 days (he had taken leave over a long weekend).

Friday afternoon he got a call from his ACC Case Manager.  Derek had e-mailed her to find out what was happening with the help he required to get to work.

She kept making excuses for why things hadn’t happened.  He finally asked to speak to her supervisor.  They then had a heated discussion.

As other Addisonians’ will tell you, Stress, when you don’t produce your own stress hormone, is not something you want to actively partake of.

Derek became stressed.  So much so that he decided it wasn’t safe to bring himself home by train.  Thankfully, before he could call me to go and get him, his boss offered him a lift home.

He rested this weekend (he wasn’t capable of doing anything).  Today he could not get out of  bed.  His blood pressure is all over the place because he is fatigued.  One minute his blood pressure is so high he gets a head ache standing up, then it drops to a point where he gets very dizzy.

He has taken extra medication again today to try and get over this.

We have now been to the Dr who has put him off work for a week, to try and recover from everything.

Now, we have done the Math on this.

Taxi to work (he will take a train home) – $250/week
Sick leave for a week (covered by ACC) – $1500/week

They say they want to save money.  You choose which option you think they should go with.  We told them last week that he was becoming sick, and would probably need to go on sick leave until they were able to sort something out.

Still he has to wait for a response.