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About Myasthenia Gravis
The name “Myasthenia Gravis” comes from the Greek and Latin words meaning “grave muscular weakness.” The most common form of myasthenia gravis is a chronic autoimmune neuromuscular disorder that is characterized by fluctuating weakness of the voluntary muscle groups, which worsens with use of the affected muscle. Different muscle groups are affected in different individuals. Certain muscles are more frequently involved, including the ones that control eye movements, eyelids, chewing, swallowing, coughing, and facial expression. Muscles that control breathing and movements of the arms and legs may also be affected. Weakness of the muscles needed for breathing may cause shortness of breath, difficulty taking a deep breath, and coughing. The "gravis" or seriousness of myasthenia is noticeable when breathing muscles are affected.
Myasthenia Gravis and the Americans with Disabilities Act
The ADA does not contain a definitive list of medical conditions that constitute disabilities. Instead, the ADA defines a person with a disability as someone who (1) has a physical or mental impairment that substantially limits one or more "major life activities," (2) has a record of such an impairment, or (3) is regarded as having such an impairment. For more information about how to determine whether a person has a disability under the ADA, see How to Determine Whether a Person Has a Disability under the Americans with Disabilities Act Amendments Act (ADAAA).
Accommodating Employees with Myasthenia Gravis
People with myasthenia gravis may develop some of the limitations discussed below, but seldom develop all of them. Also, the degree of limitation will vary among individuals. Be aware that not all people with myasthenia gravis will need accommodations to perform their jobs and many others may only need a few accommodations. The following is only a sample of the possibilities available. Numerous other accommodation solutions may exist.
Questions to Consider:
- What limitations is the employee experiencing?
- How do these limitations affect the employee and the employee’s job performance?
- What specific job tasks are problematic as a result of these limitations?
- What accommodations are available to reduce or eliminate these problems? Are all possible resources being used to determine possible accommodations?
- Once accommodations are in place, would it be useful to meet with the employee to evaluate the effectiveness of the accommodations and to determine whether additional accommodations are needed?
- Do supervisory personnel and employees need training?
- Ability to dictate notes using a voice recorder and have another staff member input the notes (if inputting the information is a marginal function of your job)
- Grip Aids, to help with holding a stylus
- Reallocating documentation duties, if marginal
- Handwriting Recognition Software
- Using Proper Lifting Techniques
- Reallocating lifting duties, if marginal
- Providing assistance moving objects, to reduce weight
- Organizing items in a way that reduces the need to move or lift items
- Reducing weight to be lifted by separating items into smaller groups
- Reassigning an employee to a modified duty position or modifying duties by removing the lifting duties
- Periodic rest breaks to get-up and move around
- Modified break schedule so that you can stretch your legs when needed
- Using break reminder software to remember to get up and move around
- Alternating between sitting and standing while working by using a sit/stand workstation
- Ergonomic/adjustable office chair
- Work at home, where employee can lie down, sit, stand, move freely
Situations and Solutions:
The following situations and solutions are real-life examples of accommodations that were made by JAN customers. Because accommodations are made on a case-by-case basis, these examples may not be effective for every workplace but give you an idea about the types of accommodations that are possible.
An administrator was having problems handling stress and had some double vision from myasthenia gravis.
He was allowed to take rest breaks, assigned a support person in the workplace, and provided a reader as an accommodation.
A clerical worker with myasthenia gravis was missing a lot of work because of problems breathing, speaking, and walking.
She was allowed to work at home part-time and to communicate via e-mail as an accommodation.
A delivery person was having difficulty loading and unloading his truck due to lower extremity weakness from myasthenia gravis.
He was accommodated with a transfer to a less physically demanding delivery route.
A teacher with myasthenia gravis was having difficulty meeting the physical demands of her job due to muscle fatigue.
She was accommodated with a full-time teaching aid, frequently used supplies/equipment were moved closer to her desk, and she was allowed several short rest breaks during the day.
A hospital employee with myasthenia gravis was having difficulty walking.
She was accommodated with a parking space closer to her work-site and was provided a scooter to use at work.
JAN Publications & Articles Regarding Myasthenia Gravis
Consultants' Corner Articles
- A Support Person as an Accommodation
- Accommodations for Housekeeping/Janitorial Workers with Motor Impairments
- Accommodations Related to Commuting To and From Work
- Best Practices for Addressing Requests for Ergonomic Chairs
- Confidentiality of Medical Information under the ADA
- Hidden Disabilities: Confidentiality and Travel
Myasthenia gravis ni ugonjwa wa misuli ya mwili unaoitwa myasthenia gravis, ambao unatokana na nguvu za misuli ya mwili, na unaonekana kuwa na athari mbaya kwa misuli ya misuli. Vikundi tofauti-tofauti vya misuli huathiriwa na watu tofauti-tofauti. Misuli fulani huhusika mara nyingi zaidi, kutia ndani ile inayodhibiti harakati za macho, paji la macho, kutafuna, kumeza, kukohoa, na kujieleza kwa uso. Misuli inayodhibiti kupumua na mwendo wa mikono na miguu yaweza pia kuathiriwa. Udhaifu wa misuli inayohitajiwa kwa kupumua waweza kusababisha kukosa pumzi, ugumu wa kupumua kwa kina, na kikohozi. "Gravis" au uzito wa myasthenia huonekana wakati misuli ya kupumua inapoharibiwa. Myasthenia Gravis na Wamarekani na Walemavu Sheria (ADA) ni sheria ya Marekani ambayo inatoa sheria ya msingi ya matibabu ya walemavu. "Kama ilivyoelezwa katika Sheria ya Ulemavu, ""mtu mwenye ulemavu"" ni mtu ambaye (1) ana ulemavu wa kimwili au kiakili ambao hupunguza sana moja au zaidi ya ""shughuli kuu za maisha,"" (2) ana rekodi ya ulemavu kama huo, au (3) huonwa kuwa na ulemavu kama huo." Kwa maelezo zaidi juu ya jinsi ya kuamua kama mtu ana ulemavu chini ya ADA, angalia Jinsi ya kuamua kama mtu ana ulemavu chini ya Sheria ya Marekebisho ya Wamarekani na Walemavu (ADAA). Msaada wa Myasthenia Gravis: Watu walio na Myasthenia Gravis wanaweza kuendeleza baadhi ya mapungufu yaliyojadiliwa hapa chini, lakini mara chache huendeleza yote. Pia, kiwango cha upungufu kitatofautiana kati ya watu mmoja-mmoja. Kumbuka kuwa sio watu wote walio na myasthenia gravis watahitaji malazi ili kufanya kazi zao na wengine wengi wanaweza tu kuhitaji malazi machache. Yafuatayo ni sampuli tu ya uwezekano unaopatikana. Kunaweza kuwa na suluhisho nyingine nyingi za makazi. Maswali ya Kuzingatia: - Mfanyakazi huyo anakabili vizuizi gani? - Jinsi gani mapungufu haya kuathiri mfanyakazi na mfanyakazi'utendaji wa kazi? - Ni kazi gani maalum za kazi ni tatizo kama matokeo ya mapungufu haya? - Ni marekebisho gani yanayopatikana ili kupunguza au kuondoa matatizo hayo? Je, rasilimali zote zinazowezekana zinatumiwa kuamua marekebisho yanayowezekana? - Mara baada ya malezi kuwa mahali, ingekuwa na manufaa ya kukutana na mfanyakazi kutathmini ufanisi wa malezi na kuamua kama malezi ya ziada zinahitajika? - Je, wafanyakazi wa usimamizi na wafanyakazi wanahitaji mafunzo? - Uwezo wa kuagiza maelezo kwa kutumia rekodi ya sauti na kuwa na mfanyakazi mwingine kuingia maelezo (kama kuingiza habari ni kazi ya marginal ya kazi yako) - Grip Aids, kusaidia na kushikilia stylus - Reallocating wajibu wa nyaraka, kama marginal - Handwriting Recognition Software - Kutumia sahihi ya kuondoa mbinu - Reallocating kazi ya kuinua - Kutoa msaada kusonga vitu, kupunguza uzito - Kuandaa vitu kwa njia ambayo hupunguza haja ya kuhamisha au kuinua vitu - Kupunguza uzito wa kuinua kwa kugawa vitu katika makundi madogo - Reassigning mfanyakazi kwa nafasi ya kazi iliyobadilishwa au kubadilisha majukumu kwa kutumia programu ya ergonomic, kusimama au kupumzika - Kwa sababu malazi hufanywa kwa msingi wa kesi kwa kesi, mifano hii inaweza kuwa haiwezekani kwa kila mahali pa kazi lakini kukupa wazo kuhusu aina ya malazi inayowezekana. Msimamizi mmoja alikuwa na matatizo ya kushughulikia mkazo na alikuwa na maono mawili kutokana na myasthenia gravis. Aliruhusiwa kupumzika, akapewa mtu wa kumsaidia kazini, na kumpa msomaji kama mahali pa kuishi. Mfanyakazi mmoja wa ofisi aliyekuwa na ugonjwa wa myasthenia gravis alikuwa akikosa kazi nyingi kwa sababu ya matatizo ya kupumua, kusema, na kutembea. Aliruhusiwa kufanya kazi nyumbani kwa muda mfupi na kuwasiliana kupitia barua pepe kama malazi. Mtoaji alikuwa na ugumu wa kupakia na kupakua lori lake kwa sababu ya udhaifu wa viungo vya chini kutokana na myasthenia gravis. Alipewa nafasi ya kuhamishwa kwenye njia nyingine isiyo na matatizo mengi ya kimwili. Mwalimu mmoja mwenye ugonjwa wa myasthenia gravis alikuwa na ugumu wa kukidhi mahitaji ya kimwili ya kazi yake kwa sababu ya uchovu wa misuli. Alipewa msaada wa muda wote wa kufundisha, vifaa vilivyotumiwa mara nyingi vilihamishwa karibu na dawati lake, na aliruhusiwa mapumziko mafupi kadhaa wakati wa mchana. Mfanyakazi wa hospitali aliyekuwa na ugonjwa wa myasthenia gravis alikuwa na ugumu wa kutembea. Alipewa nafasi ya kuegesha magari karibu na mahali pake pa kazi na alipewa pikipiki ya kutumia kazini. JAN Publications & Articles Regarding Myasthenia Gravis Consultants' Corner Articles - Msaidizi kama Makazi - Makazi kwa ajili ya Housekeeping na Usalama Wafanyakazi na Motor Vikwazo - Makazi kuhusiana na kusafiri kwenda na kutoka kazi - Best Practices kwa ajili ya kushughulikia Maombi kwa ajili ya Ergonomic viti - Usiri wa Habari ya Matibabu chini ya ADA - Hidden Ulemavu: Usiri na Safari