Q: How does one stay in touch with one's profession during a period of disability? Severe repetitive stress injury problems will keep me entirely off computers for a while. My area is journalism and public relations, and to complicate things, I have recently moved cross-country.

E-mail was previously very important for this purpose, and even voice dictation software has not proven sophisticated enough for my deadline-driven job.

Thanks for any advice. This is a very difficult situation as I loved my work but don't know if I'll ever do it again safely.

A: Don't despair, said physician Margit L. Bleecker, director of the Baltimore-based Center for Occupational and Environmental Neurology, one of the nation's leading experts on repetitive stress injuries. Bleecker, who has treated many journalists and public relations practitioners, said that even people with severe RSI can recover if they receive competent medical treatment, get adequate rest, do stretching exercises and learn how to work differently. "The body heals itself," she said.

RSI is one of many muscle ailments known as cumulative trauma disorders, which include carpal tunnel syndrome and tendinitis, caused by overexertion, repetitive motion or incorrect posture and bad work habits. They typically start with achiness, numbness or tingling in the fingers, hands and arms, but can lead to pain so crippling that people can no longer work or become unable to cook, garden, pick up a baby or carry their groceries. According to the Occupational Safety and Health Administration, more than 647,000 U.S. workers experienced such injuries in 1996, costing employers an estimated $15 billion to $20 billion in workers' compensation costs. Many companies have developed ergonomics programs to help workers by adapting the pace of work or adjusting equipment to minimize problems.

There has been ongoing debate for more than a decade about whether the government should do anything about RSI. OSHA, labor unions and some congressional Democrats want to require employers to set up a reporting system for workers who believe they have been injured, develop ergonomics programs and offer paid time off to RSI sufferers. Congressional Republicans and business groups have argued that too little is known about these ailments and what causes them for the government to impose any regulations in this area.

The bottom line is that individual workers need to evaluate their own workstations and work habits for signs of trouble and seek equipment that will allow them to do their jobs safely. For more information about safe workplace programs, check out the National Institute for Occupational Safety and Health's Web site (www.cdc.gov/niosh) or call 1-800-356-4674. OSHA also offers information on its Web site (www.osha.gov) under "Ergonomics" in the topic index.

Bleecker advised the letter-writer to look for non-deadline writing projects that she can work on when she doesn't hurt and to stop writing immediately when she feels the first twinges of discomfort. She could also look for a part-time or highly flexible position, possibly with clerical help to assist with typing, Bleecker said.

But don't try to do too much too soon, she cautioned. She said many RSI sufferers who have taken leaves of absence to recover end up injuring themselves anew later. "The problem is that as soon as they are symptom-free, they jump back in full force," Bleecker said.

She disagreed with the letter-writer's verdict on voice-recognition software, which Bleecker said is rapidly evolving and improving.

FEEDBACK: We received many heated letters in response to the query from the employed single mother (June 30) longing for a vacation because she had used up all her alloted leave due to her children's illnesses. Most were from women -- long on recriminations and short on solutions.

A woman who described herself as "child-free" said she was tired of the parents of young children leaving the job when their children were ill, and felt unfairly loaded with their work. "All this is being forced on the business community under the guise of being `family-friendly,' " she wrote. (However, generally companies adopt policies that they believe make good business sense, and many are working hard to attract and retain good workers, many of whom have children.)

Another writer, referring to the woman as "SM," for Single Mother, noted that the woman had borrowed against future leave to take time off, and suggested that she shouldn't be allowed to leave her job until she pays her employer back.

Another, from the employed mother of an 18-month-old child, viewed it as poor decision-making to stay home with a sick child, proposing instead the mother should drop him or her off with a relative (assuming she has any). "Life is hard and it is about choices," she wrote.

Almost no one mentioned the father or what his role should be.

Here's the dilemma. We're in the midst of a profound social and economic change, as more and more mothers enter the work force at a time when companies are clamoring for employees. We've put almost every able-bodied adult we can into the work force. Our record labor-force participation rate means that many of the aunts and grandmothers who were once at home are now working as well. Two-thirds of children under the age of 6 have a working mother. About 20 percent of the children in the country live with a single parent. Women on welfare are being forced to work to support their families.

But parents of small children get sick and their children get sick, and most day care centers refuse to care for sick children. I've been there -- I'm a working mother myself.

So let's look at solutions. Blaming mothers for having sick children or denying the problem exists doesn't solve it.


Got a tough workplace question? Trying to deal with difficult co-workers or handle a thorny management question? Is the work-family balance giving you vertigo? Want to be more effective on the job?

We'll take your questions, comments and concerns to workplace and management experts. We can't answer the letters personally, but we'll include many of your stories in upcoming columns and articles.

Write to workplace reporter Kirstin Downey Grimsley at The Washington Post, 1150 15th St. NW, Washington, D.C. 20071. Or send e-mail to downeyk@washpost.com. Please include your name, address and telephone numbers -- although we won't publish your name without your permission.