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Being self-employed is itself a feat, as any of the more than 14 million Americans who are their own bosses can attest. Add to the mix a diagnosis of cancer, and the days can seem suddenly overwhelming. If you've just gotten a diagnosis of cancer, and you're self-employed, here is a game plan for getting through—developing the right frame of mind, making the most of your insurance, holding on to your clients, handling your workload and maintaining most of your cash flow.

Look at the pros and the cons

Employed people have the benefit of the Family Medical Leave Act and the Americans with Disabilities Act. When you are self-employed, however, those don't apply. But you probably do have the benefit of having more control over your working hours and environment. No one knows if you've typed that report or illustrated that catalog at 7 a.m. or midnight, or whether you inputted it on a laptop in the doctor's office or the desktop computer in your office. If you're feeling puny and operate from your own home-based office, you can work in slippers and bathrobe and skip the eyeliner if that's comforting.

Step back and take stock

After the shock of the diagnosis has subsided, focus on making a plan. Just as you had a business plan or a launch plan when you went into business, you now need a game plan to get you through your cancer treatment and keep your business afloat. One of the first things to do is to confer with your health care team. Ask them what you can expect in terms of side effects and fatigue from your treatment. Ask them to be specific about if and when you should expect any periods of disruption to your work schedule due to treatment or side effects and how long and how severe they might be. Go through your list of projects, meetings and other obligations and note the timelines. Decide if you can handle everything or nearly everything and what you'll need help with. Then decide what kind of help you need. If you're a sole proprietor, you might tap a trusted colleague or two to help you. If you have a partner, confer and decide if she or he can take up the slack. Consider outside help such as workers from a temp agency.

Look over your health package

Some plans' coverage isn't as generous for the self-employed as those in a group plans. In a managed care plan, co-payments may be higher, for instance, for the individual plans than for the group plans. Figure out, if you can, your out-of-pocket expenses and whether you can comfortably cover them. Explore what other options might be available. A number of organizations, such as www.cancercare.org, can come to your rescue, offering financial aid to help with out of pocket expenses or transportation.

Think before you tell

Disclosure of your diagnosis to clients or customers is a very personal issue. In the workplace, disclosure is necessary to obtain protection under FMLA and ADA, but in the self-employed arena, you can decide whether to tell, whom to tell and how much to tell. First, consider why you might need to tell. If your treatment is going well and no one notices your absence, why tell? Decide what your purpose is in telling them. And consider what their reaction might be. If you have clients who have been nervous in the past about meeting deadlines or organizing events, you might think carefully how much if anything you want to tell them. If any of your clients or their other vendors have had experience dealing with cancer or other serious ailments, think about how the patient was viewed and treated. This will give you a clue as to the "culture" you are dealing with and what reactions you might expect. If you do tell clients, resist the urge to make them a confidante or a shoulder to cry on. Even if you socialize or are super-friendly with them typically, it's important now to keep communications and interactions as business-like as possible. That will help them maintain faith in your ability to get the job done. Don't talk about the unknown parts of your treatment equation. Rather, focus on what you do know the chemo will last six weeks, so you won't be available on Fridays, for instance. You may lose your hair, and you may not want to give a presentation in person or you might need a little more time.

Reactions run the gamut

Reactions from clients will range from super-compassionate, probably, to very business-like even cold. Realize that even as your clients try to understand your health problems, and sympathize, they must also focus on keeping their own business afloat especially if they have many employees, a health plan to administer, and other expenses.

Keeping everything afloat

When you launched the business or service, you needed to focus on projecting a sense of competence to win over new customers. Recapture that attitude and demeanor. You again need to project that sense that you can get the job done this time around maybe with some competent help, but you can get it done. If you have called in help, introduce your customers to the associate or associates and stress the person's skills and collegiality. But it's crucial that you keep control over the projects. Besides giving you an empowered feeling, it's just smart business. Why risk losing a client to your filling-in associate? It is better to contract with the associate than to let him or her contract directly with your client. You want to give the impression that you're in charge, because you are. It's wise to draw up a letter or document between you and your colleagues, so there is a clear understanding of what's what and that the arrangement is temporary. You might want to stipulate that the contract is between you and the client, and to note the duration of the contract, to discourage your associate from marketing himself or herself. The document should summarize such basics as what the two of you have agreed upon, including work to be done, deadlines, payment, payment dates, and other details. Take advantage of any professional advice your specific organizations or clubs may offer. If a colleague has gone through cancer treatment, ask if you can take him or her to lunch and discuss practical strategies. Or you can take advantage of such programs as one on shop talk, offered by The National Association for the Self-Employed to members and nonmembers alike, at 800-232-6273. This is probably not the time to take on new clients or offer new services. Be realistic about what you can and can't do. Or, if a new client comes your way, you might ask an associate to take them on temporarily, with an understanding that you will be able to bid on the project next time around.

Lean on technology and services

These days, people work anywhere and everywhere, no longer bound to the office or the desk thanks to technology. While you may be trying to limit expenditures, some investments in technology now might pay off grandly. Now's the time to decide if upgrading your laptop will make it easier and lighter to tote along to meetings and doctor's appointments. Consider other high-tech ways to improve or maintain access to your voice mail and email, such as a handheld PDA or a phone that allows you to get text messages and other communications. It's all about figuring out ways to conserve your energy for the real brain work. For instance, if you usually deliver projects yourself, inquire about a messenger service doing it for you or perhaps ask a family member or a neighborhood student who wants to make a little money. For personal purchases, consider shopping online more, to cut down on time spent running errands. You might even get groceries delivered after ordering them online or by telephone. Those with cancer who are used to being hard-charging have a tendency to work too much and rest too little. Try to take the long view—rest as much as you can, oversee others on the project, and focus on the fact you'll be up to speed sooner if you take care of yourself now. Rest is part of your treatment plan.

Managing the cash flow

You shouldn't expect to make full income, although you might surprise yourself and do so. Now is the time to check in on your disability plan, if you have one, to see if that might help bridge the income gap. If necessary, go to your creditors and try to arrange longer terms for payment. If refinancing your house or business property is a possibility, try that. You don't need to tell them the reason. Schedule a meeting with your accountant, who may have other ideas about maximizing and preserving cash flow.

Attitude is everything

f you maintain a can-do attitude, others are likely to relax and not worry about the effect of your illness on projects. Communicate your competence by such statements as: I may not be available all the time, but the project will be under control.

Sources: Our panel of experts: Carolyn Messner, director of education and training for http://www.cancercare.org/, Gene Fairbrother, lead small business consultant for the National Association for the Self-Employed (http://nase.org/) and Paul and Sarah Edwards of http://workingfromhome.com/, the authors of several books for self-employed businesspeople.