Please no medical advice, I've got that covered. I'm having a medical issue that is causing extreme fatigue, and have been nodding off at my desk here or there despite my very best efforts not to (as much caffeine as I can drink for example). This week was especially bad. I'm frantically trying to fix this medically but am terrified of getting caught at work. Problem is, I have a deep distrust of HR (sorry all of the HR folks there). Do I tell them now while I'm trying to fix this, or will it just be used against me? Also, how do I approach this without seeming like a Special Snowflake? Tell them I'm aware of it, it is totally beyond my control, and that I'm working on getting this fixed medically? Or do I wait until I have a doctor's note?