Hi Peachy,
I commuted everyday to Chicago on the train. I took a medical leave when my breathing got so bad and I couldn't walk fast enough(when I got off the train, because I couldn't catch my breath) without getting trampled on by other commuters. I also had to walk a lot at work and there too I would find myself stopping to catch my breathe a lot.
I didn't even know what was wrong with me at the time. They had been treating me for asthma and they thought I had walking pneumonia(neither of which was true) prior to that day. October 27, 2000 was my last day of work and my surgery wasn't until March 8,2001. I went to my doctor the following Monday and told him to put me on a medical leave and find out what the heck was wrong with me. So I went through about three doctors until I went to the cardiologist who said I needed a valve job. Of course i had no idea what he was talking about at the time. I quickly learned.
I would say that too is something everyone does on an individual basis. It depends on how you feel being at work all day, the kind of benefits you have at work, if your surgery is that far off can you survive monetarily. I weighed all those things and decided my health was more important. It also helped that my boss is my neighbor and best friend (we also commuted together) and she saw me slowly declining that fall.