I have a few diagnoses that require me to have regular appointments, ~ 5-6 appointments reoccurring every three months. Both clinics I go to (I'm bound by public transit and there are no other clinic available in my area) are not open on the weekends, and their clinic hours are the same as my work. So my only option is to put in a workplace accommodation to have the needed days off to take these appointments. Great, that's done and approved.
That's multiple days' worth of PTO that I have to use now to not be financially fucked every 3 months. (It burns through more PTO because of my messed up small town local bus system).
So, no vacations for me cause I gotta burn it covering my medical issues. I fucking hate the US.