I don’t even use a PTO day if I’m just feeling “blah” as long as I’m available via Slack to answer questions and can attend ad-hoc meetings. There are so many times I’ve had to/chosen to work late, I don’t say anything.

I don’t think I’ve taken a “sick day” once since going remote over 5 years ago. But for the last 10 years I’ve been leading initiatives first at startups and then at consulting companies and I mostly have autonomy and the trust to get things done.