Back to Work After Mastectomy: Too Soon?

They say you can return to work 6-8 weeks after a double mastectomy… They say! Just a few weeks after my amputation as I describe it, the day my cancer was FINALLY cut out of my body and my two beloved boobies that tried to kill me also found their new home in an incinerator of some sort! Can you believe it, only about a month and a half- two months to recover from all of that, and then there are some orthopedic surgeries take 3-6 months for recovery!  Its so shocking!

When I went out on leave from my job as an Occupational Therapist, I was in constant contact with my boss and director of rehab and we were all under the assumption that just like the doctors were telling me, I’d be good as new in 6 weeks. Here is the problem with doctors coming up with these prospective “ranges” of recovery, it sort of gives a patient a presumption that they “should” be better by that date.  This can be a good thing or a bad thing dependent upon the patient, however for me…this was BAD BAD BAD!

Though everyone heals and recovers at their own speed, I am here to tell all those doctors and professionals out there who make up  this 6-8 week range for return to work are WRONG!!!! Though some with more sedentary job descriptions may in fact be able to return without a problem, my dilemma was the fact that I lift people for a living. I am teaching people the skills they need to be independent in one of their sickest states (acute care or while they are in the hospital).  A lot of times, my patients need help to stand, assistance to ambulate and perhaps training to use a new device like a walker or care, help to get in and out of a tub or shower, a boost on or off a toilet, equipment to put on or take off their socks or shoes, oh and I almost forget about managing the patient and their IV poles and their oxygen lines sometimes all while observing the level of assistance they need, coming up with a discharge plan and what services the patient could benefit from to live a healthy, happy, and safe life after leaving the hospital! How can I return to my job of helping people if I need help my self?

The date of my six weeks out of work was quickly approaching and the stress and pressure of my company was practically causing me anxiety. The week before my anticipated return to work I was reaching out to my physical therapist, oncologist, plastic surgeon, and surgical oncologist for someone to provide me the answer.  Am I ready to return to work.  I literally felt like I was caught in the movie the Labyrinth. It felt to me that not one doctor wanted to take responsibility for saying “Yes Meghan you are healed and nothing will happen to you if you return to work”.  It went from, “well what do you want”, “how do you feel” or my favorite/ the one that pissed me off the worst”just tell me what you want me to write”.  I could only imagine what a patient that didn’t work in the healthcare system would do if these were the type of answers they received from people who were supposed to be guiding their care.

I remember sitting with my phone in my hand and just crying because I felt like no-one was listening to me.  On one hand I had work asking questions and wondering when Id be returning, I had doctors saying at 6 weeks you can return, I had my physical therapist saying how in the world are you going to go back to work if your only lifting 2 lb weights, and I myself was questioning my abilities and comfort and fear of hurting myself.  I remember going to my plastic surgeon who ultimately  my doctors said was responsible for my return to work paperwork and I asked straight out, “do I have any restrictions”, of which his response was “not really, you just can’t  like lift anyone or pull up because your at a risk of tearing your pec”.  Okay lets think about this once again, I AM AN OCCUPATIONAL THERAPIST, LIFTING PEOPLE ISSSS MY JOB! Grrrrr…

It wasn’t until I met with my lymphedema therapist the day before I was due to return to work that she explained to me the risk of heavy lifting on my chance of getting lymphedema.  She had a resident observing out session who coincidently was in the OR for my mastectomy and lymph node removal who FINALLY explained to me exactly why I am still tender around my rib cage and the reason for discomfort in my chest.  She informed me that I would feel discomfort for about 6 weeks after my last expander fill— at this time that was only 2 weeks away! FINALLY I had an answer, I was not ready to return back to my highly physical job.

I decided to delay my return to work another 4 weeks to allow my skin and tissue heal a little more, and then I began radiation.  My radiation oncologist is very in tuned with  my work and decided that I should be out until I see if I have any significant symptoms from my daily radiation sessions.  At 12 weeks out from my double mastectomy I decided I would be ready to give it a try.

 My job ever so graciously approved my accommodation for a limited work schedule so I would be able to make it to the hospital for my afternoon radiation sessions, and I thought I’d definitely be able to tolerate 20-30 hrs/ week— ~6 hours of work a day until the conclusion of radiation.  I started working after the holiday weekend on July 5th.

A few days short of 12 weeks out of surgery, much longer and thicker curly blonde hair on my head from my last return to work after chemo, and the drive to not let anyone down… I was sooooooooo beyond words anxious and nervous about my first day back.  I woke up that morning, put on my makeup, searched for my scrubs, and was ready to share my experience of being a patient with my patients!  I was excited to see my co-workers although many of the staff are new and I feel sort of odd amongst staff that don’t really know me, know the type of therapist I am, and sort of respect me for being a therapist for years now and not being a new grad. It sort of hurts me that I haven’t been able to work for many months, I don’t have “my floor” anymore, Im not on any certain committees amongst my peers, I haven’t had a student in forever, and I guess I feel a little left out because of all i’ve been through.

What I am so blessed about my job and where I work are how absolutely amazing the management has been to keep my job and welcome me with accommodations.  Those that I am close to opened me with open arms,and even those I wasn’t “close to” asked how I was doing.  The first day started off with a bang as my boss left me my assigned floor with a note to call her when I got in.  WELCOME BACK MEGHAN, YOUR IN THE ICU TODAY! It was sorta funny to me I guess, not that I couldn’t handle the ICU, but typically these are your most involved, heavier patients, I just never expected that on my very 1st day back thats where I’d be placed.

I made my way down to the ICU, logged on the computer, made my patient list, and rounded with the nurses.  My first patient of the day was a man with a new diagnosis of lung cancer.  I felt like I was put into the ICU that day for a reason! I was able to connect with him, answer questions, and decrease some of his anxiety towards his plan for chemo because i’ve been there!  I went through that fear, and I first handedly knew what to expect! It was in that moment that I realized, I am now an Occupational Therapist that has first hand patient experience that will in the end help my patients!

After a few sponge baths, trips to the bathroom, and playing with some long handled adaptive equipment.  Four patients later, 2 evaluation and 2 treatment sessions and my 6 hour work day was coming to an end.  WOW IM SLOW!  Was all I could think.  Going from working 8 hour days and seeing around 11 patients to seeing a measly 4 patients, it was depressing.  I kinda felt defeated in a way, like I was going to let the staff down… but I couldn’t be too hard on myself, it was my first day back— I had meetings with management, and had some competency tests to take.  I had to head straight to radiation, and as I was walking to my car exhaustion hit.  I sat into my stuffy car, put the windows down and realized how tired and heavy my body felt.

I got to radiation and passed out on the table for the whole 15 minute treatment session I underwent.  It was torture driving home and I went straight to bed.  6am when my alarm starting ringing the next day felt like torture.  My body was like it was strapped with a ton of weights, could this be what they say “fatigue” is?  I was at radiation session 20/30, and up until now, radiation had been a breeze.  I worked my 2nd, 3rd, and 4th day at work and had a melt down. I cried everyday driving to radiation and fell asleep right after I got home.  My body ached, I was getting more migraines, my chest skin began to feel tight and tingling… maybe I returned to work to soon?

 I had my weekly doctors appointment with my radiation oncologist (who coincidently was out on vacation but my normal nurse Scott was there alongside the fill-in physician) and lost it. Again, he passed me a box of tissues as I turned into a weeping willow. The stress of the week, my physical, mental, and emotional exhaustion just all seemed to be soilling out as I mumbled out the answers to his questions as drippy tears of salt ran into my mouth. Basically I was the definition of a hot mess! The substitute doctor came in, checked my skin, and explained that he wasnt sure I am quite ready to be working such a strenous job.

In a matter of minutes, I found myself with yet another script writing me out of work:(. To some this would be a day for a party or celebration, for me… I literally felt like a loser. This is one of the worst feelings of this journey that I was yet to experience because I feel like a straight loser. I feel defeated, upset, and sort of lost. It just really really sucks to be 27 years old and not be able to physically do something you should in essence be able to do! Its just upsetting… Oh well, 2 more weeks of radiation and I am doneso! Cancer Free at last and completely ready to start my life… Again!

Xoxo Meg