For some of us who walk this path we don’t get an option about returning to work, the long-term side effects are just too much to allow any return to a normal life. However, at 48 once treatment had finished and with thankfully manageable side-effects I needed at some point to consider returning to work as this just felt too young to retire.
For me, this has very much been about showing cancer that it hasn’t taken my life away and proving to myself that I have come through this. Teaching maybe isn’t the most suitable job to return too after having had so much treatment on your neck, and the consequences faced by your vocal chords of this, but it is what I love and is the job that stood by me.
There is also the need to consider quality of life, from two very different perspectives. On the one hand only doing so much that you can cope with the fatigue, have energy to enjoy life and maintain sufficient health to ensure you stay in remission. Many people find that after cancer they struggle to return to the work they had done beforehand, the physical, mental, and emotional toll it takes should not be underestimated. On the other, a kind of survivor guilt complex, that you have come through this and want to life a full and fulfilling life, including the holidays and treats that are only afforded through work.
Thankfully I had some very sound financial advice earlier in life. My life insurance included critical illness cover and when we married and took out a joint mortgage I stayed with my own policy because many of the newer policies didn’t provide the same level of cover, especially with a family history of cancer. In the early days of diagnosis, I had briefly scanned over my policy, but as treatment had progressed and my ability to make phone calls fell, I had left it aside. As I started to come through the other side, I decided to call the insurer. Sure enough the policy did appear to have the critical illness cover that would lead to me being able to make a claim. I just needed to scan all my hospital letters and complete a form, a couple of weeks later we got confirmation that the pay-out would leave us mortgage free. The real significance of this meant that returning to work, more specifically to my current job was a choice more than a necessity. Without mortgage payments to keep up with I could take a lower paid job if desired, so I felt no pressure.
I discussed this decision at length with both my husband and counsellor. I was still on full-pay and as my 6 months would fall during the summer holidays, I had been re-assured that this would be the case until mid-September. Again, this put the ball in my court in terms of timing my return. I had my 12 weeks check up at the beginning of July and decided that providing my consultants were happy I would start a phased return after this and booked my return to work meeting. Psychologically I needed to return before the summer holidays, I feared that a full-on return in September would be too daunting and might also mean that I decided I wasn’t going back at all. It also gave me the opportunity to still work from home some some days, make it into school on others and fit all this around my many hospital appointments.
Getting ready to head in on my first day back felt so strange. I had lost nearly 4 stone, so much of my work wardrobe didn’t fit any more. I had a couple of sessions trying clothes on, creating a pile to go to charity, one of things that didn’t fit but could store in case I gained the weight back, and one of things I could wear and hung these back up in the wardrobe. This all took 2-3 sessions as it was really tiring, I was still getting easily fatigued and had to be careful dressing as I still had my PEG. That extra complication also created two types of clothes that fitted – ones I could wear now, and ones that had to wait until the PEG was gone. These waves of fatigue were a worry, I was still having afternoon naps and wasn’t entirely sure I could make it through a full day at work.
On the actual day I carefully did my hair, I still had a very much bald patch at the back of my head / neck where the radiotherapy had made it all fall out. The rest was full of blonde highlights, a colour I hadn’t been for years. Lots of sleep and rest meant I was looking really well, one thing I am very pleased about is I no longer need to wear foundation, so a quick brush of powder, blusher, mascara and I was good to go. I had lived in leggings and really loose comfy clothes for the past six months, putting on office-wear felt so different. A quick squirt of perfume later and I felt very much like the old me again, ready to head in.
My head teacher has asked to see me for a catch up before I had my return-to-work meeting with my boss. He had been very supportive throughout, indeed his brother had gone through treatment for prostate cancer during this time, so he was pretty understanding of what I had gone though. It was so nice to see him and thank him for the support I’d had. Next, I headed to the nurse’s office, I wanted to thank her especially for her support, from that very first day I’d had the call and the regular messages checking in on me. She had been ridiculously busy, dealing with all the normal workload plus covid, so I also wanted to check she was OK. As I left her room, which is near to the restaurant I spotted two of my team having lunch, I waved and had no response, so I walked over and said hello – they were both very startled as they hadn’t recognised me at all. This was to become a recurring theme, I had my long hair, so didn’t look like someone who had gone through chemotherapy, and it was blonde, whereas I had been brunette before this. Add into the mix the significant weight loss and I can understand the lack of recognition.
I didn’t know what to expect from my return-to-work meeting, never having attended one before. We chatted through the treatment, how I had been and the sort, medium- and long-term side effects. Thankfully I had chatted through many of my ongoing needs with my CNS and counsellor, so I was prepared. The wonderful article by Dr. Peter Harvey also helped. I was able to say that the treatment was deep and would take about 3 years for me to mostly recover from, but there might be some life-long adaptations. Key concerns with coming back to work were fatigue, especially if I over did things, dry mouth needing constant access to a drink, difficulties eating making it slow to eat, the need to maintain excellent mouth hygiene and of course my weakened voice. We agreed that this side of the summer I would come in for the odd half day and work from home the rest of the time, planning for September. Then, from September onwards I would have a reduced timetable and only teach 6th form, they needed less voice and could be left if I needed medication, was slower getting back from breaks due to eating and teeth cleaning. Also, when I was only teaching half days I could come in late and go home early to help manage the fatigue. It is really important to understand what you need, then you can help those around you to navigate the path too. Each one of us responds to treatment differently, so there is no one-fits-all way to deal with this. I am very fortunate; I have an understanding employer who was happy to take my lead on how to manage this.
There have been times I have struggled. I know I am far from 100% the old me. However, I still give more and achieve more that some people ever will, it’s that old, dogged determination that got me through the cancer. One of my most important lessons has been not feeling ashamed to ask for help. I consider my health and wellbeing much more now and am happy to say no if I think either will suffer. I am not superwoman, so there is no point trying to be her. Deadlines can be set, but sometimes they can’t be met, so I am honest and renegotiate.
I am starting to plan my early retirement. The past year has taken its toll and the rheumatism is a bigger threat to my wellbeing, it leads to unbelievable fatigue. I know when I have been busy, my joints stiffen. Working in a school when covid still peaks and troughs whilst you have an illness requiring an immune suppressant isn’t ideal. Neither is having a job that requires speaking every day when you have an occupational voice disorder. My voice definitely isn’t what it used to be. I have to avoid teaching in certain classrooms where the acoustics are just too much for me, I use a microphone now in assemblies and I take voice breaks in lessons.
Before diagnosis I started a senior leadership course, with a view to becoming an assistant or deputy head. I know I could do the job. Covid and cancer were a slight hiatus, and I needed a couple of extensions to complete the work, but I did it. I am still waiting for the result, but regardless have a great sense of achievement at just having submitted it. Sadly, with my merry-go-round of hospital appointments I doubt I will ever get promoted. I can’t contemplate applying for promotion at another school, how would I explain the need to keep having time off for medical appointments or fatigue? I know there are laws that protect us, and this could be seen as discrimination, but I am a very practical person. Why put myself and my employer in that situation? They have been very supportive.
So yes, I have returned to work, and I am glad I have done. Mentally it has been a huge factor in my recovery. However, I do need to think about my exit plan, but this is going to be on my terms. My illnesses might have accelerated the need, but I am determined they aren’t going to dictate them.
