I honestly thought when I got diagnosed with the recurrence of breast cancer that I would quit work. But just as I am not quitting life, I am not quitting work quite yet. I am proud to say I am now going on almost a year working full time with metastatic breast cancer. It has not been the easiest year and I have had a tremendous amount of help, but I did worry it would be much worse. I really like my job. I feel I do a good job and I feel I am making the world a better place through my work. Work is really good for me psychologically and it would be more difficult to deal with the thought of having a terminal illness if I didn’t have the ups and downs of work to distract me. Not to discount the time, effort, and money I have put into educating myself so I can enjoy a job that pays decently, but most days I feel fortunate to go to work. The other bonus is that I work for a large company that provides me with vacation time and other benefits. I do not take this for granted. While no one enjoys working for “The Man” (whether that be a corporation, government, etc.) and playing the political game once in a while to get ahead or even keep your job, I know very well that if I were self-employed, this diagnosis would have been much more detrimental to my life. Once in a while I’ll throw a pity-party for myself and at one point I found myself complaining to my husband that I felt I should get some type of extra time off for appointments (you might call this part of the political game, yes of course I qualify for sick time, but I can really only take it at the expense of my co-workers, and that can lead to other problems). To this complaint, my hard-knocks, life-isn’t-fair, cynical husband quickly reminded me that I get six weeks of vacation time, which should be plenty for my appointments and he once worked with someone who went in for chemo over his lunch break because he had five kids and a wife to support, so I should just get over it. Okay, fair enough, point taken. Anyway, while I also assumed at one point that I must be the only person going through this hardship of working full time with metastatic breast cancer, of course I am not, there are plenty of people that continue to work. After a year of going through the ups and downs of working with cancer and the constant internal struggle of how to best live what might be the last years of my life, I’ve come to the conclusion that working is better than dying, so I should just enjoy the fact that I’m well enough to work while I can.
One interesting element of my job is that I spend about 50% of the time working the “night shift”, from 1:00 a.m. to 8:00 a.m. The night shift is actually the most critical shift in nuclear pharmacy due to the production schedule of radioactive drugs. For me and most other nuclear pharmacists, it is the most enjoyable. But it is the NIGHT SHIFT. I don’t care who you are, the vast majority of us have a really hard time waking up at midnight to go to work. It’s really difficult to hear that alarm go off at 12:30 a.m. and make myself get out of bed. One “coping” mechanism I’ve always had was being able to tell myself that I won’t have to do this in retirement. That’s out the window now…I think I’m in my retirement, and just working full time and raising young kids at the same time (I guess what many retirees are doing nowadays). The other “coping” mechanism I have is that I sleep really well from 9:00 a.m. until 1:00 p.m., so I can generally just crash when I get home from work. Appointments disrupt this. I try my best to schedule around sleeping, but sometimes it’s unavoidable and that can make the whole week rough.
Now that I’ve had cancer for almost four years and experienced many of the treatments, I can reflect on how the treatments have affected my work. I’ve preached this many times and will continue to do so, but every cancer is different and every person responds differently to treatment, so I always hesitate to put my experiences out there for comparison. My treatments over the past four years have been a combination of surgery, chemotherapy, hormone therapy, and radiation. Of these, the surgery was the only intervention that required me taking off work. I took off two weeks post-mastectomy. To be honest, I was extremely lucky and had really good healing, so probably did not even fully need the time off, but it was really nice to just have the surgeon make the decision beforehand and not question every day whether or not I should be working. Hormone therapy was the other “easy” decision. I haven’t needed to take any time off for that. Chemotherapy and radiation were trickier to navigate in terms of how to balance treatments with work and life. So far I have been completely blessed during my treatments in that I never felt too sick to work. That being said, I will completely admit that balancing work during both chemotherapy and radiation was really tricky and there were definitely days when things just seemed to fall apart.
Three and a half years ago I underwent chemotherapy to help prevent a recurrence and fortunately I had a relatively easy chemotherapy regimen. One question I’ve always wondered when I hear people are doing chemotherapy is “How sick are they?”. I mean, are they just throwing up every hour or are they spending the whole day in bed? There is a huge scale of “emetic potential” for chemotherapy drugs and they vary greatly. Also, there are a lot of really good anti-nausea medications out there and depending on the regimen, the clinic will definitely give premeds like candy to prevent discomfort. Like I said, my regimen was fairly easy. For me, the chemotherapy experience was like the first trimester of pregnancy. I never really felt great, but I could definitely work and function. I chose to work the night shift for the two months of chemo so that I could easily go in on my treatment days without taking time off or disrupting the schedule in general. As I’ve mentioned before, the night shift is not a piece of cake. It was rough working the night shift for two straight months while going in for chemo and labs every few weeks. Had I been in a terminal cancer situation at that point, I’m sure I wouldn’t have pushed through like I did, but at the time I was pretty confident the cancer was never coming back and I would never have to go through this again. The only hiccup I can report with chemotherapy is that I developed an allergic reaction to one of the medications about six weeks into the regimen. I developed hives, which are never fun, especially during the hot summer. Then one night, before work, my face swelled up. It was pretty bad, I wish I had taken photos. At that point it was midnight, I needed to go to work and I was basically debating between going to work and going to the emergency room. I would always tell anyone experiencing what seemed to be the beginning of an anaphylactic reaction to go immediately to the hospital, but this is not what I did. I loaded myself up with Benadryl® and steroids (I had plenty on hand as part of my pre-chemo medication regimen) and drove to work. At work I then put the technician I was working with in an uncomfortable position by appearing with a disfiguring swollen face and telling her she might need to call 9-1-1 at some point during our shift. But the swelling went down, we changed my chemo regimen for the last treatment and life went on.
Radiation was easier than chemotherapy in many ways, it was just more of an annoyance. I had radiation every day for five weeks, so basically I just got sick of going there. But that clinic was close to my work and I was usually in and out in 20 minutes. Radiation is different than chemotherapy because it isn’t usually a systemic thing, so while it can have dramatic side effects at the tissue being treated, it doesn’t really affect the rest of the body. Since my radiation was targeted towards my sternum and throat area, I did have problems eating for a couple weeks since my throat was sore. I was actually pretty miserable and really starting to run low on energy from not eating, but I quickly recovered and regained the ten pounds I had conveniently lost.
I am now in more of a maintenance situation with regards to treatments. I do get an infusion once a month and take an oral medication which has some of the immunosuppressing effects of chemotherapy, but to a much less degree. I still meet with my oncologist once every one or two months and have labs and scans periodically. While I don’t enjoy spending my free time doing these things, it’s not bad and I’m sure many people have more intense work-life balance issues than I do. At this point it’s a matter of making an intentional decision every day to go to work. As much as I enjoy spending money, I really have no interest in making money anymore. I have very little interest in possessions. Can’t take them to Heaven, right? I guess that’s the difficult part about going to work every day. I do like working, but sometimes I’m definitely choosing making money over spending time with my family and that’s hard. I always assumed my life wouldn’t be in day-to-day situation until I was in my 70s or 80s and by then I would have gotten to enjoy retirement for a decade or so. But here I am, 39, not sure how long I’ll physically be able to work and wondering whether I’ll have the opportunity to enjoy some form of “retirement” without too much physical discomfort or conversely, whether I’ll throw in the towel too early and cause my own demise from boredom. I’m currently reading the book “Big Game” by Mark Leibovich about the NFL. So far the author has focused quite a bit on Tom Brady and how much longer he can keep playing. When reading it I feel like I can relate to the struggle of a professional athlete to stay relevant with an aging body at a relatively young age. The author brought up the idea that “things might end badly with Brady” with regard to his relationship with the Patriots and referenced Brett Favre’s retirement “That spectacle was tough to watch: Favre’s agonizing, his retiring, the public tears and questioning of whether he was “guilty of retiring early”; the unretirement and the different teams”. To this question, Tom Brady’s father replied “It will end badly…it does end badly. It’s a cold business. And for as much as you want it to be familial, it isn’t.” Like football, my job is pretty black and white. Either you do the job and earn your paycheck or you don’t and I feel like the transition of discontinuing work is rarely easy for anyone. So there it is…as much as I’d like to say I’m succeeding in feeling at peace with my circumstances and fully having faith that I’ll know when the time is right to move on to my next life activity, the truth is I’m unsettled by all of it and the basic question of how much longer I have haunts me every day.
I haven’t cried much since learning that my breast cancer returned, but the few times I do break down tend to be in the car driving to work. I don’t know why that is. It’s not like I’m sad to go to work or going to work reminds me of my situation. Whatever the reason, on those days when I’ve had a tough drive in, I’ll park my car, sit there for a few minutes to compose myself and then march into work. Once I step through the door to work I usually get inundated by some problem that’s come up or someone has a question about something, so my cancer is forgotten for at least the next few hours. Problems such as finding a driver to go to Janesville become the most pressing thing on my agenda. And this sums up what work is for me, a profitable distraction.