Multi-part question (chemo brain; returning to work)

I have found recovering from surgery most challenging. I was advised 6 to 8 weeks but it is now 9 weeks and I am beginning to feel like myself. I had no complications of surgery. Progress was slow and not "linear". Chemo was up and down, I would have a few days after the Folfox when I didn't feel well enough to do much of anything but would come back up again, but surgery has been different because the fatigue and poor endurance was daily. I would empty my dishwasher and lie down on the sofa. Everyone is different. I lost a lot of weight due to pancreatic insufficiency, went from 145 lb to 110 and had just stabilized my weight a few weeks before surgery. I was 103 when I returned home from surgery. This might have something to do with the slow recovery. I now am back to my presurgical weight. Mental energy went along with physical energy, very low initially.

Not mowing my lawn again, but I am walking a good distance and returned to driving. Even though there was no cancer in the pathology report, I have been tested for ct DNA and am diagnosed with minimal residual disease, a great disappointment for sure. Since I have BRCA 1, I am a candidate for Olaparib. I will be talking to the oncologist this week about any more chemo vs Olaparib .I hope that side effects of medication will not be debilitating and that there will be benefit of treatment, I find myself letting go of the future, just focus on how I am today, realizing that the course of things is highly variable. I am appreciating feeling well at the moment and grateful for my good days.

I went through a lot of angst about work when I was diagnosed with stage 4 pancan in April. I'm a teacher and was at that time teaching 3 days a week. I'd intended to re-up my contract for this year because I loved the job. Ultimately, I didn't sign the new contract and retired instead. As you mention, the brain fog and exhaustion from chemo lasts several days. Plus, Folfirinox includes the lovely infusion pump for 2 days, which is not something I'd want to wear around children. I didn't think I could guarantee the school that I could work with any consistency given all that. I would likely have missed one week of work over every two weeks. I desperately miss my job, especially now that school is starting again around the country. But in reality, I don't think I could have done the job the way it needed to be done. I mean, I had chemo on Monday 8/21 after being off for 6 weeks (long story), and I couldn't even really read for a few days--just couldn't concentrate. So going forward, I'm instead planning to explore some part-time things, such as reading buddy and tutoring, that I can flex around chemo.

In your case, besides the schedule and workload issues, you need to think about health insurance. I was already on Medicare, so retiring wasn't a problem for me. You still have a lot of medical expenses coming up. Do you have coverage independent of your employer, or will you need to organize some sort of transition to new coverage? If so, what benefits does the new employer's plan provide? I also would talk to your oncologist re whether chemo will continue after surgery. (I assume you're having the Whipple.) That will provide info you need to know whether this job is right for you. Good luck with your decision!

I forgot to mention that prior to my teaching days, I was a free-lance writer and editor. So I understand, in a small way, the work flow and client needs that your prospective employer would have. I would suggest asking about flex in the schedule. That is, if you need an extra day to feel better so you can edit/proof a project, is that OK? Or are the deadlines firm and fixed? Will the employer be angry if you schedule, say, a 2-hour nap after lunch to recover and feel better? That sort of thing. Working virtually is good in that you wouldn't need to be around anyone while you're wearing the infusion pump, which is good.

One more thing I neglected to mention. (Must be the chemo brain! haha.) I assume this is a full-time job as an employee, not a free-lance job or independent contractor. As an independent contractor, you can adjust your working hours any way you wish, as long as you meet the deadline and the requirements for the project. As an employee, you will likely be required to log specific minimum hours online, which may make working with pancan trickier. My husband, who's now retired, worked for a large US newspaper. In the last few years, his department went fully virtual. He was required to be logged in--they could check and see--during specified work hours; it wasn't a flex arrangement. If this job requires you to be online and actively working during set hours, that may be difficult to manage during chemo or when you're recovering from it. Definitely an issue to explore with the employer.

I admire your optimism and wish you the best!

Reality check is that recovery from Whipple is not easy, and starting a new job where you're trying to make a great first impression puts a lot of stress on you.

Does the potential employer know your PC status and surgical plan? It ***might*** be better to be upfront about this instead of springing it on them later. Lots of pros and cons to each side. Honesty might cost you the job, but might also open another door. Perhaps a temporary, part-time, contract-to-hire arrangement as you recover and assess your ability to put in a full day's work w/o wearing yourself out.

Thank you so much for your reply -- it's very helpful.

I'm sorry to hear about the minimal residual disease; I so want for you -- for everyone here -- to be free from these stresses and to have many healthy years ahead. Thanks again, and if you feel inclined to update us (we're rooting for you), pls do. Take care.

Thank you so much for your replies -- they're very helpful. I'm not close enough to retirement age to retire (I'm 61), nor am I financially able to; I'd like to if I could (I too would like to do some tutoring).

My understanding is that my post-surgical treatment (oral chemo, or infusion chemo, or other) will depend on what the surgeon discovers. It's a bit frustrating that this job I really want (and would be considered for, despite my age) has come up now rather than in, say, 3 mos. -- but I guess that's just one of the many challenges of life with this disease.

(I've thought about approaching this employer to ask whether they could use me as a PT freelancer, but presenting even *that* is difficult because I don't know what my post-surgical regimen will be , and if the employer would want a commitment on certain days of the week, as is sometimes the case, then freelancing for them might not work.)

Thank you again for your helpful reply; I hope you're doing well during this transition (seeking flexible PT work, such as tutoring, sounds like a great idea).

Thanks for the reality check! I think I was so dazzled by the job listing that I couldn't see clearly. (Dazzled in part bc my age -- 61 -- which is an obstacle to many employers wouldn't be to this one. Sorry if I'm repeating myself -- brain fog.)

Your suggestion is very good. I'm thinking about writing to the person who oversees the relevant dept. and saying, more or less, "I'm not applying for the job even though I love your company and I'm really qualified, bc I have health issues that won't be resolved for at least a few months; if you ever use freelancers, I'd really like to be considered."

I'm a little leery about using the C-word -- for one thing, a small co. might think, "I don't want to hire someone who's at risk of having a relapse -- that would cost us a fortune, insurance-wise." Or "I don't want to invest in hiring someone who might not be around in a few years." But I'll think about it. I agree that honesty is theoretically always the best policy; I don't want to lie about my health problems, but I also think (after binge-reading the Ask A Manager website) that it's OK to not disclose them ***if*** I have a good prognosis after surgery. (If I knew that I were likely to have only two years, for ex., either I'd disclose it at the interview or I'd not apply.)

Thanks again, and I hope you're doing well.

@jk77 We have a lot in common here. I'm only one year younger than you are. I just found out a job I had been interested in for 15 years became open last month (previous guy finally retired), and another guy was hired while I wasn't looking. Similar scenario with one other dream job.

My biggest obstacle after Whipple was that I was still trying to get my bowels under control for about a month. (Not conducive to new employment!) I went back to my previous, well established job 7 weeks after Whipple, and they had a very "soft" project for me to start with. I still couldn't get through 8-hour days without a nap for yet another month, during which I became completely dependent on caffeine to get through it.

I was elated to be reacclimating to work after a cancer-free post-op report, but still reluctant to travel for any work (current job or a new one). Unfortunately for me, I had only been back at work 2.5 months (and back to jogging 3 miles every night) when I got news the cancer was back.

I've hit a point where I'm pretty burned out at my current job, but not ready to retire, so I'm up against a lot of the same age-related and medical-related biases you've encountered. I want to continue working, but on projects that are more meaningful to me. So I'm also considering the overly honest cover letter ("I really want to work here! Although I have Stage-4 PC, it's stable at the moment and I'm really feeling good, but things could change on a dime.") As you mentioned, it would be hard to land a job with benefits/insurance that way...

We obviously have a lot in common here, but I can't make any recommendations for your unique circumstances from my own experience base, other than to say be very careful of putting too much workload and stress on yourself too soon. All the other usual nuisances of life weigh just a little bit more when you're trying to recover.

@jk77
Your post op situation depends on what the surgeon will be doing. A complete whipple? Pancreadectomy with spleenectomy? Severing the tail? Whatever it may be, I don’t believe chemo will be advised until your body and chemistry heal to pre-op levels. If your pathology shows no residual disease, you may be advised to hold off chemo. A complete whipple will take far longer to recover from than a pancreadectomy.