Return to work after primary mediastinal large B cell lymphoma

Hi @pachecotc. Congratulations on being able to return to work! You’ve had a rough start to your year. So it can feel pretty good to get back to some level of normalcy. But of course, things are not 100% normal…being immunocompromised puts a little risk of uncertainty on the table. Especially when this is your first real foray into the ‘outside world’. It can be a time of high anxiety. I have felt that myself. But over time you’ll become more accustomed and comfortable with being out and about.

If your WBC and CD4 numbers are low, your immune system isn’t as robust as you’d like it to be. Even though, you should still be able to feel comfortable out in the working environment with some precautions. From my own experience having had a bone marrow transplant, I’ve avoided illnesses for the past 7 years by wearing my N-95 mask out public settings, enclosed areas, family events, etc., frequent hand washing, carrying a little bottle of hand sanitizer. I also avoid touching my face or eyes. I did eventually contract Covid last summer after avoiding everything for 6 years! And it was my fault. I went into a busy gas station without my mask…boom! But, I travel, engage in social activities and otherwise have a normal life. I also keep up with my vaccinations. In some instances, if I have to spend time with someone ‘in my space’ and I’m not sure of their health or vaccination status, I ask them to mask up.

However, as a speech language pathologist, that may not always be practical for you, if you need to see their mouth or facial movements when talking. But if you wear an N-95 mask (not a standard surgical mask) statistics have shown a great deal of efficacy over the past years as protection for most of us who are immunocompromised.

What has your oncologist suggested for your return to work?

@loribmt thank you so much, Lori for your input and insights. My oncologist is not quite ready for me to return to work, but I’m also at a point where I either have to separate from my employer or meet the minimum requirement of working at least 1-2 shifts per month. My supervisor is willing to allow me to cover outpatient and I will only see 2-3 patients. I know there is still an inherent risk, but I also feel like this is a good deal for me and I’m ready to start reintegrating back in a small capacity. I appreciate the advice about masking. Going into flu season, I don’t want to take any major risks with my health. Although I completely understand my oncologist’s concerns, part of me also knows that at some point I have to start taking these steps. I presented the plan to her about the accommodations and special requests for my work. I’m waiting to hear her thoughts on that.

@pachecotc I think your employer’s suggestion ‘to keep your foot in the door’ is a very generous compromise! I would think 2-3 patients per shift with only one or two shifts per month is a really good compromise and a good way to ease very gently back into the workplace.
If you’re in a hospital setting generally if there are patients coming in for appts, they’re asked if they have a fever, new cough, etc. So that can be helpful with initial screening so you can ask them to mask up. And it’s not unusual at all for medical professionals to be wearing masks during appointments. I was just at Mayo for my annual followup and every staff member in the transplant unit was masking. It’s a really easy way for us to avoid airborne illnesses.

I can feel the trepidation though, having been through similar myself. Baby steps getting back out in the general population! ☺️. Hopefully your oncologist is comfortable with the offer ahead of you.

You mentioned your low blood numbers yet. It can take a while after that last chemo round to recover. Have the numbers been steadily increasing?

@loribmt thank you again for your thoughts on that.

Regarding my numbers. Some of them have increased slightly others have fluctuated. My last labs showed a WBC still at 2.7, my neutrophils are now in the normal range, my lymphocytes were at 0.5 and my CD4 was just above 200.

@pachecotc my globulin is also low (2.2).

@pachecotc The important thing is the numbers are moving in the right direction! The lymphocytes and CD4 have a little ways to go but at least having your neutrophils rising to normal, the body’s first line of defense, is excellent! That should have your oncologist feeling a little more comfortable with your back to work plan. 🥰