Work, Worth & the winding road to Wellness

Alongside fear, uncertainty and the possibility of a life curtailed cancer brings many other undesirable consequences. These issues receive little media attention and this lack of publicity coupled with poor employer, government and public awareness means the implications for individuals, families and the economy at large remain hidden from view.

I know most about breast cancer so will highlight the issues through a lens I am all too familiar with. In almost all cases people diagnosed with breast cancer will require some form of surgery and surgery inevitably requires time in hospital as well as time to recover. For many cancer patients it is not a stand alone event. Even without complications people with breast cancer may find themselves facing multiple surgeries over a period of years in order to ensure the physical aspects of the disease and its aftermath are fully taken care of. As well as surgery, many patients also require additional treatments such as radiotherapy, chemotherapy, hormone or immunotherapy. These treatments can take months or years and frequently come with side effects, some of which may be permanent. Like surgery, these treatments often require regular trips to hospital for their administration or follow-up which inevitably requires some time away from work.

Cancer is an expensive business because treatments and the time taken to administer them are both are expensive. But this is only part of the story. More of us are developing cancer, more of us are developing it at a younger age and worryingly, that trend looks set to continue. Economic pressures and fragilities make it very unlikely our countries can afford the significant costs involved in providing disability benefit for hundreds of thousands of working age cancer patients who suddenly find themselves out of work. Yet despite legislation, e.g. the Equality Act in the UK or the US ADA, many working age cancer patients still find themselves facing discrimination, exclusion from the workplace and enforced redundancy. There are many good employers in the world but there are also far too many who remain ill-informed and retain outdated policies that fail to adapt to the changing face – and health – of the workforce.

This lack of awareness and inflexibility is short-sighted because it places enormous strain on the economy let alone the hardship it inflicts for individuals and their families. Research highlights that cancer survivors work at least as hard as their colleagues and take less time off for trivial illnesses when compared to other employees. In competitive employment markets where demand for skilled workers is high, finding ways to retain the services of cancer patients is therefore good for business, good for the individual and good for the economy as a whole. Although some cancer charities have attempted to provide relevant employer education and awareness, a straw poll of friends with cancer suggests there is still much to do on this front. It’s time governments and mainstream media joined forces on this issue because most cancer patients don’t want to be consigned to the dole queue or long term disability payments. It is more than an issue of income or economy, it’s also an important factor in an individual’s perception of their personal contribution and self-worth.

In many societies the way we perceive ourselves, our confidence, standing, personal and social usefulness is now intrinsically linked with our work. Our jobs, particularly when we’ve trained for them for many years or worked hard to achieve particular goals, have become part of who we are. We measure our worth not only in terms of the salary we earn but the contribution we make as employees. Cancer patients who are forced to give up work often suffer a huge sense of grief and a damaging loss of self-worth at a time when stability and security are of paramount importance. It is not the case that early stage cancer patients need less demanding jobs because they won’t be able to “keep the pace” after treatment. It is not the case that all stage 4 patients are too unwell to work, or will prefer to “spend their remaining time doing other things.”

The number of patients dealing with depression, PTSD or social anxiety as a result of enforced loss of work is significant and likely to increase as the number of working age cancer patients increases. Once again this presents a drain on local and national resources that extends well beyond the realms of individual suffering so it’s time governments and mainstream media joined forces on this issue too. Unemployment creates all kinds of social, economic and psychological problems so keeping people in work has to be a primary aim. With more lateral thinking, more flexible employer attitudes and the application of some everyday common sense, keeping people in work is rarely impossible in an age where we can connect from anywhere, converse from anywhere and complete most computer-enabled processes from anywhere. Even in more manual jobs it’s possible there are tasks employees can usefully and successfully complete with some creative thought about job design and desired outputs. We need to reach a point where pushing people out of their jobs because they have cancer is a decision of last resort.

Awareness of cancer as a critical and chronic disease has increased quite significantly in recent times but awareness of its wider implications – for individuals, families, employers, society and the economy as a whole – remains shrouded in mystery, myths and misinformation. We all have a role to play in unveiling and addressing these important issues because they aren’t going away. Without action and in a world where cancer is increasingly affecting younger people of working age these issues willcontinue to affect our children and our children’s  children if we fail to act.

 

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Stocking confessions

For anyone who thinks stockings are a throwback to the 40’s and the post-war frenzy of the nylon riots, fear not. Stockings are alive and well and making a huge comeback in my household and the homes of countless other women across the globe. These stockings are immensely functional, have a hint of sheen, an open toe and a block heel. They also have a small seam. They’re manufactured by a German company but I don’t think it’s Falke, which is a shame because Falke make good stockings. Falke or fake, I’ve been persuaded to wear these very special stockings for at least the next two weeks because I’m reliably told they are a lingerie lifesaver, for me and others like me.

Of course no stocking is ever perfect and often we have to contend with bad length, limited silkiness, wonky seams and the like. Length and texture are certainly a bit challenging though it’s fair to say I’m tall. A further downside is that they only come in white and the denier rating is a bit on the high side, easily twenty-times greater than the best pair of 5 deniers I ever owned. (Back in the days when stockings were at least as important as non-chip nail polish, 4 inch heels and a big can of Elnet.) However as I’ve already indicated they’re extraordinarily functional, extremely unlikely to ladder or run, afford excellent durability – they’ll survive at least 100 washes in the automatic machine but more likely 10,000 – they’re warm, and of course their unique selling point is the all important lingerie lifesaver label. Who could possibly resist?

I have a love-hate relationship with these stockings. They represent all that’s been difficult in my life yet they also represent hope, the chance of a future. They’ve kept me out of trouble on at least 5 separate occasions including today and will do so for another coming up in the not so distant future. It appears they’re very well designed to prevent unwanted pregnancies, ward off perverts (bet you didn’t think stockings could do that) and double-up as flight socks for anyone planning to jet across the planet or sign-up for Virgin Galatic. I suspect there’s every possibility of remaining a virgin for centuries in these beauties but its also reassuring to know I’m very unlikely to suffer a DVT (deep vein thrombosis) following  my trip to theatre today.

No, I didn’t see Miss Saigon but I did meet three very nice male anaesthetists, a lovely lady theatre nurse, a fabulous and stunning staff nurse and of course my all time favourite Miss M.  I didn’t have to wait around as I was first on the list for surgery which is good for all sorts of reasons and I think (hope) I’m now at the end of all cancer-related surgeries, revisions and repairs. Das ist alles as they say in Falke.

As with the stockings, rarely is anything completely perfect and though I warned of the heinous condition of my left side veins the consultant anaesthetist suggested the junior anaesthetist should “go for the one looking sort of ok-ish below the left index finger.” So he did, it didn’t work, I felt incredibly sorry for him – its my fault not his, and consultant anaesthetist then had to prod my right hand which was equally touch and go for a while. We got there in the end and consultant anaesthetist apologised to his junior and to me saying “I’m sorry, we should have listened as you do know your veins well.” Far too well for my liking, an intimate knowledge in fact, and so accurate that I pity anyone who has anything to do with them. Another reason on the long list of reasons why I’m very glad das ist alles on the cancer-related surgery front. (Gall bladder next and that really should be it, all done, cyborg here I come!)

After morphine and Fentanyl for the operation itself, a combination that makes me wonder why anyone would become an addict because the effects are so way out they are completely bewildering, not enjoyable, I’ve resisted any further pain killers and feel much better for it. After swimming in drugs through much of 12/13 I now steer clear as far as possible. This post-op discomfort is well within the realms of manageable, a reflection I think on the skills of the surgery team. I’m told healing is 3-6 weeks, nothing at all strenuous for 6, no driving or work for 3. That’s a real challenge because my job needs a lot of attention, the university is extremely busy, we have students to recruit, systems to develop, projects to deliver and as ever, IT problems to resolve.  Aside from all that, 3 weeks of daytime TV is almost certainly bad for my health (and sanity) and my favourite recuperation past-time – growing things to eat –  is off limits. No digging, hoeing, mowing or sowing.

So while I contemplate what to do while doing very little and avoiding as much daytime TV as possible I leave you with a photo of my souvenirs from today – port and starboard – complete with coloured gauze and post-surgery puffiness.

I couldn’t post the stockings, they’re far too risqué!