Posted By: abs How long out of work after radical neck disection? - 04-30-2004 08:45 PM
My 47 yo brother had a radical neck disection 10 days ago. He was just moved to a step down facility. Everyone says he is doing terrific.
He is getting better every day. He has a peg tube and a trach. He still has his vocal cords...
and they didn't have to do any skin grafts.

He will be doing radiation therapy for 6 weeks...which hasn't begun yet.

Initially the Dr. said he would be off work for a month. Is this realistic? I can't seem him returing to work in two weeks.
BTW his work is not very physical.

Can he work while getting radiation tx's.

Thanks!

Angie
Angie, everyone is different. Some here have worked all through the radiation, but I think most have not. I remember being very tired towards the end of treatment and doubt that if I had a job, that I would have been able to put in very many hours. I would guess that what the doctor told him is a bit unrealistic, but you never know -- your brother may be one of the ones who surprises everyone. It is good to hear that he is doing so well. You come back any time with qustions, and there will undoubtedly be someone here with an answer.
Thank you Joanna!
This came on so sudden...and we are learning as we are going.
2 medical drs. told him he had thrush -1 over a year ago!-and it was just when he went to the dentist to get his teeth pulled because he was in so much pain...that we found out it could be cancer.
He just started a temp to hire job (had been there 6 weeks as temp and they just hired him) and found out about the cancer. They are going to "try" and hold his job...but no promises. I just want to give him something to look forward to...I would hate for him to loose his job, it's a great job, and they are few and far between.
I have been calling and leaving messages for his boss as to his progress...so I am trying to keep the lines of communication open.

He also doesn't have health insurance....so that has been another experience altogehter.

It does seem as if he is progressing well...but we will just have to see.

Thanks so much for responding!!!!

I hope you are well.
Angie,

I was a Chief Financial Officer and I worked up to the 7th week of 9 weeks of radiation and 3 rounds of chemo 3 weeks apart. I had a lot of accounting and computer work plus I was directing a consultant on setting up some product costing for a process manufacturer. Our company processed a million pounds of catfish a week! I lost touch with reality because of the "chemo brain" as the nurse called it just between the second and third round of chemo. I did manage to close the books, review financials and have daily conference calls with the Board of Directors until about the end of treatment, Oct 8 and I went in to work after two weeks, Oct 22. I worked about 400 miles from home so I spent the entire week in a hotel and a lake front house of one of the owners. I worked for about 8 weeks and the owners started fighting with each other and it looked like the company was going under so I took disability January 11. Initially I drove the 400 miles the first couple of weeks so I could take an inhalation therapy machine, a cooler full of TPN bags for IV feeding and enough fluids to give myself 2-3 liters per day. I did it mainly because they were grumbling about cutting my pay in half and I needed the money to pay the $10,000 in medical bills.

It can be done but you have to have the resolve to make it happen and I personally don't think it was good to have to push that hard so soon.

Ed
Oops I forgot to mention I had radiation and chemo but no neck dissection.

Ed
Angie,
Welcome! My hubby had a radical neck dissection Christmas eve and started chemo/rad on January 12. He ended up having 8 weeks of chemo/rad. He worked a little the first couple of weeks, but could not have worked after half way and he is still recuperating now. He had max rad to tongue, throat and both sides of neck and med. chemo (4 hr. treatment every Monday). I guess it all depends on how much radiation he is getting. My prayers will be with you guys.
Debbie
Angie, I agree with other posters that don't push hard on when a patient can resume work. How long? There are many variables such as the duration/intensity of treatment, the types of jobs, the patient's willpower,.. and many more. I work as a senior administrator in a secondary school and my career has always been very important to me. I pushed myself very hard in the hope that I could go back to work 2 months after treatment. Unrealistic since my chemo and radiation had been very intensive. Every time I attended my medical appointment, I had to extend my sick leave. I felt so depressed when I had no idea when I could return work. Gradually, I couldn't sleep at night, I lost interest in everything around, I lost my appetite, I lost hope in my life. My attitude became so negative that finally I ended up in the hospital suffering from a severe depression. To cut the long story short, I was back to full time work 7 months post treatment. Be patient.

Karen.
Angie, I would be one of those that returned to work 2 weeks after the Neck Dissection. And I worked weekends all through my Radiation Treatments. I was a Hair Stylist at that time, actually I still do it a few hours a week. I thought it would be a great way to exercise my Arm, Neck and Shoulder and nothing my Surgeon said or for that matter anyone said could change my mind. I spent many hours in pain because I was so BULL HEADED(being polite). I was very tired from the Radiation and doing a haircut took a lot of time and energy. Massage helped a great deal to get things feeling better again and lots of Tylenol. I guess what I am saying is tell your brother to take it slow. Do what he can and ask for help with what he can't do. His new Boss can't be that unfeeling (I hope)that he would not understand that your brother is giving the company his best considering the circumstances.
David
Angie:We are all different. I worked through all 7 weeks of my rad with 3 chemo treatments but needed 2 weeks off after treatment due to anemia and 25% weight loss. Just finished my neck dissection with upwards of 35 nodules removed and some other "suspicious" tissue and came home the day after surgery and have been working since then. I'm an outside salesman and talking can be a bear, but I use computer/fax a lot, also. Hope your brother? is good.Rgds, Kirk.
Angie, I did the surgery/rad/chemo trip twice, each time was different. No PEG tube either time. First time was 1/6 of tongue/neck dissection followed by rad/chemo to tongue and neck. Finished up on Thanksgiving, didn't go back to work until second week in Jan. Because rad treatments were twice a day and a long trip away, didn't work any of the time. Might have been able to work the first 3 weeks first time around. Last week of treatment wound back in hospital to get fed by IV, hurt way too much to eat orally.

Second time was to get spread to other side of neck and lymph nodes. Again modified neck dissection, followed by rad/chemo to neck only. Was fully ambulatory following surgery, actually worked half day the day I got out of the hospital. Again logistics prevailed, but probably could have worked up unil the second to last week or rad, just too tired. Went back to work 2 weeks after completing rad the second time around, got chewed out from docs for going back to work so soon. Main issue second time was dry mouth, sore throat the last couple of weeks, some radiation hit the trachea.

Sounds like your brother's surgery was more extensive than mine, I'd say a month could be pushing it, depends on how good health he is in otherwise, and how stubborn he is to get back to work. As far as working during rad, everyone reacts different it seems. Again depends on how stubborn your brother is. Attitude seems to be more than half the game.
Likewise on the "everyone is different" comment. I haven't been to work since 3/22. After the surgery I was crying at the drop of a hat, couldn't focus to boil water, and didn't have appropriate makeup to cover the radiation burns - not very professional, especially necessary in my line of work. There were two weeks in the middle of radiation I felt AWESOME, but I'd already told work "sorry". They're not seeing me until after brachey next month.

If they had cut my pay, I probably could have found it in me to work a reduced schedule or from home. But my body wouldn't have received the sleep it needed to heal as quickly. Now I'm asleep more than awake.

There may be some laws requiring them to hold that position or a similar one, but that's not my expertise.

Sabrina

PS - to all those needing makup that covers your regular skin and ointment on your radiation burns - BareMinerals works incredibly well. Okay, so I gave into the infomercial. I was desperate. It was certainly worth it - you wouldn't even know I had radiation burns, and I have WELTS on my neck right now! HIGHLY recommend it.
I had a Radical Neck Dissection, Radiation & Chemo. RAD ended early December. I felt ready for office work 13 weeks later. I worked half days & am still working up to doing full 8hr days. Can do 6.5 hrs before that sense of fatigue takes over.

PS LOL! I use BareMinerals as well. I love the effect. People @ work were amazed at my healthy glow. I bought mine at Ulta.
Thanks for the tips on BareMinerals. I haven't felt much like makeup, but I might try that out. My rad burns are all gone, but my skin tone is uneven now. I look like I have burn scars, I wonder how long until they fade? I have a very fair complexion. Sorry men, forgive me while I talk a little girl talk.

Lynn
Hi Lynn
Talk girl talk all you want.. the men hog enough for barbeques and weights..
need you looking your best girl
love and hugs
Helen
Besides the weights and barbecue, I have a two-toned neck, too. I am somewhat dark skinned with Japanese ancestry. In the sun my skin gets very dark but now I am either avoiding the sun or using sunscreen. The radiated area looks like a band of suntan and under my chin is white, white, white. I'll try anything...even the BareMinerals, if it works! (I'll put it on while I am smoking the ribs!) laugh

Ed
I used a prescription cream called BIAFINE for the radiation burns and it really helped them heal. I think it also helped heal the scars from the two neck dissections I had. It is a deep wound dressing. It was brand new when I had radiation back in the dark ages and unfortunately they didn't prescribe it to the end. You are really supposed to start using it immediately to prevent the burn in the first place. My surgeon says it's a good cream to use after the neck disscetions. Just thought I'd mention it.

Take care,
Eileen
I was able to do some light duty work throughout my radiation treatments.

Ed if you put that stuff on the ribs...I don't care how well it works I ain't gonna eat them! :p

Seriously folks, check with your radiation oncologist before putting ANYTHING on radiation damaged skin. This is particularly important if you are still in treatment.
Angie,

I'm one of those who worked for most of the time during treatment. (Shortly before my diagnosis, I had received a significant promotion for which I had worked long and hard, and I felt as though I couldn't be out of the office very long.)

After my neck dissection I was recuperating at home for couple of weeks, but able to do some work there. During radiation I was working partial days at the office (about 5-6 hours a day) for most of the time, but I have to admit fatigue and pain were really setting in. I think I also had another motivation for being at the office during that period -- it seemed that some of my coworkers, who didn't know much about oral cancer, thought the treatment was just slightly more involved than a root canal. I guess I figured that when they saw the radiation burns, the effects on my eating and speech, the weight loss, etc., they might get a better sense of the seriousness of this disease.

It's fairly clear from this series of posts that there's no single answer as to how much or how soon you can expect to work during and after treatment, but your body can tell you a lot about when you're ready.
Angie,
I am one of those who DIDN'T work through treatment. I was too sick, in too much pain, drugged and too fatigued to even think about it (not to mention depressed). By the way, I "only" had radiation and chemotherapy - no surgery. I did lose 60 lbs. Since I am a consultant, talking is key and my voice and throat was wiped out for a very long time, making it impossible to negotiate with clients or the FDA. Because I spent a lot of time in bed, all of my muscles atrophied and they are still trying to make a comeback 14 months post Tx. I still have some fatigue effects. I am still 30 lbs lighter than I was.

I understand that the recovery from the surgery is about 3-4 weeks - it's the radiation part that gets complicated. The general rule for recovery from radiation is 1 month for every week of radiation.

I am not trying to discourage you here, just give a little balance because not all of us are able to work in the immediate post Tx and nobody presented that view (well, except Joanna). And I am almost 10 years older than your brother so age may be a factor as well.
I was a CFO for a company that was struggling and even though I helped orchestrate a turnaround in 90 days, a group of the owners sucked all the cash out of the company in fear it was going under. They totally changed our business model that was showing positive cash flow and return to the first profit in years. They pulled the wool over the eyes of the lender and they tried hard to keep me from coming back by threats of cutting my pay and not letting me into the numbers when I came back, fearing I would tell the lenders. I worked at home (400 miles from work) on the telephone and computer up to the last 2 weeks of treatment and 2 weeks after treatment. I had to do this because my contract had a clause that 60 days off would void it. I took Short Term Disability in January because of the stress, they folded up shop and quit paying me in March and told me to sue them to get my back pay.

Was it worth all this? Absolutely not. I even enjoyed being off since January and I really turned the corner in March, feeling about back to normal right now, 7 1/2 months out from treatment.

Take your time, live life today because it may not be there tomorrow. Love unconditionally.

Ed
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