And back we go again...

2nd May 2023

Phasing back to work is never easy, no matter how many times you have done it before.

Last year in March, when I started working full time hours and felt ‘’normal’’ again; in the way I was treated at least. I didn’t think I’d ever be off again. I truly felt like I’d got stronger and the last surgery was the missing piece to my puzzle.

IT WAS NOT…

In February this year, I was signed off work because I could hardly move or get out of bed due to severe pain and fatigue. I had an MRI and dynamic ultrasound that confirmed I had lost 50% muscle mass on the right side torso; this is the side i've had 3 thoracic surgeries. The diaphragm was not moving as well as it should; only 1 cm on the right and 4/5cm on the left. This explained some of the pain, breathing issues and fatigue.

The rehab started at the end of February when I was finally able to get moving even just slightly. I headed to hydro as that had helped me in the past and proved to be the most effective treatment for me. My physio added some level 1 pilates exercises after a month of hydrotherapy, to try to strengthen my core. The rule was to not do these exercises when I had hydrotherapy, a walk or work so try to focus on one main thing a day.

I started to feel stronger after 6 weeks or so of hydrotherapy and after a catch up with my physio we decided it would be helpful to start phasing back to work slowly so that I can work out my pain and fatigue levels and what I’d be able to manage. I found that a month focusing on hydrotherapy and physio alone really helped to strengthen and push my rehabilitation forwards. However, without trying to work, I didn’t know how I’d manage. It was a case of trialing things to see how my body would respond.

In April I spoke to occupational health to discuss where I was from a medical and rehabilitation perspective and to make a plan for phasing back to work. I remember the doctor saying to me ‘’You sound very positive, is it just a front?’’ Wow, I remember thinking at the time. She elaborated to explain that many people who have gone through what I had, are not able to remain so positive. I then explained that a positive outlook was my default setting, but I was human. So of course I have had low times in the past 5 years. I have a great therapist who know’s my story from 2018 and makes me feel heard and supported. I have a wonderful husband in NBH and the dogs make me happy. I also highlighted how much I loved my job and working, so I wonder whether some of my optimism was my eagerness to get back to work?

Two weeks later, I started back for just 8 hrs a week for a few weeks. It may sound like very little but add this up:

• 8 hrs - Work

• 5 hrs - Hydrotherapy (including commute, changing, time building energy to drive home)

• 1 hr - Physio exercises/stretches (over 3 days)

• 1.5 hrs - Breathing exercises

• 6 hrs - Wellbeing: a bath for pain relief and relaxation, meditation, naps (I managed 1!)

• 2 hrs - Socialising: this isn’t happening at the moment but I’d really like to do this more

• 1.5 hrs - Walking (I have struggled to do this much with the one main thing a day rule)

• 5 hrs - Medical appointments, wait time and commute (GP, specialists, therapist, blood tests, collecting prescriptions, medical admin, making appointments, chasing PA’s and dealing with insurance companies etc). 30 hours

It’s not as clear cut as working 8 hours a week and sleeping the rest of the week. The idea behind the build up was to allow time to go to appointments and rest in between the rehabilitation physio and hydrotherapy appointments. The commuting alone is still exhausting.

My first week back we had a lunch for one of our lovely colleagues who was getting married and we have a new head of the team. I wanted to go in to see the team again after so long and to support my colleague. I was pleased my manager had told me ahead of time so that I could work things out that week to rest and move appointments to be there. I hadn’t anticipated that doing this and physio in one day would make my first week a mega exhausting one. I am pleased I did it, it was fun to meet some new members of the team too. I am a sociable person and I really enjoyed the energy from the team environment. Even if I did feel a bit self conscious at first and was a bit nervous. A couple of my colleagues put me at ease when I got to the office and I started to find my place again.

The hardest thing about working so few hours is that I want to get things done. It's important to me to feel like i'm achieving something and adding value to the team. Currently, I feel as though my hours split into 4 a day consist of back to back meetings. I don’t have time to read, to get through any amount of emails or to feel like I’m progressing with things. It makes it really hard to feel good from a wellbeing perspective. I know I’m hard on myself and I am actually moving forward, but it’s frustrating when you want to do more and get things done and the breaks are heavily on.

I am currently working my hours around when others have booked in meetings (where more than a few are attending, I don’t see the efficiency in me getting them to change the meeting time just for me). This means I have to make sure my medical appointments, hydrotherapy and physio appointments are all worked out around those hours. It takes a good 30 mins a week to work out the logistics and to try to allow for rest around that too, which is aways the last on my list, but should probably be the first!

In the last month of being back at work, I’ve worked up to 16 hours a week. I really struggled last week in many ways, a consultant appointment, hydrotherapy, a melt down, horrendous period and not sleeping very well meant it wasn’t the easiest of weeks. The OH doctor mentioned the flexibility that was important around physio, medical appointments and work. I always try to stick as closely to the hours suggested by the doctor, mainly because it makes it easier for my manager and HR to know when I’m working and calculate pay. I’ve had to be flexible, as I really don’t know how I’m going to feel week to week but 8 out of 10 times I’ll be hitting the planned target hours.

I realised last week that I wasn’t taking breaks from my desk in the hours I was working, I didn’t prep snacks or get up to stretch. Although 4 hours doesn’t legally entitles me to a break. I think stretching and grabbing a tea I would feel so much better pain wise and I think it would help me maintain my stress levels too. I also found that I was finishing work and getting into bed (even at midday). I think we take for grated how much physical and mental energy work takes out of us.

A few of my tips for phasing back to work:

• Find an ally or trusted friend who you can talk to if you’re finding your return to work difficult, someone you can message or reach out to when things are tough
  

• Makes sure you look at your days and weeks holistically, what else are you doing that day? E.g .Do you have appointments, are you having a blood test and do you have to commute to physio and work in one day? Is there a way you can build in rest or balance? E.g. Do you have a course meaning you will be starting early and not be able to move from your desk for an allowed amount of time? Can you turn off your camera to stretch every now and then, have ab early night or balance the rest of the week out?

• Don’t throw self-care straight out of the window. Make sure that you are hydrated and eating. Take breaks and get outside if you can.

• Tell others if you’re struggling, I know this can make you feel very vulnerable but sharing how you feel might mean that others can help.

• Remember you are back at work! That’s the first step. You need to congratulate yourself for your progress to get to this point. That’s huge in itself!

If you’re anything like me and you have high expectations of yourself, you may need to temper them. The aim of phasing back to work slowly is not to race to full time hours or to re-prove your worth. It’s to ease back into working life again. You should not be giving yourself a hard time if you aren’t able to build up hours as quickly as you would like, or if you have had to pass up projects and progression. Now is not the time for that!

Your time will come…

LBH x