The funny thing about grocery bills, health insurance premiums, and mortgage or rent payments is that they don't stop when cancer strikes. Fortunately, neither do dreams nor ambition. Returning to work after treatment can be both gratifying and challenging. For me, the emotional ups and downs have at times made me wonder if my office chair should be equipped with a seat belt. (As a chemo veteran, the barf bag already comes standard.)
After seven months of chemotherapy for acute promyelocytic leukemia, I returned full-time to my job as a business development professional. More specifically, it's "kinda" full-time until I finish my maintenance rounds of chemo. Resuming my career marked a huge milestone in my recovery. I've welcomed the sense of normalcy the familiar routine has provided, as well as the abundance of diversions from listening too closely to the fear-mongers residing in the back of my brain. My bosses and colleagues, whom I consider to be friends, have been empathetic and supportive, and it's been comforting being back in their presence.
Despite the many positives, there have been days that I've wished I could be at home, completing a Lord of the Rings Trilogy movie marathon in my chocolate moose pajamas. (I know: Who doesn't have days like that?) Particularly in the first six months back, those longings were triggered by intense experiences and emotions.
Cancer trashed my self-esteem. My new insecurity shined through in the workplace like a streaker's buns beneath stadium lights. I felt self-conscious about both my appearance and my mental acuity. My bald head seemed to be glowing neon pink and adorned with flashing letters that spelled, "CANCER VICTIM." To combat the message I perceived I was projecting, I wore a hat every day, and made an effort to find stylish ones that might, just maybe, be misconstrued as an intentional fashion statement.
Unfortunately, the hats only partially hid my problem. First of all, they're scratchy! And hot! I couldn't keep them on all day, so I developed a relief strategy. I realized that anyone seeing my bald head for the first time would feel uncomfortable, but would grow accustomed to it. I selected a few colleagues and casually removed my hat during one-on-one discussions with them. I pretended to act like it was no big deal, while inside I was freaking out. Fortunately, they also acted like it was no big deal, and so my "inner circle" was formed.
Naturally, prospective clients of our firm were not part of this inner circle. Participating in these meetings was one of the toughest aspects of returning to work. My hats, pale complexion, and scrawniness made it easy for outsiders to draw the right conclusion. I worried that curiosity about what disease I had, or if or when I might die, would prevent them from focusing on my business message. I tried to overcome this self-consciousness, but couldn't. Avoidance became my solution. Not exactly a career-building tactic, but luckily my hair has grown long enough to now look like an intentional pixie cut.
The drugs that saved my life also hindered my career comeback, as well as my confidence. Recent studies have shown that "chemo brain" is no myth. To confirm its presence in me, all you have to do is ask my mom, whose birthday I forgot last year. (Again, you might be thinking: that's normal! But is it normal to call a cob of corn "chicken"?) Both the traditional chemotherapy treatments I received, as well as the anti-anxiety medication, felt like sludge coating the gears of my mind. For months after returning to work, I spoke as little as possible, out of fear of substituting a wrong word for what I'd meant to say, and subsequently feeling stupid.
A straight-A student in high school and college, I worried that I'd been robbed of what I'd believed to be one of my greatest gifts. Just like I'd done against the tumor blood cells, I fought back. The drug information for the anti-anxiety medicine listed memory loss as a possible side effect. It took me a month, and much wooziness, to wean myself off the emotional crutch. My anxiety hurtled itself back to the forefront of my thoughts, and it's still there. So I deal.
A big believer in mind over gray matter, I've made a huge effort to exercise my brain. A benefit of returning to the job has been the daily mental workout it's provided. My writing hobby also has helped to keep all those neurons firing. (All of the posts you read as part of the Huffington Post's Generation Why section on young adult cancer survivors are accomplishing the same for their authors.) My memory and concentration has improved, which I believe is due both to my efforts to sharpen them, as well as the time that has lapsed since my last heavy chemo doses.
Finally, being back in the grind has been grinding. The illness and treatments battered my body, and my energy level didn't exactly bounce back Charlie Sheen-style (maybe I still do have some chemo brain...). My first full week of work, I trembled from exhaustion and made numerous trips to the restroom to vomit. My bosses urged me to take it slow, but I was eager to prove to myself that I could handle my former workload. I couldn't, and it made me feel inadequate. One morning my second week back, I entered my office to find on my desk a hand-written outline for a new project from a colleague. I closed my office door and wept. Since those early days, I've been feeling stronger. The time I take off every three months for the maintenance rounds of chemo also helps me to recharge.
This past November marked a year since my return to work. I can't say that it's as if I'd never left. I do, however, have a routine that I've customized to be manageable. It pays my bills and has me back on track toward a brilliant future. I may not be traveling as fast as I once did, but I'm heading in the right direction.
Shelley Nolden was diagnosed with acute promyelocytic leukemia (APL) in April, 2011, at the age of 31. Shelley is currently in remission, and intends to stay that way. She would like to thank her bosses and colleagues for being so supportive during her treatments and in helping her transition back to work. Their kindness and generosity show the human spirit at its best.