Career crossroad

[PatriceH]

I finished herceptin Aug 2010. Unhappy in job for quite a while. After treatment, I started a light job search. I now have an offer on the table I need to respond to on Monday.

I have a mammogram on Monday...followup from 6 months ago with suspicious area - radiologist said that was normal at that stage of the game--post radiation....

What to do, What to do?

I think it's a good business decision...but I am SO afraid of finding out cancer is back after changing jobs.

Talked to oncologist today said post treatment chances of recurrence are around 15%. If it would be a good change - go for it...just be cautious about a seemless insurance transition.

Right now I am on 6 month screenings. Time-wise, that is pretty much like the rest of the world...So, I guess to summarize my questions:

1) change jobs? i.e. sink or swim?
2) press for opinion of mammorgram before I leave telling them situation? Oncologist said he would know Wed or Thursday
3) Although I am terrified, and my current employer has been supportive. We just don't match anymore. In my heart I truly don't feel I am able to be me and be all I can be, due to who they are. Not mean, just they way things are, chaos...etc.
4) I've identified part of my problem as grief...loss of purpose, saying goodbye, feeling like I'm letting someone down..loss of who I used to be...loss of success...etc.

Sisterly advise..pleeeeeeeese

[BonnieR]

Oh, Patrice, I feel for you. I hear the turmoil and indecision. I hate indecision, although I pretty much reside there
There are so many variables involved in your situation.
Is there someone you have been talking with at your cancer center who might help walk you through this? A social worker, psychologist, or what not? Even a trusted friend.
Insurance is certainly an issue to be factored into any decision at this time.
You know, I belong to a 12 step program and we have a suggestion to newcomers that, as much as possible, not to make any major decisions in the first year of sobriety. I think the same could apply to the first year of so of cancer treatment. We are in such a state of turmoil already. And I know, for me, that chemo brain and stress contributed to my not being at my sharpest and making some impulsive choices that I now regret.
I also believe in "signs". Be still and see if something reveals itself to you. Keep the faith.
(Are you sure you need to tell them on Monday? It is a holiday)
I will be interested in hearing what the others here have to suggest.

ETA: ask yourself, what's the worse that could happen?

[whatz]

What would you do different if the suspicious follow up was bad? Would you stay at your current job because of insurance and support? If so...try and see if they would extend their deadline until Thursday so you can have your Onc's feedback. Also...ask on Monday if somebody (radiologist) could look right now and give you feedback and if there is anything they can do for you (to speed the process) since you are considering a lifechanging decision. Our clinic now reads the mamogram while you are there to determine if further diagnostics are necessary (i.e. ultrasound).

[tricia keegan]

Patricia,

I'd push to get the results asap. and in the meanwhile ask the new job for a few days to think it over

Its a huge decision and sadly, only one you can make but wishing you luck and hope its the right one for you. xx

[Jackie07]

You can contact the insurance board of your state and find out details about how to get covered in between jobs. My experience is that the insurance provided by a new job usually does not kick in until almost two, three months after your hire date. So you are probably looking at paying the full insurance premium out of your own pocket to be on 'COBRA' for several months.

Staying with the old company is a safer bet because according to the law, your [permanent] job is 'preserved' for one year after a serious illness. Your current employer has the obligation to accomodate you in your current position. It's also a more familier environment where any cognitive decline would not have too much impact on your job performance.

Having a new challenge in the brave new world will probably give you a sense of purpose and excitement about life. Sometimes a traumatic experience will make us feel 'alieneated' from our environment - perhaps that's part of reason why you feel so 'different' about your current job. You might want to talk to a close colleague to help you figure out if it is just your perception or the atmosphere has indeed changed.

[Mary Anne in TX]

They can tell you within a short time. The place I go makes us wait until the mamo is read and to see if more tests are needed or if we are clear. Ask for that.
Maybe make a list of reasons to and not to or a list of if the answer is _______ or _________. Wish it was easier, but surely am glad you have a choice! ma

[Rich66]

I can't address most of the career issues. But I'll empty my head on one thing.

This will seem extreme. But given that a full body PET/CT is seemingly the current gold standard for one shot detection of metastasis, might be the best peace of mind money (or insurance) can buy.
If we were to continue down this path, a brain MRI would complete the picture. Here in Wisconsin, there's an MRI facility that does them for around $600.
I still remember mom's first onc telling me scans weren't necessary unless there were symptoms of recurrence...wouldn't change treatment or outcome if caught earlier.

But..came to learn that's not true. Early detection can be a benefit in recurrence as well.

Insurance probably won't go along with this. But that doesn't mean it's not possible or worthwhile.

[PatriceH]

Yes, I had taken the past two days off work. I had the 2nd interview on Thursday came back that afternoon to a phone message, which I delayed responding until this morning. I did spend a few hours with a counselor pinpointing my temperment, which was spot on. So I did confirm that I do have strong clarity about who I am. I AM in the right profession, just not in the right place. I've been talking with a friend, and my sister. Today I spent cleaning, which is good for the house and good for the soul. I cried. But I also took myself out to lunch to digest the packet from the new opportunity with respect to benefits, etc. I sat in the park and did my homework from the counselor...made a list of pros and cons. Talked again tonight to my sister and her husband.

I do agree that serious decisions should wait until a year after life-changing things, but I also know that obviously as evidence by my seeking out advice here, that I am not being compulsive. I'm analyzing this thing to death That alone gives me comfort.

I'll keep watching for other advice. Thanks for your input.

[BonnieR]

It does indeed sound like you are bringing alot of input to the situation. And seeking "second opinions". Maybe you are at a point where you sit back and wait for one of the "signs" I mentioned. I am not given to magical thinking but I do believe we get answers from outside sources sometimes. Moment of clarity, so to speak.
Keep the faith.

[Jean]

Patrice,
Without knowing the type of work you do or the fine details, my response is from what I read in your post.
You sound unhappy and not fulfilled at the present job.
Maybe you have been feeling this way longer than you realize and your dx. and trt has made you more aware of realizing that we waste many days in jobs and realtionships that we are not satisfied with but just continue to do our best and make the day.

Since my dx. I have made many changes and mostly due to my dx. I no longer waste a moment. I do what I enjoy and I no longer fear much of anything since bc.
Strange as for me bc was my strongest fear and now that I have delt with it, well it has made me stronger.

Maybe your dx. has brought you to a career point where you are comfortable to make a change. Of course you have to consider your insurance. Can you afford to make payments to cover yourself during the start up time.

To a great extent we do have a loss of who we were after bc. If we are lucky we grow from it and find new areas of our life to be successful with. It sounds from your post that you are ready to move forward and take on new adventures that will bring positive feelings.

You do not sound happy in your present job and my 2 cents worth....we deserve to find what makes us happy and go get it. We have earned it. If bc has taught me nothing else....don't wait to be happy...make yourself happy. I certainly do not think you should just jump at any or all opportunities. But if this new career opportunity is sound and offering what you are seeking,
then you have the answer. But you must be wise and make sure you have insurance coverage. The odds of recurrence are so tiny...after radiation your mammo's can show negative results, but that is normal after treatment as your dr. already explained.

I wish you all the best in your journey.
Kindest Regards,
jean

[bejuce]

This thread could not have been more timely, for I am at a career crossroads myself and also have an outstanding offer for another job that I have to reply to early next week.

Before BC, I had what I thought was the perfect life/balance working at a 70% schedule as an associate at a law firm plowing through the ladder and really enjoying my work. BC hit me like a ton of bricks in 2009 and I went on disability, taking almost a year off just when the economy hit the law firms pretty hard.

When I talked of going back to work when radiation ended in Oct '09, my supervisor told me that things were really slow and that I might as well wait for 2010 to roll around to see if things got better. I waited and in January of this year I was offered to go back not at the 70 % schedule, but as an hourly employee, which meant I could have all the flexibility I needed but also that I would only get paid for each hour I worked without any benefits whatsoever (luckily I'm on my husband's insurance so that was not an issue for me). Since I have 3 kids to take care of, I didn't mind the flexibility so much at first.

But here's what happened - people I used to work closely with never even stopped by my office to welcome me back, they simply ignored me and assumed I was no longer productive and could no longer work on their projects. I barely had any work to do because either (1) there really were not enough projects going around to keep everyone busy or (2) people didn't trust I could do it anymore. The environment left me feeling very sad and lonely when I went to work and I basically would go up to my office and work away without sometimes any human contact besides the good morning and goodbye to my secretary. My immediate supervisor was being supportive, but then when work dried up over the summer he too had no work for me to do.

So I finished Herceptin at the end of July, went on a summer vacation with my family in August, and when I came back I started getting more work all of a sudden, but the work I got (and have been getting) is work that nobody wants to do or is too busy to do. I feel trapped, and don't believe the situation will improve. I feel that I no longer have any shot at making partner, and will always be viewed as the one who got cancer. Some people still avoid me and don't know what to say when they see me in the cafeteria. It has been somewhat shocking to me how some people have reacted to my BC.

In any case, to cut this short, I now have an offer at a big public company to work full time with all the benefits. It should be easy for me to jump ship based on the above, but here is where I have doubts: (1) should I assume I have lots of years ahead of me and still can have a meaningful career or do I just work the hours needed to cover our expenses and spend the rest of the time creating memories with my kids? (2) is it worth it to give up my flexibility to work full-time with only 2 weeks vacation? (3) is it worth it getting an after school babysitter to watch my kids? how do I overcome the feelings of motherly guilt for not being with them after school and taking them to soccer practice and so forth? (4) what is the point of working so hard anyways now that I've seen the light and changed my life perspective?(5) should I quit it all together and just be with my kids and do breast cancer advocacy? And if so, can I be happy doing that given that I've invested so much time and effort to be where I am?

As you can see, Patrice, you're not the only one struggling with career issues post BC. I think a lot of us may be on the same boat. It's very distressing to go through a major illness and have everything that you've worked for somewhat collapse because of it. I recently read an article sent to me by a friend at Salon.com that talked about the difficulties of surviving the survival after a cancer diagnosis. It was very interesting and gave me lots to think about. You can find it here and I recommend you check it out (scroll down the page to read the letter and the answer to it).

In any case, sorry if this is too long. But I too have to make a major career decision early next week and wanted to share this with you if only to show my support and companionship in this battle that we fight.

I wish you a clean mammo on Monday and peace of mind in making your decision work for you,

Marcia

[PatriceH]

Marcia: So glad I could start the conversation. My response to that article -- BINGO! and to others..Yes, I have been unhappy a long time. The situation hasn't changed, I have. Yes, I am ready to burst with a sense of sitting in a cubicle just wasting my time...getting all the leftovers. I'm not necessarily interested in climbing any later, but I want to use all the talents God gave me...I want to be who I was created to be in the fullest. That is important now, more than ever.

One thing for sure...We're all in this together. I'll be praying for you too. God does give gifts of clarity.

[Becky]

Patrice

There is nothing worse than being unhappy in your job. That said, you can always accept the new job Monday but just don't give notice at your old job until you get the results of your mammo. Also, a quick call to your onc (since your onc knows of this possible career decision). When you get the green light from your onc (and you will), then you can move forward at your current job and give notice.

[joyce lutz]

I would go for the new job BUT be aware that should you need it, you will not have the protection of FMLA leave until 12 months from the start of your new job and therefore your job will not be held for you (via the regs any way). Also if you aren't on your husband's policy you will need to go on COBRA until the insurance (assuming they offer it) at your new company kicks in. AND you want to make sure what type of insurance they offer. Who is the carrier? Are they as good or better than your present carrier etc. If you are on your own policy and not your husband's then it may be a good idea to go on his in any event and have double coverage if you can afford it. If you aren't on your husband's policy and are on your own make sure you request a Certificate of Portbability from your current insurance carrier. This establishes that you have alread met the pre existing condition clause and aren't required to do it again. Let us know what you decide and best of luck! Joyce

[fauxgypsy]

I believe that you should not let cancer hold you back. Check your present insurance and check the insurance that they offer. I wish that was not an issue but I know that it is. If you can swing it, that would be wonderful. Other than the insurance, make the same decision that you would have made before. Don't let cancer rule your life. Of course, that is my opinion. In the end, make the decision that is best for you. Good luck!

Leslie

[Barbara H.]

I would take the new job. I was originally diagnosed in 1998, and then diagnosed with mets pretty much through out, including the brain. I still work full time as a 5th grade teacher, and continue to take courses. Even with stage 4 breast cancer, I refuse to give up working. I have taken off less time than others who are healthy, and have always had great support. I can't believe that you are receiving no support. Everyone eventually has ups and downs in life, and I wouldn't want to be living the life of your current colleagues. I sounds like a very unhealthy atmosphere. If you feel the new job is right for you, I would accept it. We also have teachers who have been hired at our school after a cancer diagnosis. They are productive and supported both by their colleagues and the parents.

You have to decide if the job you want to accept is right for you. I did take off time to be with my three children when they were young, but my middle daughter has autism. Nevertheless, i have noticed that the students in my classes whose parents work are very well adjusted and do well in school.

Best of luck with your decision.

Barbara H.

[PatriceH]

Earlier this year I made a Vision Board - pictures of things I want in my life. pictures of dogs (do more with dogs - I train and compete and raised a service dog through my own treatments, want to do pet therapy some how...picture of bible (want to be more in God's word)..picture of two ladies who are obviously friends (want to put friends and family higher)...dollar signs with down arrow (work on reducing debt)...a certain number (wanting to lose weight)...people in business clothes bouncing on those hoppy things (have more fun at work or find work that is fun)...

So far, my year in review:
1) do more with dogs - check. Got a young dog who will undoubtedly be a star!
2) God's Word - making progress
3) Family and friends - making progress
4) reducing debt - making progress
5) That "certain number" only 10 down, 10 to go!
6) Fun at work...interesting that with just 2 months to go, this is the one area left on the list that needs attention.

Hmmmmm?!

[BonnieR]

Hmmmmm. Maybe that's your sign.

[Trish]

I'm glad you started the thread too. You seem to have things pretty well under control and have had some great advice. I'm really impressed by people who have mets and still work full time. I worked 3days/week and had 3 kids when diagnosed. I had a lot of sick leave and did get back to work for a couple of years post met diagnosis. I quit when I realised the treatment was taking it out of me and I wouldn't be a reliable contributor. I was a Speech Pathologist, loved my work and had very supportive colleagues. I still see many of them and have lots of regular contact with supportive friends. I am working on a project with a former colleague which gives me some work focus but at a leisurely pace. Have loved being able to prioritise my kids (teen and young adult) but after 2 years have just started to miss work a little bit. The hard part of mets is not being able to plan (I have a very "guarded" prognosis). I agree with those who say do as you would without cancer-you have had state of the art treatment (I missed out on having herceptin at early stage) and every reason to hope for no recurrence. It seems to me you are using your cancer experience constructively to re-focus your priorities. Good on you. Good luck with the decision.
Trish

[Barbara H.]

Hi Trish,
You give an excellent perspective on the issue of working. I too did not have Herceptin when I was diagnosed in 1998. In spite of having 7 out of 9 lymph nodes positive, it took six years for me to be diagnosed with Stage 4. As a result of my daughter's wedding, I had brain surgery with focused radiation and then went on Herceptin alone. It completely put me into remission and lasted to for 1 1/2 years. To this day I feel that I would have had a good chance of no progression if I had been able to have Herceptin after Chemo. I then had Navelbine from April to about November. After that I was on Herceptin alone for a few months and went off of it to try to get into the weekly Phase 1 TDM-1 trial. I was on that for 2 years, and a year ago I had to go off of it because it was causing lung inflammation. For the past year I have been on Tykerb/Hercepin. My CEA is less than .5 and my CA27/29 stays below 20. Because I had so many scans during the TDM-1 trial and am doing so well, I refuse to have any scans as long as I do not have symptoms and my markers remain so low. So far I have been able to rely on them. The reason I do not want scans is because I am hoping that the eventual development of targeted therapy will keep me around longer, and I do not wish to expose myself to more radiation than is necessary. I know that when I my markers begin to climb, or if I decide to go on a trial in the future I will have to be scanned.

The point that I getting at, is that targeted therapy has allowed me to have a pretty good quality of life, and for the most part has worked. Therefore it is relative easy for me to continue to work. I was younger when I had AC-T, and I continued to work because I knew that the time I was on it was limited. However, if I were to go on an endless road of difficult chemo drugs, I would also have to stop working.

I looked at your profile and can certainly understand why it would be difficult for you to work. This is one of the reasons that I am so upset that the FDA did not have the compassion and understanding to fast track T-DM1. It is truly a miracle drug when it works, and it allows the people who are on it to lead a normal life.

Best regards,
Barbara H.