12 hour shifts and Radiation treatment

sammi2006

Hi!

I am going to be starting radiation in about 4 weeks and I have been cleared to go back to work when I start radiation. I work 12 hour day shift from 6:45 am to 7:15pm as a RN on a busy unit. I have been off work since last July because of chemo, surgery, and being neutropenic. My radiologist and oncologist have said that radiation should cause some minor fatigue and that I should be able to work through it, but I am not sure about that. I am wondering if any of you that have gone through radiation can give some advice?

Hopeful82014

The trouble with radiation is that some of the side effects are rather unpredictable and vary wildly from one person to the next. Because it can cause fatigue I'd be wary of 12-hour shifts unless you can be assigned light duty. Some people have no fatigue, for others it's cumulative and builds over time. I found it worse towards the beginning - go figure. I worked about 3/4 time during radiation but I have a desk job and primarily telecommuted during that time. A 12-hour shift in a busy unit PLUS a commute sounds like an awful lot to take on, frankly. I hope you will have some flexibility in how you ease back into it and the option of adjusting as needed. Good luck.

xxyzed

I did not return to work until about six weeks after I completed radiation. I had been off since the commencement of my treatment.

Radiation was inconvenient as you had to go in every day for a month but they could not tell you what time your appointment would be until the week before. You could make requests and they tried to accommodate as much as possible. Some days I also needed to see the nurse or radiation oncologist. Again this added time to the visit. It would be difficult to fit this in around a 12 hour work day.

Yes I got tired and would randomly fall asleep in the afternoon if I sat down. If I tried to do too much my feet would get tangled up and I would fall over. I had a number of falls when I went back to work after completing my treatment from exhaustion.

The radiation keeps burning for two weeks after it has finished. My skin split at the two week after mark and I had raw open wounds that took about a month to heal. I found it difficult to dress the wounds properly due to the sheer size of the effected area and found clothing made it worse.

I couldn’t have worked through radiation without causing myself significant distress. You may be able to but you won’t know until you try. If you have been off work for the rest of your treatments it would not be advisable to go back to full on work. If you could negotiate shorter hours to start back you could try and see how you feel but personally I would wait.

Spookiesmom

Good point about your skin breaking. As RN you will be exposed to all kinds of germs, higher risk for infection. May or may not happen, my Skin broke.

Rad treatment in itself isn’t tiring. It’s going Every. Darn.Day. It’s a bit of let down after the whirlwind of tx, still recovering from surgery, takes a while longer than you think to recover. Nap attacks are common.

coraleliz

I recieved RADs to both sides & both axillas. The fatigue never materialized. I work 12 hour shifts. I worked both weekend nights & one other night. The RADs center was within the hospital & the techs knew I had been up all night, so they got me in first. If you can coordinate with the techs, it might be possible to pull this off on a 1/2 hr lunch break. But if you can work the weekend, it will only be a problem 1 day week. I ran every day during RADs. I didn't notice any fatigue. My skin didn't fair so well.But I found working & keeping busy kept my mind off the blistering, redness,itching,soreness(I'm sure I'm leaving something out). So, you might be able to pull this off. Hoping your skin tolerates it better than mine.

sammi2006

Thank you ladies!

I met with another radiation oncologist (one closer to home) this week and she has treated several people where I work. When I asked her about going to work she said that if I really wanted to go back, she would fill out paperwork needed for me to work light duty while on radiation. Her worry is that I haven't been able to work through chemo, I have been too tired, anemic, and for the past two months despite getting neupogen-I am still neutropenic, so she is afraid of the risk for infection. She told me that she would prefer that I not go to work during rads, and that she wants me to use that time to get used to being on my feet for 12hrs at a time so that when the time comes, I will be ready.

Unfortunatly the rads center is not in the hospital and is only open 8-4:30. Also my job wont let me come back part time, they want me back full time. Luckily with my leave of absence I have until July 31st. My last taxol is friday, yay! I am going to ask my MO tomorrow when I can be okay to get back to the gym, I think that will help. In the meantime, we have had gorgeous weather here, so I have been going out for walks on my good days!

jo6359

Are you enclosed in a machine for rads? I don"t understand the specific process of radiation treatment. Would you explain it please?

sammi2006

I don't think so, I haven't started yet. A friend kf mine is undergoing radiation for lung cancer and recorded one of her treatments. She was laying on a table while a machine rotated around her.

Hopeful82014

jo6359 - there is quite a bit of info on radiation therapy on the main BCO site (as well as some others such as the American Cancer Society and Komen).

Kcrab

I worked night shifts. My boss let me work 11p to 7a 5 days a week. I would leave work, get my radiation treatment then head home to bed. It was very doable.

jo6359

I will check Komen's site. Thanks. I haven't been told I need radiation yet but based on my incomplete path report it seems likely.

gb2115

I think if you can swing the time off with your leave of absence, definitely consider it. Those are long haul shifts, with physical work, and radiation is long haul treatment. You will be tired and will need rest to heal your "cooked" breast.

I worked but have an extremely flexible work schedule, and was right across the street from where I had treatment. And worked short days a lot of the time. Even with that I was wiped out and almost went on FMLA. Honestly the --only-- reason I didn't is because I wanted to save vacation time for actual vacation. I would have preferred to be off.

For radiation the machine (linear accelerator) rotates around you. No being enclosed or claustrophobic. Side effects were not fun but the actual treatments are easy.

Outfield

Hi Sammi, I also work in healthcare. I did start start back working during radiation, but only part-time and my job was not as demanding as a floor RN. There is no way I would have been able to do that. I just did not have the stamina. I think the big issue is where you are starting from. Radiation is injury, and injury causes all those cytokines to race around making you feel tired and puny. How bad the burns are on the skin varies, but what doesn't vary is that you're frying internal tissues too so it's not all visible. If you are in general feeling pretty good right now and have some cushion to be a little more fatigued but nevertheless still be able to work, that's different than if you're still struggling to get back to speed. If you walked in today could you work a 12? Could you work an extra hour or two if someone called in sick? If you don't have that kind of reserve yet, you may be pushing it.

Katiejane777

I’m currently having Radiation Therapy. I did not need chemo and only had a lumpectomy. I have worked during Rads but only a max of 3/days a week so far. I have been doing everything I normally do at home but I am slowing down as I come to the end of treatment. I don’t work 12 hour days but my job involves lifting prams, kids and walking a lot. I played Laser Tag yesterday but it hurt my boob a bit lol. Stupid harness thingy. (I do supervised contact visits for foster kids and the parents they have been removed from.) I reacted to RT pretty much straight away so I’ve been sore, red and very swollen for most of treatment. I would think with your job if your skin breaks down it would be very uncomfortable for you. What has helped me is being able to moisturise, rest and put cool cloths on my breast on the days I don’t work or when I have a short day. All the best x

CarrieMichelle

I’m concerned about the degree of fatigue I’m having, as well as a bit of nausea. I had 2 lumpectomies in November and December, then radiation in January. My last treatment was a week ago. Radiation is not supposed to cause nausea, so why do I have it? I usually work 12 hour day shifts in intensive care, but I just can’t....so exhausted that I have to rest after a shower, again after getting dressed and brushing teeth. I only had 20 days of radiation, and the doc said this much fatigue should not happen from that so he checked blood work (CBC, basic metabolic, thyroid panel) but its all good. Hinting about depression/anxiety. I had just returned to work, part shifts at first, after collapsing at the desk. Full work up, 4 days inpatient, neurologist diagnosed stress induced silent migraine (neuro symptoms without the headache), so I was off the month of December for physical therapy. Seeing a psychotherapist for stress, but she thinks I have a good handle on it and doesn’t know what else to do with me. (I did have a bout of clinical depression a decade ago with a divorce, and I don’t feel depressed now, just frustrated; anxious to get my life back.). I’m not malingering, I really want to function, so any input would be helpful

Moderators

Hi Carrie, and welcome to Breastcancer.org,

We're so sorry to hear you're dealing with this terrible side effect of cancer and its treatment -- fatigue is a very common effect of both diagnosis and all kinds of therapy associated with breast cancer and can certainly be very debilitating. You may find some really helpful information on the main Breastcancer.org site's section on Managing Fatigue, including ways to manage it.

We hope this helps, and that you start feeling better soon.

--The Mods

gb2115

Hi Carrie, I most definitely had nausea from radiation. The radiation staff denied it was possible, said I had the flu (for 6 weeks with no other symptoms yeah right), saw my medical oncologist who said it can absolutely cause nausea, said she hears it a lot.

I can't remember how long it took to go away after radiation finished, but it eventually did. Hang in there!!

sammi2006

Thank you gb2115, Outfield, and Katiejane for your input. This week marks two weeks after my last taxol and I am just now starting to feel a little more like my old self. I have decided to take my radiation oncologists advice and return to work after rads are completed. She has told me that during this time I need to work on increasing my stamina so that I will be physically ready to go back. I am going to be doing hypofractionated radiation with 15 rads and 6 boosts.

Carrie-I am so sorry about the nausea and fatigue you are having. I hope it gets better soon!