Recurrent Lymphoma

Medical consultant with lymphoma – case study

History

A medical consultant, with a past history of lymphoma, was recruited to a part-time post to set up a new service. It was likely there would be opportunity to increase sessions in the future as the service developed.  Unfortunately within two years of starting in post she had a recurrence of the lymphoma which required extensive treatment. Recruitment of a locum was required for a year to manage workload.

Occupational Health Assessment and Advice

After several months of absence a return to work was planned with input from Occupational Health. At assessment the main problems were fatigue and muscle wasting. She was frustrated by slow progress and the length of time required to undertake daily activities. Often overexertion one day caused excessive fatigue the next.  Sedentary activities such as reading a journal or meeting friends were reasonably manageable, although interacting with people was tiring.

In addition her dominant hand function was affected by a fracture which occurred after a fall. This meant her writing and typing were very slow and taking notes in meetings was problematic.

Adjustments

A phased return, initially to part-time non-clinical project work (8-10 hours/week), was planned, taking these factors into account. There was the option to work from home to reduce the need to travel and allow her to pace work, spreading tasks over the week when necessary. Stamina continued to be compromised with limitations in ability to climb stairs. She was paid only for her hours of work. 

Hours were gradually increased, along with clinical duties as strength and stamina returned. As she had more difficulty functioning in the morning, she initially worked afternoons in a supernumerary capacity. Due to ongoing limitations with standing and walking it was advised that initially clinical duties were restricted to clinic work in one location. She was not required to undertake on call work at this time. Attending external meetings and conferences was found to be demanding and rest days needed to be organised following these.

A Dictaphone was provided and notes could then be typed up. She was not required to be the main minute or note taker at meetings

She was also encouraged to increase activities, including walking for exercise, outside work to obtain a proper work-life balance, even when only working 8-10 hours. This was beneficial to her mental wellbeing.

Review

The work pattern was variable as it depended on when conferences and meetings were planned. However she found it manageable and was still able to pace work to balance meeting her health needs and job demands. She had some memory problems associated with the chemotherapy which slowly improved. This was not associated with clinical mistakes.

Stamina gradually improved such that she was able to walk on the flat and climb a flight of stairs without difficulty. Climbing hills remained a problem. She was encouraged about her progress and reassured that timescales for full recovery would normally be considerable after this type of illness and treatment. Ongoing support from Occupational Health was ensured for several months. She eventually resumed her contracted part-time clinical role.