Vocational rehabilitation - Helping to manage long-term conditions

Laura was first diagnosed with Crohn’s disease in 1988, but has generally been able to manage her condition with medication and by adapting her diet. However, a number of severe flare ups have needed major abdominal surgery, requiring time off work for her operations and subsequent recovery.

After surgery in March 2018, Laura started to experience different Crohn’s symptoms, including fatigue and joint pain. Her consultant prescribed an infusion every eight weeks, which initially led to an improvement. However, a blood test in August 2019 revealed a need to double the infusion dosage. Unfortunately, the first double-dose infusion caused a number of side-effects, including hot flushes, headaches and increased joint pain. The second infusion made these symptoms worse, which also began to affect Laura psychologically.

Her manager spotted that Laura was struggling and arranged for her to work from home more often. While this helped her cope, the infusions continued to take a toll. The third left Laura with difficulty swallowing and increasingly fatigued. She also had trouble sleeping and suffered dizzy spells.

On top of managing her condition on a daily basis, Laura then had a severe reaction to her medication, resulting in swollen glands, a recurrent cough and even more worrying – difficulty breathing.

Recognising Laura was struggling with the side-effects of the medication and the impact on her physical and mental health, her employer contacted us at the end of January 2020 to ask what we, and they, could do to support her recovery and help Laura return to work when she felt she was ready.

Within three days of the initial contact, our Vocational Rehabilitation Consultant, Shelley Beaumont, had a conversation with Laura so she could fully understand her condition, her goals – and just as importantly, her concerns for the future.

Shelley created a graduated return to work plan for Laura and her employer, one which spanned seven weeks and gradually increased her duties. It also included regular catch-up calls between Shelley and Laura to discuss her progress and recovery, along with results and advice from Laura's medical teams. Any adjustments required while Laura discovered what she was capable of doing, and where she needed extra support, were also taken into account.

Following Laura’s return to work, the plan was adjusted slightly to tackle some initial problems. Back pain, often associated with certain digestive conditions, became an issue, so Shelley signposted her to the Health and Safety Executive’s website which offered a comprehensive self-assessment on her desk set-up, and offered hints and tips on how to arrange her workstation for the best possible comfort.

After her first week back, Laura found she felt fatigued, so her working hours were slightly adjusted for the second week. She was also given advice on how to properly pace her activities so she didn’t attempt too much, too soon to help prevent a recurrence.

Her employer also agreed that she should work from home on days when she had hospital appointments, giving Laura the flexibility to accommodate both her duties and her time away as she saw fit.

As Laura continued to make good progress, she and Shelley had a conversation every fortnight to check on her progress. To accommodate the government lockdown following the coronavirus pandemic, Shelley advised Laura how to manage potential fatigue and back pain while working continuously from home, and her employer also provided Laura’s own chair from her office. In April 2020, Laura returned to full-time working hours.

"I've been extremely poorly and at times I've felt that I wouldn't recover from my illness. This has made me depressed, emotional and unable to see a way forward to return to work. Then along came Shelley.

Shelley made me feel like she truly understood everything about my illness and long-term health condition and also how I was feeling. Her expertise in supporting me with a workable return to work plan was outstanding.

I received regular calls throughout my phased return and Shelley had a genuine interest in what I had to say about how things were progressing. I was listened to, changes were made, and I felt fully supported with getting back to my normal routine.

She even provided advice when other issues became a problem. I drew an enormous amount of strength from Shelley's exceptional support and that allowed me to feel more positive about what I was trying to achieve".