Side-Effects Chemotherapy

The small matter of fatigue


Below is a piece I wrote in my journal two years ago when I was experiencing continuous fatigue and was trying to ignore it until I became completely exhausted.

For such a small word it has such a huge impact on people’s lives following cancer treatment. When I was initially reading the tome of side effects that accompany chemotherapy, I dismissed fatigue as one of the milder side effects to contend with. Little did I know at that stage that fatigue was and probably had been previously influencing all of my lifestyle choices, socially, psychologically and physically.

After my initial diagnosis years ago I had noticed that my energy levels had improved approximately two years following diagnosis. Reflecting now I now understand that fatigue had manifested itself insidiously into my life without me realising it. I rarely socialised as I couldn’t cope with the following day. I did exercise prior to having the kids, a bit more ad hoc afterwards. Energy levels could be great one day and completely depleted the following day. Not realising the situation I adapted and adjusted and moved on with my life.

With this in mind, after my second episode, I had given myself a benchmark of about two years to feel tired and under par before my energy levels returned. Much to my dismay it is now two years since diagnosis and I continue to experience fatigue. It has taken me a couple of months to accept that this could be my new normal. I now realise I have been setting unrealistic, unachievable goals that further exacerbated my sense of frustration and powerlessness at the profound effect a cancer diagnosis has had on me. I refused to be a victim. I was determined to get back to normal. I pushed and pushed until finally I started experiencing palpitations which frightened me considerably. That was when I took notice, my body was screaming at me to stop.

I attended a workshop through the local cancer support group, which has validated for me that fatigue is a huge disabling sided effect of cancer and cancer treatment, but there are tools available to adjust and live a good quality life with a bit of forethought and being kind to oneself.

The reason why I’m writing about it again today is that for some reason the familiar feeling of overwhelming fatigue is back. I now know there is no point in pushing myself. I just have to rest. The fatigue has improved over time as I only have a window of about two to three hours in the evenings now compared to five or six hours a couple of years ago, but today in particular the feeling has been creeping up for most of the afternoon.

Here are some tips to help you get through the tired days as I call them:

  • When you feel overwhelmed with fatigue, all you can do is rest. Try not to judge yourself. Tell yourself that it will pass.
  • Prepare for these periods. When you have energy, do your household chores, prep food for dinner later.
  • If you have a family event or a social night out, be organised and rest beforehand. Plan and do odd jobs every day rather than leaving it all to the day before an important event. I am a great one for lists! I also try to have everything done a day in advance of an event so that if anything crops up, like it usually does, I don’t get too stressed.
  • If you have school age children, rest for 30 minutes before home time. Do absolutely nothing. I find just lying down helps. Sit with your children while they are doing homework. I usually sit after dinner for a couple of hours and am ready again to organise for the next day.
  • Managing smaller children can be a bit problematic. All I can suggest is that you nap with them if the fatigue is particularly bad. Have DVDs or the dreaded tablets/ipads on standby for the times you need to lie on the couch. Enlist the help of family and friends with household chores or consider paid help.
  • It has been shown that exercise does help with fatigue. It is probably better to have smaller periods of exercise rather than one long period. As your body regains strength your stamina will improve. Don’t compare yourself to your non cancer friends!
  • Drink plenty of fluids-sometimes you may be just dehydrated.
  • Have a good sleep-wake pattern. Go to bed at the same time every night. Avoid electronics, caffeine from early evening. Easier said than done I know , but the research does recommend it.
  • For me acceptance is probably the most difficult aspect to achieve because I do still tend to fight fatigue every time. I now recognise this and am working on adjusting and adapting my regimen to allow for these episodes.
  • Be kind to yourself. I find that reflexology helps me. I am still attending my local cancer support centre for reflexology every few months for a treatment and mostly feel energised afterwards.

A lot of the above tips are what have personally helped. If your local cancer support centre has workshops on fatigue management, it may help you gain an understanding of fatigue and help you to adjust to this sometimes debilitating side effect of treatment. Today isn’t a particularly good day for me but I have come a long way from how I was two years ago and I am now confident that once rested my energy levels will return. Time to pamper myself now…

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