Fatigue:


So...are you tired of being tired yet? I know I am... It seems like it never ends. Don't you feel frustrated each day as you tire easily from the littlest things? Do you get frustrated by people who don't understand that you're tired all the time so when you say you're tried you're really exhausted? I haven't lost all my hair even after 10 chemo treatments, so I still look pretty normal. I think that that makes it even harder for people to comprehend just what the chemo, let alone the disease does to the body.

Yes, fellow Hodgkin's patients, we have been hit with a double whammy. Not only do we have to deal with chemo, which fatigues us, but our lovely disease is one of fatigue to begin with! So, we were tired even before they made us tired! But we can help ourselves somewhat. And that is what this page is all about.


Causes of Fatigue:

The level of fatigue that you feel will be determine in part by the stage of disease you have. For example, if you have bone marrow involvement you'll be even more tired than most because your body will not be able to produce the red blood cells necessary to carry oxygen throughout the body. In addition, if any other organ's have been effected, like lungs or heart, you may have trouble compensating for this which will tire you out.

The normal process of cancer can cause fatigue as when cancer cells kill other cells the old cells are now "waste" that the body must work to rid itself of, not to mention the energy the body must use to try and fight the cancer cells.

Pain has been noted as a cause of fatigue because it both takes energy to try and forget about or deal with pain and because pain can keep you from getting the sleep you need. How many of us have been kept awake by night sweats? Fevers take energy to fight. Or prednisone highs? All of this leads to fatigue.

Did someone mention stress? I'm very familiar with stress. I have failed everyone of those "how much stress is in your life?" quizzes that exist at one time or another. Stress of trying to figure out how to cope with the disease, how to handle it with work and family, how to make ends meet, how to pay the bills, how to deal with a loss of job, insurance companies, treatment...I could go on and on. Stress is a leading cause of fatigue!


That's all fine and great, Li, now what do I do about it?

Well, I'm glad you asked....

There are many things you can do to cope with the fatigue. I can't promise you to be rid of it, I haven't found a miracle cure, but there are things that can be done to manage it.

1) Consider getting a temporary handicap hang-tag if you do a lot of walking that could be avoided. Exercise is nice, but if it is interfering with your productivity and quality of life, you may need to rethink this. I got mine because I was walking over a mile to and from school. This led to three hour naps and an inability to focus in class. I can now park next to the buildings and my grades returned to pre-cancer levels and I have more time to do things at home.

2) Have a friend or family member help with the housework. I had a friend come by once a week to help catch up with dishes and vacuuming and take me to the Laundromat. Again, I could have done it all on my own, but if I had I would also not have been able to focus on school or friends as the energy needed to do that would have been used up washing silverware and chasing dust-bunnies. Your friends want to help, let them. Enjoy your time as much as you can.

3) Take a nap. Schedule a nap for an hour a day. Even with the extra help you'll still be tired and this should allow you to stay up later into the evening and still feel alert. If you are continuing to work, I would ask for an extended lunch so that you can both eat and nap. I think that your boss will find you more productive if they give you 90 minutes rather than 45-60. Don't sleep more than an hour though as that may mess up your night sleep leading to more fatigue. Gauge your body. You may only need a thirty minute breather.

4) Remember to rest often. Pace yourself. I find that I allow myself an extra 20 minutes to get places so that I can stop and rest of I need to. When I go to the mall I rest on benches. When I go to the grocery store I buy less each trip or I take someone with me to help me push the cart so that I don't use my energy up that way. Don't stand for long periods of time. That is often more tiring than walking.

5) Remember to rest when you start to feel tired rather than after you are exhausted. It's just like the nausea drugs: if you wait until you feel sick it is too late to do anything about it.

6) Join a support group. This will help you decrease the stress in your life. You can try a usenet group on the internet like alt.support.cancer, or the Hodgkin's Mail List, or maybe a group in your hospital. Anything that helps you to feel better will help you regain energy.

7) Eat properly. I know it is hard, especially with the various chemicals doing odd things, but try. If you eat healthy you will have more stamina and be more alert. If you can't eat because of nausea or taste bud problems, please see the sections on those topics for pointers. Otherwise, try to avoid caffeine in the evenings, taking a protein supplement like Carnation Instant Breakfast Drink, and/or eat a lot of cheese and warm milk. For whatever reason, cheese and milk have something in them that helps you to relax. It's done wonders for me on many an occasion.

8) If prednisone gets you up at night (hungry otherwise) try to take it all in the morning/early afternoon. If you get it all in by 2 p.m. you should have fewer sleep problems. If you have to get up to use the bathroom a lot at night, try drinking less in the evenings and more in the afternoons so that you can be more restful at night.


Copyright 1996, 1997. Last updated July 19, 1997.

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