Nine years out from breast cancer and four years out from her melanoma diagnosis, this cancer survivor still combats her fatigue.
I have basically decided that my fatigue comes from several sources - some of it is cancer-related, some is more broadly health related, and some is emotional stress. What is the fix for fatigue? A pill to pop? A guided meditation? Fatigue can be a complex thing to tease out but it is worth the time and effort to address it.
Here are my suggestions:
First, pursue every possible medical cause. This can involve everything from blood work, seeing an endocrinologist, and seeing a pulmonologist to have a sleep study done. Look at the life stressors that can impact your fatigue: relationship changes, job changes, and the loss or decline of loved ones. Finally, look at the health habits that may be contributing to your fatigue: carrying extra weight and/or not getting enough physical exercise. Unfortunately, fatigue can come from many different sources, some that we have control over and others that we may not. Be thorough and persistent with this step even though it is not fun, especially for cancer survivors, to add more medical appointments to their calendars.
Keep a sleep and fatigue journal for a couple of weeks. Nail down how well you are sleeping. Do you have trouble falling asleep or staying asleep or both? Do you sleep better on days that you exercise? What time of the day finds you tired and fatigued? Right when you wake up, mid-morning, in the afternoon or evening? Are you practicing good sleep hygiene? These answers will help you improve your communication with your doctors. Oh, and don't forget to ask your doctor about supplements like non-addictive quick-dissolve low dose melatonin at bedtime.
Be gentle with yourself. Sometimes it can take time measured in months and years, rather than days and weeks, for fatigue to improve, kind of like grief. It may not go away overnight, no pun intended. Do give yourself the gift of time. Fatigue can be a lingering complaint for cancer survivors. You are not a bad person and you are not lazy.
Consider baby steps. Try to sneak in a twenty-minute walk and note whether your sleep is better on those days that you do walk. Pay attention to your hydration. Sometimes a big glass of room-temperature water improves my afternoon fatigue. Knock off any self-beating for being tired. You are tired. It is what it is. Try not to add emotional angst to your physical symptom of fatigue. For me, I drink caffeine in the morning, take naps on days that I can, allow myself calming distractions (reading or television) when I am too tired to do anything else, and pray.
Finally, identify your personal prime time. Save your tough work for your best moments in the day, and do the easy stuff when you are not up to tackling the more difficult things. Yes, you have your own personal prime time. Persistent use of this strategy has been helpful to me.
At some point, I decided that other than a recurrence, it doesn't really matter which previous cancer event (chemotherapy, radiation, hormone changes, or surgeries) caused and continue to cause me fatigue. I also know the ongoing stresses of cancer survivorship (fear of recurrence, medical tests, doctor appointments) contribute to my own personal exhaustion.
Each of the ideas above may offer some help, yet I continue to work on addressing my own fatigue and I hope you are motivated to find some relief for yours too. While it is true we are grateful to be here each day, it is also possible to work toward living the best life we can each and every day that we have here. Please don't give up on finding answers to your fatigue!