Fatigue The word fatigue can describe a range of feelings. Fatigue affects different people in different ways. Your fatigue may be due to the cancer itself, or the result of symptoms caused by the cancer. It can also be a side effect of treatment for cancer (chemotherapy, radiotherapy or medication). You may feel an overwhelming tiredness and everyday activities may take much more effort than normal. You may feel as if you want to sleep more than usual (and when you do it may not give you new energy as expected). Some people have described their fatigue as feeling like they are wading through mud, or having a fuzzy, murky head. Whilst you want to do something, your body may not be able to do it. You may notice feelings of weakness in your muscles and limb heaviness when you try and do things. You might also notice sleep changes; sleeping much more; not being able to sleep, or needing to sleep in the day. You may find you become forgetful or that you can t concentrate on things for as long as you used to (for example you may no longer be able to read a chapter of a book in one go). You may also find that when you are feeling fatigued your other symptoms seem worse, and you feel less able to enjoy things.
Fatigue can interfere with what you would like to be able to do. Your fatigue may be mild or severe, but will have an impact on your day to day activities.
Your Energy and Fatigue Everyone has a fixed limit of energy that s available to them to use on any one day/or in any one week. This amount varies from person to person everyone is individual. Since your diagnosis, and any treatments you may have had, your energy levels may have decreased. It is important therefore, that if you are going to use your energy wisely you know how much of it you have at your disposal. By sticking to your limits rather than using too much you may find that you have much more consistency in your days and abilities. The energy we have and use can be categorised into three main areas: Physical Thinking Emotional At any one time you may use up more energy on one kind of activity than another. For example, if you are walking back from the shops you are mainly using physical energy, but if you are watching TV you are probably using mainly mental or emotional energy. However, it is important to remember that we don t have a limitless supply of energy. For example, if we are using more energy on emotional activities we may have less energy for physical activities
Recharging your Battery Rechargeable batteries have a set amount of energy in them. As the battery is used, its energy decreases. You then plug it into the electricity to re-charge the battery to full energy capacity again. It s the same with your energy. Sleep or rest is like plugging you into the electricity and topping up your battery of energy. During the day, the things you do drain your battery of energy. Before you were affected by fatigue: You would drain your battery of energy by doing activity and it didn t take too long to recharge your battery. Since you have been affected by fatigue: You have a smaller battery of energy available to you. Sleep doesn t always help to recharge your battery. If you stop and have lots of rests in your day before you get too tired you may find you can expand your available energy over the course of the week.
The good news is that there are some strategies which can help you manage your fatigue. This can help it to have less impact on your life and help you feel more in control. Below is a list of some of these strategies that can help you cope with fatigue. Prioritise- Find a balance between what you want and need to do. o Does it all need to be done? o Does it need to be done by you? Plan- Write a list. What time of day are your energy levels highest? Keep an energy diary to assist you. Pace Allow extra time to get things done. Always stop before you are overtired. Balance your day between activity and rest. Break tasks down into smaller tasks and take regular breaks. Use Relaxation techniques e.g. Breathing exercises, Muscle relaxation, Guided imagery Position- Make the task easier. Can you sit instead of standing? Reduce bending, reaching, walking or pulling by re-arranging your environment. Permission- Give yourself permission to do things differently. Learn to say no and tell others how you are feeling.
Exercise can seem exhausting. However, small amounts of regular, gentle physical activity may help to relieve the symptoms of fatigue by boosting your energy levels and mood. Examples of appropriate activities include: o shopping, cooking, cleaning or gardening o walking, swimming, t ai chi, yoga Eat a well balanced diet and drink plenty of liquids. Avoid reliance on stimulants and supplements. These include: caffeine, alcohol, nicotine based products, refined sugars, and non-prescribed food supplements Sleep Try to get a good night s sleep. Have a daily routine. Set an alarm, even on the weekend and get up as soon as it rings! Make your bedroom comfortable, dark and the right temperature.
Sources of Support If you would like further support for coping with your fatigue you can find this from the following services: Free online self help resources: http://www.ntw.nhs.uk/pic/selfhelp/ Your GP (you may be referred to the surgery s counselling service). Macmillan Cancer Support: www.macmillan.org.uk or 0808 808 0000. Tenovus: www.tenovus.org.uk or 0808 808 10 10. Leigh Bodilly, Velindre Patient and Carer Information and Support Co-ordinator: For information on support services in your local area 029 20196132. Velindre has a group program aimed to help you to manage fatigue. Your Consultant or Clinical Nurse Specialist can provide you information about the services available to you and request a referral to the group programmes or Clinical Psychology and Counselling team at Velindre Cancer Centre.
This leaflet was written by health professionals. The information contained in this leaflet is evidence based. It has been approved by doctors, nurses and patients. It is reviewed and updated every 2 years.