"No, I'm not just f*cking tired, thanks". This tends to be my mental response when I know for a fact that someone thinks I'm full of s*it about fatigue. I can see the look take over their face, they think I need a nap and I'll be fine. "Who isn't tired?!" News flash: cancer patients, we're fatigued. And there's a huge difference.
Fatigue is defined by the National Comprehensive Cancer Network as "a distressing persistent, subjective sense of physical, emotional and/or cognitive tiredness or exhaustion related to cancer or cancer treatment that is not proportional to recent activity and interferes with usual functioning".
It's a menace, it's unstoppable, and you can't fight it. I actually get 'Resting Bitch Tone' when I'm suffering from fatigue, and become completely unable to emote. And while resting may help, fatigue results in the inability to do pretty much anything for me, no matter how many "positive thoughts" people tell me to think.
I was fortunate this past weekend to attend Living Beyond Breast Cancer's Young Advocate program. It coincided with their annual 360 series, this one in particular focused on fatigue and how to fight it. (They actually keep these recordings on their site, so watch this space for when this one gets uploaded!)
The panelists included three survivors: Dr. Shockney, Samantha Horn (a badass friend I'm lucky to have in Baltimore) and Jamil (a metastatic thriver who was in our class!). So now that we have that out of the way, let's get to the exciting bits!
Advice on preventing fatigue:
- Powerwalk 30 minutes a day - it's been scientifically proven that getting your butt out of the door for a brisk walk can stave off fatigue. Can't muster 30 minutes? Start small and work your way up. You don't have to start at 30, just try to incorporate some type of physically activity.
- Avoid caffeine and alcohol, and eat a healthy diet - also known as 'BOOOOOOOOO' - but it's legit. If you have to have your morning coffee (guilty) then keep it to the morning, and never drink caffeine past 3pm. If you do, you're setting yourself up for a fatigue frenzy. If you want to partake in libations, do so moderately, and expect it to trigger your fatigue. If you're able to cut out both completely, then you are on your way.
- 7-8 hours of restful sleep each night - also known as 'But have you heard of Tamoxi-somnia?!' This one seems easier said than done, but it's a big one. Creating a routine and figuring out how to catch these hours of zzz's will positively impact your life. For me, I find that if I exercise regularly, I'm able to sleep more soundly throughout the night, and get as much as I need.
- Write down your worries! Journalling can be an effective way to soothe the mind.
These all seem pretty obvious, right? But how many of you are actually sticking to these? I know I'm not. I'm guilty of bad habits, including too much caffeine and not enough sleep. I'm a work in progress and I bet you are too. If that's the case, don't be too hard on yourself, we'll find that balance right?
Just recently I spent several days in a fatigue slump. I was able to do what I needed to, to get by, but I spent most of my time in my house, in my pjs, tired constantly, the fatigue never seemed to leave. According to Dr. Shockney - when you're in this funk - you HAVE to get up, change your clothes, put on makeup (if that's part of your regular routine) and persevere until you're back to doing what you do everyday. Fatigue is a black hole, and it can suck us in. Even when it feels extremely difficult, force yourself to get back to a solid routine.
However, if it does feel impossible... if you feel severely depressed, and you are unable to function through your everyday life and responsibilities, seek out your medical care team and communicate clearly with them. There is a difference between fatigue and clinical depression, and I'm not qualified to make that call... so please please let your doctor know, and find the next best steps there.
I hope this helps. I know I sure got a bit of a wake up call (OMG PUN INTENDED) and plan to incorporate some small changes in my life. Yes, small. Because that's all you need to do to try and fight the fatigue.
For a boatload of resources and literature on other issues affecting breast cancer survivors, please checking out www.lbbc.org (and sign up to their mailing list) - they are amazing!
Here are some quotes from the evening:
"Fatigue feed fatigue"
"Quality of Life coaches can help"
"Power walking + power naps"
"You bring the baggage of your life to the disease"