Fatigue – Does It Get Better?

By Barbara Cunnings-Versaevel

Fatigue seems to be a common side effect of cancer treatment. It’s the topic of many conversations. Always the question asked is ‘Will it go away?’

In reality, it varies for individuals. We all react to treatments differently according to our own body chemistry and the type of treatment. I recall being advised when I was going through treatment that although it may appear that everyone is getting the same thing – chemo and/or radiation – in fact, all treatments are individualized. No one gets the same amount or the same ingredients. Given that each of us has a different energy level to start with, then it is to be expected that our reaction to treatment will be unique.

I can speak to my own issue with this side effect. At the beginning, even the first few years after I had finished treatments, fatigue would creep up and sideline me when least expected. There seems to be a phenomena and analogy that explains this apparent sudden appearance. We all have an energy bank. Pre-cancer, we may have had a slush fund or reserve that we could call upon when needed. Post-cancer, this slush fund or reserve seems to have been totally used up. Now, when the energy bank gets low, we don’t always notice it, but when it runs out, we are done. There is nothing left.

This is totally frustrating to me – and I’m sure to many of you. As a professional dancer, I trained to push through fatigue. It was how we built endurance. Athletes do the same thing. You push through the fatigue and draw deep on inner reserves. Well, now, this doesn’t work anymore. There simply isn’t anything there. The tank is totally empty.

This is why we need to know how to balance our life in this new norm. It’s learning how far we can go before we’re in trouble. It’s learning to take life at a slower pace, aware that we need to be cognizant that we have a limited supply of energy. We learn to identify the signs that the tank is getting low. Sometimes, there is no warning. You’ll feel great one day and the next day find it hard to crawl out of bed in the morning. A mystery! But usually, there are some niggling signs that all is not as it should be and it’s time to slow down, recharge, and take a break.

As I’m now 23 years after treatment, I forget that this happens. You’d think I’d be smarter, but it is very easy to just be in ‘normal’ mode and not catch the warning. Usually, I’m aware, but when life gets busy and I’m excited about what is going on, I put on my ‘awareness blinders’ and before I know it, I’m into fatigue.

Does it go away?

Well, not really. It gets better. Over time, you build up a bigger reserve in your energy bank. It takes time and patience. Those first few years, if I went on a long walk one day, it had to be a shorter walk the next day. I couldn’t put two long walks together without draining my reserve. For me, that was significant as I was accustomed to walking long distances, jogging, and being very active.

As the years have progressed, if I’m mindful, I can do those long walks, teach dance classes, and all the other parts of daily life as long as I’m getting enough sleep and my stress level is manageable. If those factors start to become an issue, they will drain my energy reserve as fast as a long walk. I can have one great day of activity and getting things done but need a day to recharge – still. There is no overdrive anymore.

There is a Lesson here:

In our North American culture, we thrive on being ‘on’ 24/7.  It seems to be expected. We work hard, we play hard, and we come home to all the responsibilities there. Technology keeps us in the loop 24/7. There is little ‘down’ time. It’s like driving your car at top speed 24/7 without refueling. It will eventually run out of gas and the parts will start to show signs of wear.

Stress is a big factor in illness. Not having ‘down’ time to recharge our energy reserves puts our stress levels on high. On top of that, we often don’t give our bodies the fuel it needs to stay healthy. When we’re in a hurry, it’s harder and takes time to prepare meals so we eat well. Fast food and packaged food become the go-to solutions. Given that there is very little nutrition in these items – they barely qualify as food – is it any wonder that our bodies revolt and run down. It’s like putting extremely low grade fuel in our car. How well would it run?

With cancer, we have been given a huge 2 x 4 learning experience. It’s time to think carefully about what is important in our lives and make appropriate changes to readjust. When we lose our health, we’ve lost everything. We’ve lost our ability to make an income, look after ourselves and/or our family, and be independent. Even with a good financial base, with ill health, there is no joy – you can’t even appreciate it. I still remember this fact years later because it made such an impression on me at the time. It was devastating to not be able to earn an income and take care of my family. It was a tough time.

Fatigue is a Warning Sign

Fatigue, pre-cancer, that is a constant companion is a signal that all is not well. If you pay attention, serious consequences can be avoided or remedied. Ignoring these signs is done at your peril.

Trying to go back to pre-cancer activity levels will be a challenge. Most people are able to get back to a near new norm, but lots of people have had to make other choices. Some have changed professions and selected work that is less stressful and demanding. They have actually gone on to find something that brings the fun factor back into their lives. Others have retired early and found joy in new or renewed hobbies, family, and travel. Then there are those who have decided to downsize and learn to be happy with less. Life can still be fun and fulfilling on a smaller budget. Its choices and expectations! When you’re healthy and happy, you don’t need a lot of stuff in your life to fill a big empty hole.

Fatigue is not the end all and be all

Fatigue becomes a governor of your energy reserve helping you create a life that is more designed for wellbeing. Yes, it will take a shift in your usual patterns of being. Yes, it may be a challenge for both yourself and others who are accustomed to your higher functioning level. However, you can think of it as a chance to practise ‘slow living’ where life is savoured not devoured. You can become part of the slow movement that is starting to move around the world.

There are two books I’ve read on this phenomenon which helped me get in touch with a new norm and become better acquainted with my revised energy bank.

  1. ‘Slowing Down To The Speed of Life: How to Create a More Peaceful, Simpler Life from the Inside Out’ – by Richard Carlson & Joseph Bailey
  2.  ‘Time Shifting’ – by Stephan Rechtschaffen

Both of these books speak to the concept of being present in the now. Learning to embrace life with all the riches it can bring if we only pause and have a look around. Life is not perfect and never will be. There will still be challenges, the good, the bad, and the ugly, but in and around these constants in life are moments of joy and opportunities for gratitude.

Fatigue may be an unwelcome part of your life; however, you can view it as a ‘reality check’ monitor that will help you slow down and appreciate life more. In all likelihood, if we had paid more attention to fatigue prior to cancer, we may have been able to avoid our current circumstance. Just saying!

Hugs,

Barbara

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