Face to Face with Fatigue
by Marilyn R. Grainger, RN
As an oncology nurse, in 1995, I participated in the Oncology Nursing Society’s patient education program Fatigue Initiative Research and Education (FIRE). The goal of FIRE was to teach oncology nurses about the reality of cancer-related fatigue, along with proven interventions to lessen this common cancer- and treatment-related side effect. At the end of the four-day conference, the nurses set specific goals for how they would spread the information they learned about cancer-related fatigue to patients, caregivers, and the rest of the medical staff on their teams. I never imagined that one day I would be diagnosed with breast cancer and would need to apply what I had learned at that conference to my own recovery.
During a routine mammogram, I was surprised when the radiologist ordered an ultrasound to examine a small spot in my left breast. A subsequent MRI also found a small spot in my right breast. After another ultrasound and needle biopsies of both suspicious spots, I was diagnosed with stage I bilateral breast cancer. My treatment included a bilateral lumpectomy followed by six weeks of bilateral radiation. And, you guessed it, a major side effect of breast radiation is fatigue.
To cope with my fatigue, I used the strategies I had taught to other cancer survivors prior to my diagnosis.
I breezed through the first three weeks of radiation with no sign of fatigue. Then week four began, and the fatigue dropped me to my knees. Despite a good night’s sleep, I would wake up with the sensation of a heavy weight on my shoulders and upper body. I could barely move from one room to another without sitting down to rest. Shortness of breath and light-headedness accompanied the fatigue. The cancer survivors I had worked with often said they felt like a truck had run over them. I could now relate.
I never knew when the fatigue was going to hit. But it had become an almost daily occurrence – some days worse than others. There were times when I was too mentally and physically fatigued to drive myself to treatment, even though it was only a 10-minute drive. The fatigue could last all day, or it could disappear and not return for several days.
To cope with my fatigue, I used the strategies I had taught to other cancer survivors prior to my diagnosis: spacing out and prioritizing activities; letting some things go; fixing easy, nutritious meals; drinking plenty of fluids; not making important decisions on days of mental cloudiness; and staying active. I tried to keep my daily activities simple by recognizing and accepting my limitations.
I’ve now completed my radiation treatment, and most days I am back to my normal amount of activity. I still experience some fatigue and shortness of breath, especially when I climb the stairs. And if I’ve had an especially busy day, the weight of fatigue will again lie heavy on my shoulders. I have to remind myself to keep using the strategies that helped me cope with fatigue during my active treatment.
Cancer-related fatigue can last anywhere from several months to several years after treatment. But I know that as time goes on, my fatigue will continue to dissipate until one day I can say, “I don’t remember the last time I felt fatigued.”
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Marilyn Grainger is a breast cancer survivor, retired oncology nurse, and great-grandmother who lives in Waukesha, WI, with her husband and two dogs.
This article was originally published in Coping® with Cancer magazine, May/June 2013.