You know that feeling when you wake up and you’re rested, energized, and ready to face the day? I haven’t felt that since chemo started…and don’t expect to for quite some time. 

Fatigue is when you feel tired, weak, drained, or worn out. Cancer and cancer-related fatigue is more severe - one feels physically, emotionally, and mentally exhausted most of the time.  Interestingly, cancer fatigue is not the result of physical or mental activity. And, here’s the kicker: cancer fatigue doesn’t get better with sleep or rest.

Studies show most, if not all, cancer patients experience cancer fatigue at some level.  It’s one of the side effects that most often sticks around long beyond treatment.  Most folks find they finally feel better and their energy levels return 6-12 months (!) after treatment ends, but some may battle fatigue for years. 

Doctors don’t know what causes cancer fatigue, but they have a few guesses: immune systems on overdrive, medications, insomnia, stress, depression, physical inactivity, cancer cells fighting with healthy cells for nutrients, changes in how cells work because of chemo/radiation, anemia, changes in hormone levels, the list goes on.

Fatigue this cycle stuck around a lot longer than the first.  I don’t make it through any day without at least one nap.  I try to do five things each day: eat breakfast and dinner with Ellie, go to that day’s medical appointment (3-4/week), empty the dishwasher, take a shower, and take a walk around the neighborhood.  Sometimes I swap in, or add, 1-2 more things: open the mail, pick up Ellie from school, make lunch, laundry, read bedtime stories.  But that’s it. The other day I took the car to get gas and drove through a car wash - that was a really big day. Most folks could probably knock out my to-do list in an hour or two - it takes me, quite literally, all day.  Our house isn’t spotlessly organized, our yard isn’t brimming with vegetables and flowers, I haven’t scrapbooked Ellie’s life story, and I don’t have any new hobbies.  I’m not even bored (usually), I’m just tuckered out, all the time.  

Thinking I’m invincible, I tried to power through a day earlier this week. We’re in the “bonus” week when my counts weren’t high enough for chemo but I feel good (read: not nauseous). So, I picked Ellie up from school and took her to an afternoon dentist appointment.  Everyone at her dentist wears masks, there are partitions, and it’s a ghost town before the local schools get out - perfect errand for me and my low blood counts. Her teeth are shiny clean and I was a ball of parental support and energy.  When we got home, Ellie wanted to capitalize on my energy by playing outside and, by then, it took everything I had to just keep my eyes open. I kid you not, she was bouncing a ball on my arm and I barely noticed it.  I texted Jamie, who works from home, and he popped out moments later to challenge the kid to a basketball game and I stumbled to the bedroom with one eye already hopelessly closed. 

I expect my cancer-related fatigue will last throughout chemotherapy and for some time after it is finished.  There’s things that can/will help when I get to the other side of chemo.  For now, taking walks, sticking to my activity goals, and learning my new boundaries helps - but it’s definitely a far cry from what I could do this time just a few months ago.