Fatigue

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One of the most common side effects is fatigue.  Fatigue may accompany surgery, radiation, chemotherapy or biologic therapy, and may continue even after treatment is completed. Whether a side effect of treatment or of the tumor itself, the fatigue associated with brain tumors is not I-just-need-some-sleep fatigue. It is like no other tiredness.  You may experience a profound lack of energy that can come on suddenly and bring dramatic changes to your daily life.

 

There is more to this fatigue than just feeling tired.  Symptoms can also include weakness, a feeling that your limbs are too heavy, inability to concentrate, irritability, and, ironically, sleeplessness. 

 

If you feel the onset of fatigue symptoms, don’t dismiss them. Talk to your nurse or doctor right away. With a few tests – including a blood count to check for anemia and infection - and a physical exam, your doctor can make a diagnosis and prescribe treatment. If your symptoms are indeed fatigue-related, there are several things you can do to manage the severity. 

 

Respect the Fatigue

The energy you’re accustomed to having has been transferred to helping your body through treatment, perhaps leaving you too exhausted to even watch TV.  Keep track of when your energy is up or down, and plan your days accordingly. Your doctor can give you information about occupational therapy evaluations to teach energy-conservation strategies.  Meanwhile, accept that you are going to need some down time, and figure out what activities you can let go of or delegate. 


There are some tasks that may not be worth your limited energy.. Someone else – a family member, a caregiver, a professional – can take over the laundry, the shopping, and the cleaning.  If it is difficult to ask for help from family and friends, your doctor or palliative team can advise you on services available to help with everyday tasks.


Even with help, you will want to make adjustments. Don’t stand when you can sit. Set up your environment so that you spend as little energy as possible.  Make everything easy to find and easy to reach.  Outfit your bathroom with grab rails, a shower chair and a raised toilet seat to minimize the effort expended.

 

Eat like a Marathon Runner

Pasta, fruit and whole-grain breads are full of complex carbohydrates that provide long-term energy.  Small, frequent meals that combine complex carbs with vegetables, dairy and a small amount of protein will keep your energy stable.

 

If you have the energy to cook, focus on fresh ingredients.  Over-processed or refined foods have less nutritional value and are not a good choice now.  Do your food prep sitting down, and make large amounts.   A pan of pasta with vegetables can be divided into several small containers and frozen for future meals.  If you don’t have any willing kitchen helpers, try frozen vegetables, pre-cut produce and disposable aluminum pans to make it easier to eat healthy.   Since take-out food tends to be high in calories, fat and sodium and low in energy-boosting properties, consider it only as a last resort.

 

Move a Little

Before starting any exercise or fitness plan, it is important to check with your healthcare team first to establish what they think is appropriate.

 

Moderate exercise can improve your energy level.  Any fitness enthusiast will tell you it clears your mind, reduces stress and improves sleep as well as overall health. 

 

Now is not the time to go all-out on a fitness routine, but it is important to get some exercise.  Go for walks, or find a yoga class. A recent study showed that yoga alleviates symptoms of fatigue and sleeplessness. There are also some good yoga DVD’s that you can try in the comfort of your own home.  

Sleep like a Baby

Babies need an established routine and schedule for sleep in order to thrive. So do you.  Ask for the doctor’s help in adjusting your medication schedule, if necessary, to avoid interruptions. Avoid electronics – phone, TV, computer – for at least one hour before bedtime. Stick to your bedtime schedule as much as you can – record favorite shows  to watch later, instead of staying up for them. You are going to need several hours of sleep per night, so if you’re a 6 a.m. riser, 8 p.m. is not too early for lights-out.

 

Naps should also become part of your daily routine.  A short nap of less than an hour long and not too late in the day can provide some much-needed mental and physical energy to get through the day.

 

Quiet Your Mind

With everything that is going on, it is essential to find a way to take a break. Worrying about treatments, prognosis, family, and daily well-being can drain sap your energy.  It may be helpful to find a place where you can feel peaceful and spend time there alone.

 

Give time to activities that you enjoy and that take your mind off your treatments.  Time off will give you fresh energy.

 

There are a lot of complementary treatments available that can help calm the mind. Meditation, guided imagery, music therapy, and yoga are just a few worth investigating.