Help with Side Effects - Fatigue

Fatigue is a symptom experienced by almost everyone undergoing treatment for a brain tumor. Fatigue related to tumors is different from the fatigue you might have experienced in the past. This type of fatigue is severe, persistent, and not related to physical activity. It can be unpredictable and emotionally overwhelming. Most telling, it isn't fully relieved by rest or sleep. In this article, we will discuss the probable causes of tumor-related fatigue and offer some suggestions for battling this debilitating symptom.

Causes of Fatigue
Researchers are still unsure of the exact causes of disease-related fatigue. It is possible that the disease, or the treatments, lower blood counts and those lowered counts cause fatigue. Or, the tumor may release substances that cause a chain-like set of events ending in fatigue. The emotional impact of receiving the diagnosis, the trauma of surgery, the treatments required to kill tumor cells may all add to this extreme tiredness. The good news, however, is that extensive nursing research has lead to helpful guidelines for managing, and sometimes taking the edge off, that fatigue.

Learn Energy-Saving Skills
There are routine, daily activities you perform everyday to prepare and care for yourself during the day. Your nurse, occupational therapist and physical therapist are good resources for hints on how to make this self-care easier.

• Become very organized: Lay out your clothes ahead of time (or have someone else do it for you). Organize toiletries so they are all in a single, convenient place. Use a shower or bath organizer so you don't have to bend or reach while bathing. Avoid rushing.
• Use assistive devices, such as grab rails in the bathroom, a raised toilet seat, extension handles on brushes and sponges, to minimize the energy you need to expend.
• Use a shower chair to bathe. Sit down to dry off. Avoid bending and leaning over as much as possible.
• Organize your home to be as efficient as possible. The closer things are to each other, the less energy you need to spend on getting to them.
• Wear comfortable clothes and low-heeled shoes.

Choose Your Activities Wisely
On a daily basis, you participate in many activities: work, leisure, household tasks, child care, etc. If possible, let others help you by assuming some of your responsibilities. Allow people to cook, clean your home or shop for you. It may be difficult and a little stressful for you to give up some of your independence, but in the long run it will help you.

• Organize your time. Schedule those activities that are the most important to you during the times when you have the most energy. Pace yourself and don't overdo it.
• If you have a lot of helpers, take advantage of them. You may want to assign one person to organize the others and assign their tasks.
• When you do housework, sit down whenever possible. Schedule tasks throughout the week instead of doing them all at once. Delegate housework as much as possible.
• When shopping, organize your list by store aisle. Shop when it's less busy so you don't have to wait in line to be checked out. Ask someone to help load the groceries into your car. Delegate shopping whenever possible.
• When preparing meals, sit down as much as possible. Prepare double amounts and freeze half. Soak dishes instead of scrubbing let dishes air dry. Use the dishwasher as much as possible. Delegate cooking and clean-up as much as possible.
• Child care is a difficult issue, because young children may not understand why you can't spend as much time with them as you used to. Plan activities that allow you to sit and at a time when you have the most energy. Try to explain your limitations answer their questions truthfully, but at a level they can understand. Teach your children to climb onto your lap, rather than expecting you to lift them. Have someone help with activities involving lifting.

Sleep, Rest and Exercise

Rest is extremely important in your battle with fatigue. It is also one of the hardest things to do.

Night Time Tips

• Decrease environmental noise: close windows, use a white noise machine. Tell family members that you are going to bed and ask them to keep noise to a minimum. Turn off the phone in your bedroom and let the answering machine pick up any calls.
• Go to bed at about the same time every day. Develop a sleep routine. Let friends know what time you go to sleep so they won't call you.
• Don't eat or drink anything with caffeine late in the day. Try herbal teas or decaffeinated coffees. Avoid chocolate.
• Don't drink too much late in the day, unless it's necessary during your treatments.
• Avoid taking sleeping pills, if possible. They can disrupt your normal sleep cycle and you will feel groggy the next day.

Napping & Resting Tips

• Take a short nap during the day. Naps are good, but make sure they aren't too long or so late in the day that they interfere with your nighttime sleep.
• Allow yourself some quiet time each day. Remove yourself from others and spend it in a peaceful place. Walk in a natural environment such as a park or garden. Spend time in activities that interest you to take your mind off your treatments. "Time off" helps you gain energy.
• Investigate meditation, self-guided imagery, music therapy, yoga and other complementary treatments.

Exercise

• Try to fit an activity such as walking into your daily schedule. Exercise promotes a healthier body and helps reduce psychological stress. Exercise may also help you sleep better at night.
• Don't overdo your exercise routine. Ask your physical therapist to help you develop a routine. Increase activity gradually. If you do too much all at once, you'll increase your fatigue.

Additional tips for managing treatment side effects are available in the Treating Brain Tumors section of our web site. Or, visit other sections of the ABTA web site:  

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Current as of December, 2008