- Question from Sandy: Is it normal to feel rested, then once the normal work routine is resumed, the fatigue hits again?
- Answers - Lillian Nail We don't understand the relationship between the fatigue that people experience with cancer treatment and their life demands. It makes sense to think that as your activity levels increase you are more likely to get tired so people who were away from work and then return to work may find that they are more tired when they return to work than they expected it to be based on how things were going for them when they were not working. But the studies have really not looked at that relationship and there is a lot more work to be done.
- Marisa C. Weiss, M.D. How do you suggest that the women manage the expectations of the people around them?
- Lillian Nail I usually suggest to people that they plan ahead of time what they are going to do when they encounter specific situations so that you are not taken off guard. So when friends and family members say, you can't still be tired, that you have an answer that you have rehearsed. You can say, you know, I thought that too, and I did some research and found out that the fatigue doesn't always end right away. I expect it to be better, but it doesn't improve right away. And with co-workers, I have found it helpful for me to explain it to them up front and explain that they are the side effects that go with the treatment that I have, and this is what might happen, and this is what I might need from you, such as flexibility or scheduling. Or when I tell people I am too tired to do something that they respect that instead of telling me I can do it anyway. And the third is that if I ask someone to give me a ride home, that they are willing to do that. I try to have a plan in place for that. People can really depend on other people or have people that can be a back up for you.
- Marisa C. Weiss, M.D. Do you have any advice for people that have a hard time asking for help?
- Lillian Nail When people ask if they can help you, I finally reached the point that I needed to pay attention to that and I started looking at what other people told me helped them and I used those things to assign jobs to people including assigning a job coordinator who filters all of the assignments because it can be tiring for people who want to bring you dinner, what night, etc. The job coordinator took care of coordinating that and told me who was doing what and when it was arriving, and everything was taken care of. It made it hassle free. There are a lot of day-to-day things you can give up. A neighbor can take out the trash. Someone can do the lawn care, or the laundry. Taking stuff to the dry cleaners, all the little errands. People don't recognize that those are some things that they can volunteer to do and you don't always know what the answer is, but that would be a great project for an organization. People say, "Let me know what I can do to help" but they don't have any idea how they can be more specific than that and we need to have lists of suggestions for women to look at, to see how they can use that offer.
- Russell Portenoy For patients who have the ability to obtain professional help for this type of planning there are psychologists and other health care professionals who specialize in this type of cognitive work in medically ill patients. This work may include learning about being assertive to take care of one's own needs,) blonde learning some of these techniques for handling tasks and time in a way that minimizes fatigue and improves the person's ability to function.
- Marisa C. Weiss, M.D. I sometimes give my patients a prescription that says, "Give up the housework!"
On Wednesday, March 21, 2001, our Ask-the-Expert Online Conference was called Ease Fatigue, Boost Energy. Lillian Nail, Ph.D., R.N., Russel Portenoy, M.D., and Marisa Weiss, M.D. answered your questions about ways to manage fatigue and increase energy levels.
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