I know we talk about fatigue a ton here, and rightfully so. It’s one of the worst side effects of any disease, and cancer gets it in spades. The disease and the cure both cause exhaustion and tiredness. The thing is, there is more to fatigue than just being extra sleepy or needing a nap. Fatigue has so many facets, it’s difficult to enumerate them all. That’s why it is so insidious.
The three facets of fatigue
Like I said above, fatigue can be both a side effect of the cancer itself and is almost always a side effect of chemo. Yes, we’ve all seen the quintessential portrayal of a chemo patient, lying in bed, unable to move much, and napping frequently. While this is certainly what some patients experience, many more of us are more like the walking wounded – we go through our day with only a portion of our faculties working at one-hundred percent. That’s mainly because fatigue is made up of three main parts – tiredness, energy drain, and lack of motivation. Three components that are more than the sum of their parts. At first glance, those three things may look identical, but if you dig deeper you’ll find there are more than subtle differences, and that’s why fatigue is so debilitating.
It’s the facet of fatigue everyone is most acquainted with and it is exactly what the name says – an extreme form of tiredness that makes you want to stay in bed all day. Right now, even though I am only going through a maintenance chemo phase, I still find myself sleeping ten, sometimes eleven hours a day. I can’t stand it, either. I hate having wasted such a big chunk of the morning. It kills me every day, and every night I tell myself this is the night I will go to bed earlier. Unfortunately, even if I go to sleep at an earlier time, I can still easily stay in bed for twelve hours if I let myself. The exhaustion is real, and it’s a monkey on our backs that just won’t let go. It makes getting any work done extremely difficult, and I frequently work late into the night just to be able to write and do other tasks while I’m fully awake.
This is a lesser known aspect of fatigue, but it’s no less crushing than the other two. Energy drain is a constant sink on the energy you do manage to muster, which makes everything two times as difficult. It's like you are walking through waist-deep snow, or like you have one-hundred extra pounds dragging behind you all the time. The energy it takes to start a project is immense, and the energy you expend doing it is so much more than it should be that it makes you want to do nothing else all day. Our gas tanks have a leak in them, and the more we move, the more fuel leaks out.
Lack of motivation
I don’t know about other people, but for me, this one’s the killer. It’s the one component of fatigue that is the most difficult for me to beat, and the aspect I spend most of my time trying to overcome. When you are fatigued, you have absolutely no desire to do anything but sit and watch TV or read a book. You don’t want to get up to make food, you don’t want to get up to sweep the floor, and you certainly don’t want to do any real work. It’s as if your body weighs one-thousand pounds, and instead of not having the energy to move, the dread you feel about the energy you’re going to have to expend to move makes you not want to even try. Deep down, in your heart of hearts, you want to stay in the chair and binge all five seasons of Breaking Bad on Netflix. Unfortunately, you know your articles won’t write themselves, you know the pets won’t feed themselves, and you know the groceries definitely won’t shop themselves. So, you reach down to that area of yourself where you store your reserve of resolve, and you get up and do as much as you can. Make no mistake, though, it takes a mental fortitude on a scale rarely seen to beat the lack of motivation, and fortunately, cancer patients are some of the toughest mofos around.
Fatigue is more than being tired
So, as you can see, fatigue is more than simply being tired. Sure, there are other components to fatigue, but the triad above is the big three. When you are on chemo, it’s one of the daily battles you have to undertake, and it is sorely underrated in terms of difficulty if you ask me. Nausea, pfft. Phantom pains, bah. Hair falling out, I look better bald anyway. Fatigue, though, is scary. It has the most potential to keep me from being the me I tell myself that I need to be. It can be lessened, it can be partially mitigated, but it can never be defeated fully.
What type of blood cancer are you or your loved one diagnosed with?