- Fatigue and tiredness are two different sensations
- Tiredness is a universal sensation, usually has an identifiable cause, is short-lived, and is dissipated by a rest or sleep
- fatigue experienced by people with cancer is often described as unusual or excessive whole-body tiredness, disproportionate to or unrelated to exertion, and is not easily expelled by sleep or rest
- it can be acute or more long-term
- it can have a profound negative impact on the person's quality of life by interfering in the ability to perform activities and roles, as a result, care givers begin to assume many roles and activities previously held by the patient
- many factors may contribute to fatigue, including:
- changes in energy production
- loss of weight and appetite
- decreased nutritional status
- overactive or hyper metabolic state due to tumor growth
- side effects of therapy (chemotherapy, radiation, biotherapy)
- neurotoxicities of cancer or its treatment
- changes in activity and rest patterns
- sleep disturbances
- instruct patient and family to keep a diary for one week to identify time of day when they are most fatigued or have the most energy
- - look at the contributing factors
- be aware of warning signs of impending fatigue, including tired eyes, stiff shoulders, decreased or lack of energy, inability to concentrate, increased irritability, nervousness, anxiety, impatience
- identify which activities or situations make fatigue better or worse
- a "1 to 10" scale can be used to assess levels of fatigue, with 1 being the least amount of fatigue and 10 being the worst possible sensation of fatigue
- develop a plan to pace activities by scheduling activities according to fatigue/energy patterns, see Suggestions for Energy Conservation
- exercise may improve fatigue, develop an appropriate exercise program with the physician and physical therapist
- monitor the effectiveness of medications and other strategies that you are using to control other symptoms such as pain, nausea and vomiting and insomnia
- encourage a balanced diet with complex carbohydrates (grains, legumes, vegetables) that provide a more sustained source of energy over time
- encourage plenty of water (8-10 glasses/day if not contraindicated) to maintain hydration and to excrete toxins that may be associated with fatigue
- use distraction techniques to focus on things other than tiredness, illness or disease
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