Transcription
[Music] my name is julie reese and i'm a macmillan complex case manager and i've been working as part of the prostate answer team for the last year. i'm going to do today about fatigue and fatigue management.
the definition of fatigue is that it's a common persistent and subjective sense of tiredness related to cancer or cancer treatment which interferes with usual functioning. it's more than just a physical symptom. it's described as multi-dimensional and embraces physical emotional and cognitive aspects. it's an overwhelming sustained exhaustion that's unrelieved by rest and not proportionate to activity and that's where it differs from just normal fatigue or just feeling tired.
some facts about the fatigue. up to 90% of people with cancer suffer from fatigue. it's the most frequently reported symptom by cancer patients. many find it to be the most distressing. it can occur at various stages of cancer journey and it can be sustained over a long period or occur in waves and come and go. it has a considerable and negative effect on the quality of life and sense of well-being. some people find their fatigue is very mild and doesn't interfere much with daily life but for others it's very disruptive so it's a personal experience.
what causes fatigue? or the effects of cancer itself and the effects of treatment for cancer have an effect on fatigue. and this may be because the body needs extra energy to repair and heal or it may be a build up of chemicals as cancer cells are destroyed and the body's immune system is affected. cancer-related fatigue usually gets better after treatment finishes but it may continue for months or even years. everyone is different and there's no way to know how long fatigue may last for each person. there are other medical conditions such as diabetes heart disease thyroid disease which may exacerbate symptoms of fatigue too and also some medicines for other conditions that may cause tiredness and there are other factors that will affect it too that could be anxiety about finances and work.
so what effect does the fatigue have? in the physical sense it's an overwhelming tiredness. they feel low in energy and sluggish. they have difficulty sleeping and they experience pain. stiffness with the reduced activity. many do not experience pain but for those that do it can cause fatigue. anxiety depression stress and tension as well as poor sleeping can all contribute to fatigue. people may feel more moody or more emotional than usual and this can lead to frustration and irritation. also feeling abnormal and feeling too that no one really understands how you are feeling.
cognition is affected. it affects concentration ability to focus. affects memory and you may experience feelings of being overloaded and unable to make decisions. even difficulty concentrating watching television or reading. fatigue can affect behavior and relationships too and people may want to spend less time with others and feeling patient or want to avoid going out because of the effort involved. so this will stop people from engaging in usual social activities and they may feel that they want fewer responsibilities in days off.
the good news though is that it can be managed. you can take control. you don't have to be ruled by it. the first thing to do is to eliminate other causes. so with your gp or your clinical nurse specialist if you have underlying conditions like anemia or infection or insomnia then obviously these need to be treated first. then it's important to talk about it with healthcare professionals and gain information about the condition because that can help and release some of these effects and improve your quality of life.
our bodies get energy from food we eat. so it's important to maintain a well-balanced diet and plentiful fluid intake to boost energy levels. it's important to keep the good sleep routine even though you may feel like sleeping all the time. exercise is important too. traditionally the advice was to rest and conserve energy but whilst this could be important at times there is evidence to support the use of exercise and increased activity to reduce the impact of fatigue. it's also important to manage any anxiety and stress that you may have.
to what you need to do is to change the way that you do things and to conserve energy. so there are techniques and equipment to help you to do this. you want to simplify the task and break down the activity. so to see if there's any part of it that can be eliminated. you can use equipment too to help such as when you're showering use a stall in the shower or if you're doing activities in the kitchen have a purchase stool to sit on to conserve your energy. it's important to plan ahead and work out what the priorities are but be realistic about what you can do. for instance with household tasks you need to spread them out over the week rather than try and do everything in one day as you might have done previously and it's important too that you ask for help and accept help when it's offered.
keeping a diary of energy levels at different times of the day and particularly if you're having treatment helps to work out how the treatment affects you but also what times of day you have most energy. you need to note down things that may affect your fatigue. plan important activities for when you have the most energy and work out what makes your fatigue better or worse.
we talk about the the jug of energy. just imagining that you have a jug which is your ration for the day and so you need to use it wisely. but i prefer the human battery as a better analogy. everything we do requires energy. a drop in energy means that even minimal activity can lead to prolonged feelings of fatigue. attempting to do as much as possible when energy is there and push past our limits but this flattens the battery even more and there's no choice but to stop and recharge. it is possible to avoid flattening the battery entirely by learning to manage activity and rashing energy. alternatively by always doing very little as we try not to flatten our human battery we're not allowing our bodies to build up energy reserves. our body needs activity in order to produce energy.
if you remember nothing else about the presentation remember the five p's. the first being to prioritize the activities that you have to do. plan ahead and make sure that you pace yourself. energy can be lost through poor posture and pain. rounded shoulders or leaning to one side can put pressure on breathing on the front muscles and this costs energy. so it's important to avoid bending twisting or reaching movement. and finally permission. give yourself permission to accept help and to ask for help.
as we've said exercise and increased activity are important. so graded regular exercise improves symptoms. it improves your sense of well-being. improves appetite. take short walks or do light exercise but pace those activities and build your endurance slowly. make sure that you wear comfortable shoes and clothing and all stretch before walking warming up and starting slowly. important to remember to exercise at your pace and enjoy yourself. it's helpful to set some personal goals for yourself.
and finally relaxation. making time for activities that help you relax is important in managing and preventing fatigue. stress uses up energy and causes fatigue. using specific relaxation techniques can help to relieve tension and boost energy levels. this works by physically working on tension in the body by tensing and relaxing each part of the body in turn and using breathing exercises. mentally this helps to relax the mind and you can use imagery exercises. that's imagining you're in a place that brings you pleasure like for example on a beach or in a forest. and breathing. mention the breathing 7 11 that allows the body to fully exchange incoming oxygen with outgoing carbon dioxide and this has been shown to slow heartbeat stabilize blood pressure and reduce stress. so that's counting to seven as you breathe in and counting to eleven as you breathe out. also you can buy relaxation tapes or listen to music that you enjoy such as classical music or listen to natural sounds of birds or animals and this will help you in your relaxation.
thank you for watching. if you have further questions please do not hesitate to contact us. all of the contact information details will be shown on the screen. do you