Posts Tagged ‘fatigue’
02.02.2012
I had my 6 month oncology check up yesterday. I am happy to report that all is well.
My husband came with me because we were feeling very unnerved by the intensity of the fatigue I have been dealing with the past few weeks.
My risk for recurrence is 20%, and the most likely time for it to happen is 2-3 years after diagnosis, which is where I am right now.
My blood levels were all normal, but the doctor believes that it comes from trouble metabolizing the anesthesia from my recent surgeries.
Even perfectly healthy people have setbacks with anesthesia. It takes 6 months to leave the body. Because of the damage from chemo, my liver
is likely only functioning at about 80% of normal, making any metabolic process more challenging.
Cancer: the gift that keeps on sucking.
Anyway, the doctor gave me low dose Ritalin to help me through this time. The fatigue has become really debilitating. I can take a 3 hour
nap, feel fine for an hour, and then feel tired again. It’s undermined any attempts to exercise consistently. My husband has had to pick up more
than the usual slack.
I have 3 kids and a big job, so I know tired and even exhausted. This fatigue is more like a light being dimmed from the inside. The bottom
is deeper than tired or exhausted can explain. I took a wee dose of Ritalin this morning (half of what the doctor normally prescribes,
given my sensitivity), and I already feel like the lights have been turned back up.
The plan is to do this transitionally until I get some more mojo back.
Will keep you posted.
Tags: changes, chemo, chemo rollercoaster, coping, fatigue, side-effects
Posted in Survivorship, Wellness | 6 Comments »
07.05.2011
Since I finished treatment, I’ve been a half-marathonin’ fool.
I ran the NYC in March with a childhood friend.
I ran the Nashville in April.
This is one of those race photos they try to sell you. Hehe.
I took May off, but was back at it again in June, this time in Seattle.
Me and my Seattle running buddies. They stuck by me the whole way.
Interesting Fact: We have 10 kids between us.
How do I explain this marathoning madness? Simple. I know myself.
When I asked my oncologist what I could do to minimize my odds of recurrence, she said, “You will hear a lot of things. But there are only two things we know for sure. Exercise regularly and keep yourself to your lowest healthy weight.”
I am a compliant patient, but I knew I would be even more compliant with these goals on the horizon.
So that’s that. I don’t want the cancer to come back. Plus there are added bonuses.
When I run regularly, I feel better. I’m more confident in my body. It’s the only time I actually enjoy my booblessness.
Vigorous exercise marks a clear before/after for my treatment. I couldn’t run during treatment because of my extreme nausea and pain. Now I can.
Running helps me combat post-treatment fatigue. I sleep more deeply and have more energy when I’m running.
Running is an individual sport but runners compete against themselves. “To PB” is a verb — it means to get your personal best time.
So I thought that by running three races in four months, I would PB by the end.
I was wrong. I PW’d.
That’s right. I got my Personal Worst.
I’m not one for excuses but I do like a good story, so here goes. Pull up a chair and stay awhile.
Devoted readers of my blog may recall that I started an experimental use of an old medication, Metformin, in early May to prevent the cancer from recurring. My oncologist reassured me that any side-effects would be short lived. She obviously forgot she was talking to the side-effect queen.
I was so nauseous, I ended up back in bed most evenings. My doctor told me to take Zofran, the big guns anti-nausea drug. It only kind of helped and heaped on new side effects like dizziness and constipation. It was one thing to endure those when I could lie in bed all day during chemo. But I’m trying to hold down a full time job and raise a young family here.
I tried cutting my dose in half, reasoning that taking some of the drug was better than none of it. They had to back off on my chemo dose because of my bad reactions, so why wouldn’t I do the same thing with the Metformin? When the nausea persisted, diabetic friends offered suggestions. Cut down on your carbs. Take it with meals.
I tried all of the above, to no avail.
Worse yet, the nausea and related fatigue started to cut into my running. Exerting one’s self while dizzy and pukey is highly unappealing. As I pulled back on training, I started losing some of the ground I had gained in my wellness. I went from feeling better to pretty bad again.
The morning of the Seattle race, I took my medicine before the run.
I spent the first 8 miles feeling nauseous.
“Slow down a little, I’m sorry,” I kept telling my friends.
They obliged, insisting that it was all about running together.
And we did. We ran the whole way, except for the water stations. And my insistence on high-fiving the kids who came out to cheer for the runners. And to thank the people carrying flags to remember fallen soldiers.
Oh, and the potty stop.
But we ran and we ended with the uniquely exhilarating feeling of delicious endorphins coursing through our veins.
Even a PW wasn’t terrible.
But that was the beginning of the end of my affair with Metformin.
When I got back home, I had an evening where I became arrested by nausea. That was the final straw.
Why, I reasoned, am I trading in something I know will help me (exercise) for something that might help me (Metformin)?
So I stopped taking the pills.
Today I met with the nurse in the Survivorship Clinic. She’s a runner so she appreciated my PW tale. She has seen a lot of people on Metformin and her opinion was this:
The running is more important. The drug is a hypothetical. Metformin is hard for some people, and it sounds like you are one of those people. Quality of life matters and you need to keep exercising.
Cancer and survivorship often involve selecting between two crappy options. It feels unsettling not to do something medically to keep the cancer from recurring. But it felt even worse when I tried to.
My PW clarified the best of the crappy options. Stop the drugs and keep running.
And keep finding ways to hang out with good friends. They’ll make it fun, even when it is your worst time ever.
Tags: attitude, body issues, changes, coping, courage, essay, exercise, fatigue, healthy people, identity loss, nausea, running, side-effects, survivorship
Posted in Survivorship, Wellness | 29 Comments »
05.13.2011
Yesterday, I ran on a shady paved trail through the park. The 5.8 mile path is a refuge in the heat, which was climbing toward 90˚.
I like running the same route week after week. Partly, I am a creature of habit. Also, running the same trail allows me to monitor my progress. I check in with my body. How fatigued am I? What pace can I go? How do I contend with this hill? How strong do I feel when I’m finished? I note all of these things and feel the runs getting easier, which is good for my confidence.
At the top of a big hill near the halfway point, I felt the fatigue setting in. The heat was draining me and I was sweating profusely.
Running helps me practice patience and compassion with myself, so I don’t tell myself to push on much of the time. I stopped to walk for a couple of minutes. After catching my breath, I felt much stronger and continued on my way.
It was time for a big descent. In the recent past, I have kept my pace steady, even on downhills. I don’t know what has been holding me back –– a fear of the speed, a fear of falling. I just haven’t been up to it.
With my renewed energy, I decided to let myself fly. It was a joy. I also felt hopeful that I might pick up some of the time I lost walking and make a good overall pace for this run.
As I rounded the curve, I saw a woman climbing over a wall separating my path with one of the many unpaved trails in the park.
She looked lost. She was about my age, dressed in running garb.
Pace be damned, I thought, letting go of the time I was making up. I stopped to see if she was okay.
She asked me how to find a certain trail. I told her that I am only familiar with the paved routes.
“We are about one mile from the exit,” I said. “If you want to run with me the rest of the way, I can drive you to your car.”
“Okay,” she smiled. “I think I’ll take you up on it. I’ve been running for about an hour and a half. I promise I don’t have a knife stashed anywhere.”
She continued with me on my flight down the hill. I took one of my earbuds out so I could converse.
“Are you training for anything?” I asked.
“No, I just like to run a lot,” she told me. “Are you?”
“I finished cancer treatment at the end of last year, so I’ve been doing half marathons like mad.”
She was unfazed.
“That’s great. What kind of cancer did you have?”
I told her.
“I had Hodgkins when I was pregnant with my fourth child. She’s 12 now.”
“I knew you were a cancer survivor! You didn’t blink when I told you. Usually people get really quiet and awkward.”
We ran the rest of the way down the hill, chatting about treatment, side-effects, fatigue, and children. I took her to her car, as I promised. She did not have a hidden knife, as she promised.
I realized, once again, what a unique bond survivors share. It’s as if we can enter the middle of a conversation and not have to provide all the explanation that other people require to make sense of our experience.
This is why our online community is so powerful. We are what my fellow blogger Feisty Blue Gecko aptly calls stranger-friends. We often understand each other in ways that our closest intimates cannot.
I hope to cross paths with my new stranger-friend some time soon.
Tags: coping, daily life, fatigue, hope, running, support
Posted in Survivorship | 19 Comments »
05.09.2011
I’m sorry I haven’t posted in awhile. My regularly scheduled life has demanded much of me lately. I also have been contending with fatigue. It’s been a bit of a dance — keep on top of life and manage to rest and exercise.
It’s a little scary to have experienced a sense of ascension from the Cancer Pit and then feel it tug me back in. Aside from my own physical symptoms, last week two online friends died. Both were parents of young children. Both were around my age. Sarah had been in remission and faced a recurrence that ultimately killed her.
This is Sarah. She made a promise to herself that she would die with her hair.
Derek wrote about going through the same treatment as an online friend on the same timeline. His friend’s treatment worked, but his did not.
These events renewed my sense of urgency about improving our understanding of cancer –– not just breast cancer, but the ovarian cancer that killed Sarah and the colorectal cancer that killed Derek.
Last week, I also participated in my first clinical trial. I had learned about it through Susan Love’s remarkable project, The Army of Women (AoW). I had a doctor’s appointment anyway. It only involved drawing a few extra tablespoons of blood and a follow-up phone call. The researcher I spoke with said that AoW has made a huge difference in their ability to recruit enough subjects for their study. Across the board, she said, the participants have been eager to help.
I had intended to do another clinical trial at the end of my treatment, but it didn’t work. For that trial, I would take Metformin to prevent a recurrence. Because my tumors were hormone-receptor negative, I am not taking anything like Tamoxifen or Armidex to prevent recurrence. My chance of recurrence is around 20-30%.
My oncologist had explained to me why they were prescribing the diabetes drug to breast cancer survivors. They had done meta-analyses of survival and recurrence rates in breast cancer survivors. Metformin seemed to significantly lower recurrence rates when they looked at populational data, controlling for other factors like weight, age, and fitness. They thing it has to do with cortisol suppression.
I ended up not being able to do the clinical trial because the Metformin shipment got held up in Canada. By the time it arrived, I was no longer qualified because of my date of diagnosis. My doctor offered to prescribe it to me for off-label use.
I hesitated. There are potential gastrointestinal side effects to Metformin. And for those of you who are new to my blog, you may not realize that I am a Side-Effect Queen. No discomfort, however small, seems to pass me by.
Then Sarah and Derek died.
That was it.
I called my doctor and decided I couldn’t bank on my fitness, youth, and good attitude to prevent a recurrence. I felt better about doing something at a molecular level that might interfere with tumor formation.
I spoke with three breast oncologists who thought the Metformin was a good idea. My blogger buddies who went to the National Breast Cancer Coalition conference and reported that the Metformin trial seemed like the most promising thing out there in preventing recurrence.
I needed to make a choice. The consensus was that this seems like a good one.
Because if my cancer comes back, it will be metastatic.
Diarrhea or metastatic cancer?
I’m going to take Door Number 1, Bob.
Let’s hope I have made the right choice.
If you are a woman in the US or Canada, please sign up for the Army of Women. You don’t have to be a cancer survivor. There are a lot of clinical trials out there that just need participation. We need a better understanding of cancer. Knowledge is power.
Tags: changes, clinical trials, coping, fatigue, self-advocacy, survivorship
Posted in Survivorship, Treatment, Wellness | 20 Comments »
01.09.2011
What I feel like I should do today:
Laundy
Groceries
Sign kids up for camp
Fill out form for financial aid for camp
Go for a run
Organize everybody for the week
Cook dinner
What I feel like doing today:
Sit by the fire
Listen to music
Knit
—
This ain’t gonna be easy.
Tags: coping, fatigue, survivorship
Posted in Survivorship | 5 Comments »
