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Let's Discuss...Fatigue

Re: Let's Discuss...Fatigue

Posted by Dhenne on Nov 7, 2019 11:27 am

This is the worst side effect. There are times, I want to do something,  but I just can't get up. Feeling tired after waking up is worst and can sometimes feel depressing. The people from Inspire health suggested to go for short walks and deep  breathing. I tried and it helps. Though, sometimes, I have to figure out if it is fatigue or depression that's pulling me down. It is really difficult emmotionally too. It's a struggle every day. I try to find ways for comfort, some encouragement and inspirations to move on and that gets exhausting too. It's a cycle.🥺

Re: Let's Discuss...Fatigue

Posted by MyrlaneB on Nov 7, 2019 11:48 am

Essjay‍  I am not on the same level as you with regards to energy.  I am having problems with my feet and legs which is an hinderance.  I am scheduled for a knee replacement in March.  Regardless I realize that I must push myself a little harder especially after reading your writeup. Thank you.  MyrlaneB

Re: Let's Discuss...Fatigue

Posted by Essjay on Nov 7, 2019 12:26 pm

MyrlaneB‍ - I hear you! I have mild neuropathy and sometimes walking or running hurts! I have no idea how it’s going to be through winter either! But I have found that moving helps. 
Good luck with the knee replacement - I have a couple of friends prepping for their surgeries and they are working hard on their fitness and mobility to help their recovery.
i have pushed myself hard, I have cried, I have made myself hurt, but doing so has helped...
Triple Negative Breast Cancer survivor since July 2018

Re: Let's Discuss...Fatigue

Posted by allie on Nov 7, 2019 1:50 pm

I seem to be tech-challenged these days, so I couldn't find a way to make a new post LOL  One of the side effects, apart from fatigue :)
Yes, fatigue has been an ongoing battle for me since chemo, which ended in August 2018.  I have always slept with earplugs and sleeping pill, but I haven't been able to sleep through the noise of the rest of the apartment house I live in, over the past couple of years.  It is only in the last month or so that I've regained 9 hours/night.  I've done that by shifting my sleeping hours.  I have no need to get up at 7am, and am a night owl anyhow, so going to bed super early in order to get up at 7am is not for me.  What I'm doing now is to go to sleep at about 2am and wake at about 11am.  I don't *like* getting up that late in the day.  OTOH, getting that sleep again is wonderful.
Apart from even getting enough sleep at night, I do suffer from fatigue.  I also recognized that I've been suffering from depression, and have started therapy of a sort with an oncological therapist, who is uniquely able to help with this type of depression.
I just, one week ago, had a prophylactic bilateral mastectomy.  I'm dealing with healing and fatigue again!  I have the lessons of recovering from cancer and chemo last year to lean on this time around.  I'll be having full clearance dental surgery and immediate full dentures in January.  At this point, I'm wondering if I'm going to be able to deal with the months of recovery that come with that.  Guess I'll find out ;>


Re: Let's Discuss...Fatigue

Posted by Garrie on Nov 7, 2019 3:47 pm

My last radiation treatment was 14 months ago and l still suffer from extreme fatigue. I”m okay in the mornings but then it really hits me in the afternoon and evening. It’s so bad l don’t want to get off the couch. Doctors don’t want to discuss it because there is nothing they can do for cancer fatigue. Just like there is nothing they can do for my destroyed salivary glands. It has been very difficult to deal with my limited energy because before this nightmare started l was very athletic and was constantly on the go. I try to take one day at a time and hope that one day this fatigue will pass. 

Re: Let's Discuss...Fatigue

Posted by LPPK on Nov 8, 2019 11:16 am

I had fatigue while going through radiation treatment and for a few months afterwards.  I am 23 months post radiation and most of the time have a good energy level.   I am retired and I have the luxury to take a "day off" when my energy level is low, I look at it as a pampering day I give to myself.  I curl up with a good book, watch netflix or work on a small project, let my husband do the meals, and think of positive thoughts.

Re: Let's Discuss...Fatigue

Posted by Lacey_Moderator on Nov 11, 2019 2:02 pm

Garrie‍, allie‍, Essjay‍, MyrlaneB‍, Dhenne‍, Wendy Tea‍, princessmaura‍, Nan1‍, Mama Bear‍, Elsie13‍, Rob0009‍, law‍, Marcell‍, JustJan‍, Mystiquewolf‍, Amores‍, Hadrian‍, Marsh‍, WestCoastSailor‍ , SpeedyStill‍ , Picasso’s mannequin‍, Missk‍, Aries‍, Peanut‍ 

Thank you to everyone who took the time to share their personal experience with fatigue! Here is some additional info I hope you find helpful:


Managing fatigue

Fatigue can affect everyone differently. For some, fatigue may be more of a nuisance. For others, it interferes greatly with daily life. Your doctor will treat or manage your fatigue based on its possible causes and your individual situation.

Fatigue can be a short-term problem that goes away after treatment ends. It can also continue long after you finish treatment. Follow-up after cancer treatment includes checking for fatigue.

Once your healthcare team knows the cause of your fatigue, they can suggest ways to treat it. Treatment may include nutritional supplements or medicines. If your red blood cell count is low, you may need a blood transfusion.

Some people find it hard to manage fatigue. It can be helpful to keep track of your activity and resting times in a journal or calendar. Make notes of when you are most tired, when you have the most energy and what activities increase fatigue. This can help you find ways to better manage your fatigue. You can also try these tips:

  • Make changes to activities that increase fatigue or try not to do them as often.
  • Plan activities for when you have the most energy.
  • Pick what’s most important to do and do it first. Or do only it.
  • Rest when you need to.
  • Limit stress.
  • Eat well. Talk to a dietitian about healthy eating.
  • Be as physically active as you can be. Ask your doctor about what activities might be good for you.
  • Meditate or try relaxation exercises.
  • Talk to a counsellor to help with your emotions and managing stress.
  • Focus on what you can do and not on what you can’t do.

Read more: http://www.cancer.ca/en/cancer-information/diagnosis-and-treatment/managing-side-effects/fatigue/?region=ab#ixzz64zt9q6UB

Hang in there!

Re: Let's Discuss...Fatigue

Posted by Kims1961 on Nov 16, 2019 10:48 am

Such a great topic!

I haven't had a chance to read all the posts but wanted to also mention Compassion Fatigue.  

Our caregivers can also suffer fatigue  - it isn't easy as we know being the caretaker .  I certainly know I have cancer, but unfortunately, I know it has also "given" cancer to my family.  It has changed all of our lives.  In addition, I sometimes wonder about all of the health care professionals we see.  I can't imagine how difficult it is to see so much loss and illness everyday.  Sometimes, when I have someone who is not on the top of his/her game - I wonder if they are struggling with compassion fatigue.

I found a great website on Compassion Fatigue - I'll post the links in case anyone is interested.

Thanks for getting this topic going -so very very important.



Her2+, ER+ Bilateral mastectomy in 2017, followed by chemo and radiation. Mack and Hannah's mom

Re: Let's Discuss...Fatigue

Posted by Cynthia Mac on Nov 17, 2019 7:57 am

Hi, Kims1961‍ , you could not have timed that better! It’s been a week, so thank you.
“When the root is deep, there is no reason to fear the wind.” - Japanese saying

Re: Let's Discuss...Fatigue

Posted by Kims1961 on Nov 17, 2019 8:42 am

Cynthia Mac‍  I think of you often. You are not just your Dad's caregiver but to so many here.  Your responses have been so helpful.   I hope you are also taking care of you.💕 kim

The Cost of Caring: 10 Ways to Prevent Compassion Fatigue

February 9, 2016 • By GoodTherapy.org 

Walking in park

Compassion fatigue can be a serious occupational hazard for those in any kind of helping profession, with a majority of those in the field reporting experiencing at least some degree of it in their lives. This is no surprise, as it is typically those with the most empathy who are the most at risk.

Compassion fatigue is characterized by physical and emotional exhaustion and a profound decrease in the ability to empathize. It is a form of secondary traumatic stress, as the stress occurs as a result of helping or wanting to help those who are in need. It is often referred to as “the cost of caring” for others who are in physical or emotional pain. If left untreated, compassion fatigue not only can affect mental and physical health, but it can also have serious legal and ethical implications when providing therapeutic services to people.

While it is not uncommon to hear compassion fatigue referred to as burnout, the conditions are not the same. Compassion fatigue is more treatable than burnout, but it can be less predictable and may come on suddenly or without much warning, whereas burnout usually develops over time.

Because it can arise so abruptly, it can be important for therapists and others in the helping professions to protect themselves from this condition. Here are 11 ways to prevent compassion fatigue from happening to you:


If you know you are at risk for compassion fatigue, taking the time to learn the signs and symptoms can be a helpful means of prevention.

The most common signs and symptoms of compassion fatigue include:

  • Chronic exhaustion (emotional, physical, or both)
  • Reduced feelings of sympathy or empathy
  • Dreading working for or taking care of another and feeling guilty as a result
  • Feelings of irritability, anger, or anxiety
  • Depersonalization
  • Hypersensitivity or complete insensitivity to emotional material
  • Feelings of inequity toward the therapeutic or caregiver relationship
  • Headaches
  • Trouble sleeping
  • Weight loss
  • Impaired decision-making
  • Problems in personal relationships
  • Poor work-life balance
  • Diminished sense of career fulfillment


Knowing the signs and symptoms and continuing to check in with yourself can help you better prevent and manage compassion fatigue if it arises. Many people find that ranking their level of compassion fatigue on a scale of 1-10 is an effective strategy. For example, a rank of 6 might mean you are declining social invitations due to feeling drained and a 7 might be difficulty sleeping due to excessive worry about someone else’s well-being.


Cultivating a high level of self-awareness and understanding of how your 6 differs from your 7 can help you gage where you are so you can implement necessary strategies to avoid the red zone that would likely be a 9 or 10.

It is not only the work itself that poses a risk, but the person’s life conditions as well. For example, someone who is not only taking care of people at work, but also caring for a child or adult family member at home may be even more susceptible to compassion fatigue. If you are currently experiencing increased life stressors at home as well as in the workplace, prevention strategies against compassion fatigue may be important.

If you think you may be experiencing compassion fatigue, you can take a compassion fatigue self-assessment developed by the Compassion Fatigue Awareness Project here.


Practicing self-care can be a critical method of protecting yourself against compassion fatigue. It is not uncommon for those who are constantly concerned with the needs of others to wind up neglecting their own.

Those who practice good self-care are significantly less vulnerable to stress and compassion fatigue than those who fail to do so. A good self-care regimen will look different for each person, but it should generally include:

  • Balanced, nutritious diet
  • Regular exercise
  • Routine schedule of restful sleep
  • Balance between work and leisure
  • Honoring emotional needs

Making time for these self-care activities leaves less room for overworking, which can lead to compassion fatigue, said Nicole Urdang, MS, NCC, DHM, a holistic psychotherapist based in New York.

“Overworking is often at the heart of compassion fatigue and its first cousin: vicarious trauma,” Urdang said. “Taking the very best care of yourself includes setting limits.”


It can be especially important for therapists, social workers, nurses, and caregivers alike to set firm emotional boundaries to protect themselves. Empathy and compassion are generally at the forefront of a human services career.

If left untreated, compassion fatigue not only can affect mental and physical health, but it can also have serious legal and ethical implications when providing therapeutic services to people.The challenge is to remain compassionate, empathetic, and supportive of others without becoming overly involved and taking on another’s pain. Setting emotional boundaries helps maintain a connection while still remembering and honoring the fact that you are a separate person with your own needs.

If people in a human services career are exposed to too much trauma, they may begin to feel overwhelmed, and people may feel that overwhelm in different ways, Urdang said.

“It might manifest as insomnia, overeating, skipping meals, addictive behavior, isolating oneself, depression, anxiety, or anger. We might find ourselves fighting with partners or children, having no patience, feeling exhausted, noticing a lowered libido, unmotivated, and, paradoxically, being less interested in what our clients have to say,” she said. “Believe it or not, these are all helpful, as they quickly alert us to our depleted state. If we are paying attention and are committed to radical self-care, we can act on this awareness by rebalancing our life. If that is not possible, simply taking short breaks throughout the day to close your eyes, focus on your breath, or put your hands on your heart and send yourself some compassion can all make a big difference.”


Maintaining a solid work-life balance can help protect you from compassion fatigue. When all your time is spent working or thinking about work, it can be easy to burn out. Studies have shown work-life balance is becoming more important to workers, and making time for leisure activities and personal hobbies outside of work can help lower stress levels and improve overall life satisfaction.


While it is great to have strong relationships with your co-workers, it is equally important to cultivate and maintain healthy relationships outside of work. It can sometimes be difficult for co-workers to avoid talking about work even outside the workplace. Connecting with friends who are not aware of the ins and outs of your work situation can provide much needed emotional and professional relief.


Journaling is an excellent way to process and release emotions that may arise from your line of work. Taking the time to cultivate self-awareness and connect with your personal thoughts and feelings can help prevent suppression of emotions, which can lead to compassion fatigue over time.


Resilience is our ability to bounce back from stress. While some people seem to naturally be more resilient than others, resilience is a skill that can be learned and cultivated.

“Resilience can be thought of as the ability to adapt to and become stronger through adversity,” said Marjie L. Roddick, MA, LMHC. “It can be a protective factor against compassion fatigue, so those with higher resiliency are better able to prevent compassion fatigue. Resilience is something that can be learned, and enhancing or boosting it can reduce the effects of compassion fatigue as new coping methods are learned.”


While it may be tempting to wash away the stress and emotional burdens of your job with alcohol or drugs, this can actually work in the reverse and compound stress in the long run. Consider making a list of positive coping strategies to use in times of stress. This might include deep breathing, meditation, taking a walk, talking with a friend, watching a funny movie, or relaxing in a hot bath.


Workplace strategies are often an important part of compassion fatigue prevention. If your employer does not currently have any in place, consider suggesting their implementation.

Some workplace strategies that have been proven to be beneficial are:

  • Support groups and open discussions about compassion fatigue in the workplace
  • Regular breaks
  • Routine check-ins
  • Mental health days
  • Onsite counseling
  • Relaxation rooms, massage, meditation classes, etc.


If you find yourself feeling emotionally vulnerable, significantly stressed, or overwhelmed, consider seeing a therapist who can help you process your feelings and implement strategies to help you combat compassion fatigue and maintain a healthy work-life balance.

Her2+, ER+ Bilateral mastectomy in 2017, followed by chemo and radiation. Mack and Hannah's mom

Re: Let's Discuss...Fatigue

Posted by Drscrs on Nov 18, 2019 9:12 am

Yes, I experience fatigue, most of the time.  I had colon cancer surgery July 2015 followed by chemo and radiation.  That took the good out of me.  My bowels worked overtime.  Having to go to the bathroom 30+ times a day was the norm. Loss of weight and sleep.  It took some time before my bowels even started to settle down.  Even now, 4 years later, a good day is 6 - 8 times.  Before I could get over the surgery, I found out that I now had lung cancer. I had surgery for that Sept 2017.  That really took the good out of me.  Of course, it does not help that August 2019 I had pneumonia. My oncologist told me that my lungs were weak.  It does not help that I have a partial blockage in my heart as well as sarcoidosis (in the lungs). Since Sept 2017, I am having a lot of chest pain.  Every time I do any type of strenuous work, give me 15 minutes, the pain starts. I have suffered from PTSD, anxiety and depression all of my life.  Where does the fatigue end and the depression start?