Posted January 13th, 2009 by Jane

I have written about ‘chemotherapy fatigue’ before. Nothing changes but its therapeutic to write again.

I am tired. I am tired all the time. I am also because I’m tired: grumpy and irritable..all the time. I didn’t get up on Saturday. I rose on Sunday…briefly…I got up at lunch time yesterday and wept. Today, I ’should’ be feeling better so I’m up already…11.30…but ‘getting up’ bathing, ‘getting dressed’…forcing an elasticated sleeve on a hard hot puffy arm, pulling open drawers to find clothes…all this is very tireing and I have to sit down between each activity.

I will probably be tired for the rest of my life. That which isn’t chemotherapy fatigue is, so I am told, the onward growth of cancer, though no one has yet explained what physiological changes cancer brings to induce this exhaustion.

‘Exercise’ says my oncologist. ‘Gentle walking’ She is both right and wrong. I can’t any longer get up the steep route into town, but yes I do feel sort of better when I manage a few hundred yards to the local shops. Except walking makes my back hurt which means more oramorph.

”You have to adjust your thinking about what you can do’ says my hospice nurse. ‘Focus on what you can do, rather than on what you can’t do.’ She is both right and wrong. Cognitive behavoural techniques are the easy answer to any contemporary difficulty…and yes they work…but only up to a point. I don’t want to adjust my thinking to realising that if I have a visitor on Friday, I can’t do anything for the next three days.

Buzzing round my head is the definitive essay on the perils of ‘positive thinking.’ It doesn’t get written because I haven’t quite got the stamina to sustain an argument. I’m too tired.

Meanwhile I have had just one and a half cycles of vinorilbine…with another half due on Thursday if my ‘bloods’ are OK. I think the tumours are softer. Onc thinks they’re softer too. But they’re still there, and always always my rational voice wonders if this tiredness is worth slightly softer tumours. For now yes probably it is, because when I’m not on chemotherapy the rapid growth does make me feel completely out of control…and in any case these days I seem to be tired whether I’m off or on chemotherapy…oh how perceptions change, how thinking changes, how easy it has become to take on that role of desperate cancer patient.

And I am so tired.