Battle Fatigue

Laughter and tears are both responses to frustration and exhaustion. I myself prefer to laugh, since there is less cleaning up to do afterward.
Kurt Vonnegut


Prior to starting chemotherapy and radiation, my doctor described the fatigue that accompanies these treatments as "the feeling you have after you've been at the beach all day, times ten." I experienced this phenomenon this past week and there was very little in it that I would consider beachy. What I experienced was exhaustion on a cellular level. It was as if every bodily process had just completed a triathlon and now lay sprawled on the ground gasping for air.

I was caught off guard by this latest side effect, which is so common it even has the initials CRF, for Cancer-Related Fatigue. (Although I think Can't Really Function is more appropriate.) My first two weeks of treatment were marked by an almost hyperkinetic energy, fueled no doubt by anxiety and the steroids I was receiving every two days. I was able to carry on all my usual activities, including working, without as much as a yawn. "This is going to be much easier than I had imagined," my overly active mind assured me. By the end of my first series, my doctor even joked with my wife, Kathy, that I was looking too good and he was going to have to increase my dose. (If he wasn't joking, I planned to find a new doctor, post haste.)

Then the wheels fell off the energy bus, to be followed quickly by the transmission and engine. Not only was reporting to work no longer an option, as supervisors tend to frown on frequent power naps, but minor activities became a test of endurance. Imagine becoming winded after vacuuming, light headed after walking the dogs, and in need of oxygen after grocery shopping. (That last bit was for dramatic effect; I didn't really need oxygen, but let's just say it's a good thing I had a cart to lean on.)

According to Chemocare.com the exact causes of CRF are unknown. Although, in my case, I'm told it's partly the result of the reduction of red blood cells and my body having to restore the healthy cells that are being destroyed by radiation. The website lists the warning signs of CRF as: tired eyes, tired legs, whole-body tiredness, stiff shoulders, decreased energy or a lack of energy, inability to concentrate, weakness or malaise, boredom or lack of motivation, sleepiness, increased irritability, nervousness, anxiety or impatience. While it's fair to say that at least half of the above menu described me even before my diagnosis, the difference is the shear weight of them all happening at once, minus the ability to recharge one's battery.

The psychological impact of CRF is just as profound. It's hard to imagine that you're getting better when your body feels like a rapidly deflating balloon. It's much easier for the mind to spin anxious tales of health-related horrors, converting each bump and bruise into a new tumor. The saving grace is that CRF eventually exhausts the mind. This means that thought processes that once flowed with Class 5 whitewater momentum, slow to a trickle. This creates gaps in thinking that are normally experienced only by advanced yogis tucked away in a mountainside, eating rice one grain at a time. These gaps are highly prized in the mindfulness world as they are seen as the dwelling place of true peace. In my case, they offer wonderful opportunities for meditation practice without the constant interruption of what Buddhists call the "monkey mind." The extra payoff is that meditation helps restore one's energy and reconnects one to the life that lies beneath all health related concerns.

Following the advice of Chemocare.com, I have learned to conserve the energy that I have, rest when I need to, give my body the nutrients it needs, and limit my stress. Following the wisdom of the ages, I routinely throw in a "This too shall pass," prayer for good measure.