I cried this evening.
I began to get tearful while talking to a friend on the phone, describing how tired I’ve been lately. Just tired. “It scares me,” I said, and I welled up. I did my best to keep it in but only partially succeeded, so I went and blew my nose and splashed water on my face and came back to the phone, declaring myself to be “just fine”.
After the phone call I set about doing evening things – tidying the house, wiping the kitchen counters, going upstairs to get ready for bed – and I burst into tears. I feel like I’m declining – slowly, but inexorably.
I’m not ready yet. So much left to do! There’s a major writing project that is barely off the starting block. There are people I haven’t yet told how important they are to me. There is a broken relationship in my family that I’d love to mend before I leave.
Then I realized that it’s still not death that is worrying me, but the inactivity of end-stage illness. I am nowhere near that point, but I find myself thinking about it more often recently. This increasing fatigue makes me think of it.
Being the person I am, I began researching cancer-related fatigue. This is a way of gaining control: perhaps there are factors I can influence. Even if there are not, knowledge is a kind of mastery for me. Things are less intimidating and frightening if I understand them.
I found this diagram at CancerNetwork, home of the journal Oncology. It is from an article called “Fatigue and Dyspnea” by Sriram Yennurajalingam, MD and Eduardo Bruera, MD of the Department of Palliative Care and Rehabilitation Medicine at M. D. Anderson Cancer Center and was published on 11 November, 2011 in the online edition of Oncology.
I can see I’ll be referring to it frequently in the coming days. I already see some factors that I can influence and probably change with a resultant improvement in my energy level.
- Dehydration. I am very bad at getting enough to drink, especially in the winter. I already have a medicine tracking sheet, so I’m going to add a column to it where I can keep track of how much I drink each day.
- Pain/drug side effects. I need to rethink my decisions about pain control, to discuss it again with my doctors.
- Psychological distress. I will stop diagnosing myself (I’m fine!) and arrange to be evaluated, especially for depression and anxiety.
And now I feel much better – for real this time. I’ve gathered information and started to make an action plan. It’s a quarter to one in the morning; I should probably think about getting some actual sleep after all this talk about fatigue.