Best Tips to Combat Fatigue

December 2, 2020

Featuring Stacey Prieur RN and Jennifer Gillette

December 2nd Lunch & Learn with the LINK Notes

Best Tips for Battling Fatigue

1st Speaker- Stacey Prieur RN, BSN,CHTC, Transplant Coordinator,
Blood and Marrow Stem Cell Transplant Program at the Barbara Ann
Karmanos Cancer Center- Has been in BMT since 1991.

Fatigue is different than tired. It is an unrelenting exhaustion that does not
go away with rest alone. It can be chronic, and it can come and go.
It is the #1 complaint of oncology patients, so it is important not to be too
hard on yourself about it.

It can cause brain fog.
Why does fatigue come with transplant/cancer treatment? A new immune
system, responses to intense chemotherapy/radiation, major changes to
your daily structure, lower appetite that could affect nutrition, low blood
counts, side effects of medications, hormonal imbalances, pain, stress,
other underlying health issues.

Tips to manage it the best you can-
1) Talk about it with your health care team, maybe even a counselor.
2) Try to create structure with your day, it can lower stress.
3) Shower daily, sit in a chair as much as possible, try to walk what
you can daily.
4) Keep a diary of when you are most tired, when you are most
awake, and try to plan accordingly.
5) Set limits and learn to not overdo it. Do things in pieces instead of
trying to accomplish everything at once. Pace yourself.
6) Talk to a peer mentor.
7) Try meditation or hobbies to relax you and lower stress.
8) Exercise
9) Plan ahead
10) Accept help or consider paying for it (Ex. Get a housekeeper).
11) Freeze extra meals
12) Allow yourself to rest
13) Balance rest with activity
14) Exercise
15) Plan ahead
16) Accept help or consider paying for it (Ex. Get a housekeeper)
17) Freeze extra meals
18) Allow yourself to rest
19) Balance rest with activity

2nd speaker- Jennifer Gillette, LMSW, MSW Staff Social Worker at
nbmtLINK- over 20 years oncology experience

And now, I will share some of the great tips we received from patients.
Keep in mind, what works for one person might not be the exact formula for
you. However, you will figure out how to best manage yours by taking a
trial-and-error approach. If it is something you and your doctor are
comfortable with, try it at least a few times before you automatically say it
does not work for you.

FATIGUE TIPS
• It is important to focus on what we can change when managing fatigue.
We cannot change a diagnosis, a treatment path, getting older, etc.
• We can try to change pain management, how one is coping/depression,
our nutrition, our sleep habits, management of other possible health issues,
muscle fatigue, and blood levels. We can also look at how we manage our
time and prioritize what we can get done in a day.
• Sugar and excess carbs such as those found in alcohol can make sugar
levels spike and plummet. Therefore, they can make fatigue worse.
• It is important to learn your limits with your energy and try not to overdo
too much. You want to steadily grow in endurance but going way beyond
your limits one day can cause great consequences for the next few days.
• Exercise is highly recommended to those with fatigue as building back
muscle increase energy. It can also increase mood, help memory, and
keep you at a healthy BMI, (body mass index).
• You can start exceedingly small, perhaps 5 minutes a day or by starting
physical therapy. Livestrong and the YMCA have also developed a great
program for cancer patients.
• 30 minutes a day as recommended for many adults is not realistic for
most patients. It is important to start small an add to it as you can tolerate
it.
• Relaxation, mindfulness, and CBT Therapy can improve quality of life and
help people cope better. Some people also do better with medication for
anxiety/depression as well.
• It is important to eat enough protein and healthy fats to promote healing.
• Keep hydrated, drink 8- 8oz glasses of water a day.
• Practice good sleep hygiene. Do not watch TV or play on screens for 30
minutes before bed. Only sleep or be intimate in your bed. Other activities
in the bed can make your brain more stimulated before sleeping. Do not eat
right before bed. Consider a sleep study if apnea suspected.

• Some people get Ritalin/Methylphenidate on occasion to help them have
more energy for special events. Taking it daily will lessen its ability to help
but it can give a boost for a special day or when trying to start back to an
exercise routine.
• Fatigue is challenging. It is important to plan ahead, ask for help, and to
prioritize what you need done

Barb
She shares to go outside every day, find humor, and put on your lipstick.
Anything that helps you feel better helps you get through this. She
chooses to just accept the changes in herself and to walk in gratitude for
what she has. She keeps positive as she focuses on trying to help with the
care of others, especially with helping with her grandbaby.

Tom
After his transplant, Tom really struggled with fatigue and strength issues.
Once again, his mindset determined how he was going to push thru it. He
belonged to a gym and started as quickly as he could to get back. This
took time as he even had a hard time lifting his feet after the transplant.
One time, he even fell asleep in the tub. However, he just kept trying to get
stronger every day and within a few years he ran in a leukemia charity
event with all three of his kids. “I had to do it, I needed to have a goal.”
Tom said after five years, he felt rather good.

Rhonda
Rhonda Kokot- Survivor
• Shared that she never would have wanted leukemia but that her
experience has turned into a gift. It has taught her how to live her best life.
• As a runner, she shares that she sees the transplant journey like a
marathon and not a sprint. She framed her experience to be a mile she

had to frame her brain to run 26 times, (instead of looking at the marathon
as a whole 26 miles at once).
• Everyday she asked herself, what can I do to make myself physically
stronger, mentally stronger/more positive, spiritually stronger, and socially
stronger. She believes 80% of this fight was psychological. Envision your
goal.
• In the beginning, she found it helpful to ask for a treadmill for her
room. She found even short walks on it or even moving from the bed to a
chair made her physically stronger.
• She emphasized the importance of having someone to advocate for
you. You cannot do everything and need to reserve your strength for
things you need to do.
• Keep your eye on the prize, your second chance at life.
• Ask for help, you need a support network.
• Change negative mindsets. Remember, you are not a burden, you
are a blessing.
• It is hard to keep up with others socially. However, you need support.
She chose to blog. This also allowed her to control what she shared.
• She had someone that was her liaison to control her social agenda.
They arranged visits when she was up to it but also informed others when
she was not up to visitors.
• It helps to have someone taking care of the financial aspects of this
situation. This person can assist with negotiating, payment plans, etc.
• Spiritually, she found that she had to figure out what this was in her
life. What is my connection? For her, this went beyond a belief of a
doctrine, this involved a belief that I can and will continue.
• Be at peace with your choices.
• She shared several losses. She took time to review options every
time she faced a loss. You cannot always choose what happens to you,
but you can choose how you handle it.

• She still lives in fear and lives everyday as if it could be her last and it
has been 17 years.
• Fighting for your life takes enormous courage and you need to will
yourself out of bed every day.

Meredith
Discover what time of day your body is at its peak and try to schedule what
you need to do during these times
Allow yourself breaks
Prioritize
Break bigger tasks into smaller tasks
Ginseng Tea- Mayo study 2gram a day about 8 weeks improvements

David
Find ways to be social, even on the transplant floor
Exercise
High Quality Foods instead of junk food
When able, get involved (He helps others going through the journey now)
Fatigue is no joke, get the rest you require, and it helps you get more done

Jen
Jen recommends keeping a list of the gains you make so you have
something to reference when you feel discouraged. Jen learned how to
adapt with the changes she noticed with herself. Walking around the office
once an hour and resting her eyes from the computer were important once
she was strong enough to return to work. She also modified her time in the
office.
Jen recommends the video, The

New Normal, made by nbmtLINK.
Visit our website, www.nbmtlink.org. Jen shares how important it was to
see this recovery as a marathon and not a sprint.