Help me avoid lethargy after three months of chemotherapy.

June 8, 2011 11:08 AM

I've had a chequered history of employment and illness over the last year - after redundancy last summer, I finally got a job (i'm a bid manager) in December, only to be diagnosed with testicular cancer in February. I've spent three, nearly four months going through chemotherapy with the associated recovery periods at home in between, and now the chemo is finished I can't seem to get myself started again.

My employer has been exceptionally generous and paid me in full whilst I wasn't working over the last three months, and they are keen for me to restart work (slowly), but I can't seem to find the energy to do anything other than read fiction, sleep and occasionally watch TV. It's dragging me down and starting to depress me; not something I typically do.

I've tried teaching myself Java (something I've always wanted to learn), but lose interest quite quickly - this is a new trait that is intensely annoying. I find it difficult to concentrate for any length of time on anything! To add insult to injury I have a number of blood clots in my body, caused by the tumour, that will take surgery to remove and as a result I can't really do much in the way of exercise as I get tired quickly.

So, my question is: do you have any advice for getting started / restarted / getting energy back? Or am I trying to do too much too quickly? The last chemo session was three weeks ago.

posted by jjleonard to Health & Fitness (9 answers total)

Best answer: I think you might be trying to do too much too fast. I would imagine you've been through a very trying time, both physically and emotionally, and you might simply need time to heal.

What you are describing sounds very much like depression: the lack of energy, the lack of interest. Being depressed doesn't necessarily feel like sadness... Have you talked with your doctors about these symptoms?

In the short term, I would advise to be very gentle with yourself. Accept that reading and watching TV and sleeping are perfectly acceptable activities; sometimes you truly need the downtime to recharge. Additionally, I think getting out of the house every day would help. Go to a cafe, check out the library, take yourself out to lunch. Low-stress and short duration outings can be energizing.
posted by Specklet at 11:49 AM on June 8, 2011

First, congratulations on completing chemo!!

The lack of concentration is a documented side effect called chemo brain or chemo fog. Your memory may be fuzzy for a while.

As for the sluggishness, that's part of chemo. Talk to your doctor about lingering side effects. I had chemo and radiation in 2008 and my energy levels are still climbing back. It won't happen overnight, but you will eventually feel better. It's not you, it's the chemo.

Take it easy, eat well, exercise in moderation and get plenty of rest. You'll be back.
posted by Atom12 at 11:52 AM on June 8, 2011 [1 favorite]

Modafinol has had some indications of success for chemo brain.
posted by yarly at 11:57 AM on June 8, 2011

I only have anecdotal evidence, but when my father went through his first round of chemo, he felt much the same as you did afterwards. Sluggish, couldn't focus, tired easily - he complained that he thought he'd never feel "right" again.

However, after a few months, he told me that he woke up one day and felt pretty great. He described it as the weirdest thing - tired, tired, tired, still tired, tired, tired... Hey! I'm awake! He thought of it as being in a cocoon and letting his body heal, and then when it was ready, all systems were go again.

I hope this is the case for you, too - take your time, and make sure to eat what your body craves - my dad loved to eat beef broth during the "tired months," but wasn't at all interested afterwards.
posted by HopperFan at 12:22 PM on June 8, 2011

I think you're probably trying to do too much too quickly. Surgery, chemo and hormonal changes can all really wipe you out, and in combination and with additional complications it makes some sense that your are still feeling the effects. I'd recommend speaking to your oncologist/physician to see what the typical recovery looks like for someone who has had your particular chemo regimen and your complications. Let your employer know what to expect based on that, and work out a plan together for how to integrate work back into your life.Do you have any contact with other survivors of testicular cancer? They would really be the experts for what to expect and how others have coped with the transition from treatment and battling the cancer back to more prosaic everyday stuff. Here are a http://www.cancercompass.com/message-board/cancers/testicular-cancer/1,0,119,30.htm?source=CMPASPPC&c=adCenter:adCenter-Compass-Testicular_Cancer:Testicular_Cancer|Living_With:survivors_of_testicular_cancer:Broad&ef_id=C3xNnJqbXX8AAAKe:20110608183016:s of spots to start

In the meantime, how is your support system? Do you have friends/family that can pick up some of the day-to-day stuff that might get in the way of your recovering (e.g., grocery shopping, light cleaning, etc.). Rest, eating well and slowly building up your endurance for activity (e.g., add 10 minutes of work, or housekeeping or something like that to your day at a time. If you tolerate that add 10 or 15 more. Back off when you get tired). are what you can focus on now.

Congratulations on your fight so far and continued healing in the months to come.
posted by goggie at 12:35 PM on June 8, 2011

Argh! Those links got garbled between preview and post. Here they are again

Cancer Survivors Forum for TC
TC Cancer dot com
Cancer Compass
posted by goggie at 12:39 PM on June 8, 2011

Response by poster: Thanks all for your input thus far. I've discussed this with my wife (who is an absolute rock, btw) and she tends to agree that I'm doing too much too soon.

I've not considered the 'chemo brain' effect - i wasn't even aware of that - and I'm overdue to see my doctor, so I'll investigate the options with him. I've still got the testicular surgery to come; i'm aware that this may have some hormonal affects.

Thanks for the links and the support - it's back to the sofa and a bit of relaxing for me!
posted by jjleonard at 1:16 PM on June 8, 2011

Another thing to consider is low testosterone. Bring that up to your doctor the next time you see him/her. They can check your level with a simple blood test.

Mine kept getting lower and lower. Got my first shot on Monday. What a difference. In addition to more energy, I just feel...better. Downside is that a possible side effect is prostate cancer, though, so make sure that gets covered too. For me, it became a quality of life choice. I feel a LOT better than I did, and my treatment was a couple years ago.

Feel free to MeMail me with questions.
posted by Atom12 at 1:39 PM on June 8, 2011

Response by poster: Long term followup to the question - thanks for all your input.

I've taken it a lot easier and relaxed myself thoroughly, adjusting my expectations of what I can do from one day to the next and things are a lot better. The hardest thing to adjust to is 'chemo brain', which I genuinely hadn't heard of until I read this thread - and is incredibly frustrating. It's a battle every day to not set myself tasks that aren't instantly flummoxed by my short attention span.

My employer is proving to be very supportive about easing me back into work, so with their support and the concept of more rest than I used to, I'm getting back into things slowly!

thank you to all.
posted by jjleonard at 10:41 AM on July 11, 2011 [1 favorite]