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Tired after cancer or heart problems
If you’ve been seriously ill, you want nothing more than to get your life back on track. But a lingering fatigue sometimes prevents that. What can you do then?
‘Everyone is tired at some point, right?’ Many people who remain tired after an illness have heard it. Yet the fatigue after illness is very different from when you go to bed too late. Your body feels very heavy and you have no energy for anything. Moreover, the fatigue can suddenly overtake you. This makes it difficult to make plans. After all, you don’t know if you have enough energy for the things you want to do.
A quarter of people who have been seriously ill – think of cancer or heart problems – remain extremely tired for a long time, sometimes up to more than ten years after they have been declared cured. The fatigue can then no longer be directly traced to the illness they had. It is usually impossible to see from the outside how severe their fatigue is and the complaints are difficult for those around you to understand: ‘You were better, weren’t you?’ The good news is that you can do something about it. With professional help and a different view of the fatigue, it is possible to recover a large part of the fatigue.
Not just a little tired
Why is it that your body continues to falter for so long after illness? With cancer, your life is turned upside down. Fatigue is very common, even after the treatment has already been completed. Whether or not you suffer from fatigue partly depends on the type of cancer and the treatments you have had. With heavier treatments such as chemotherapy or radiation, the risk of fatigue is greater than if you had surgery alone. These treatments are simply taxing on the body and you spend much more time recovering. Age also plays a role: if you get a treatable form of cancer at a younger age, in many cases you can fully recover. At a later age, the condition is often a lot less than before and you may also suffer from other conditions. The consequences of the disease are added to this. How long the fatigue lasts varies from person to person and is difficult to predict.
Tired from stress
Another cause of fatigue is tension or stress. When you are recovering from a serious illness, you have to deal with all kinds of insecurities. Questions like ‘will I get back to my old self?’ or ‘will the disease come back’ running through your head. These thoughts cause a lot of stress. Our immune system responds to stress. After you have been seriously ill, your immune system is often more sensitive; it not only comes into action faster and more violently when you have a virus among its members, but also when you experience stress. Stress makes you tired sooner than before your illness. This can make you even more insecure; you don’t know exactly what’s going on and you may be worried that the disease is back. You enter a negative spiral, which can be frustrating and exhausting. With chronic lung diseases such as COPD, your lungs also deteriorate. You become short of breath and get less oxygen. As a result, you quickly feel more tired than before.
Roadmap
It is therefore not surprising that you are tired with many chronic illnesses. What can you do about it?
1. Get your blood tested
To start with: first make an appointment with your doctor for a blood test. You can become very tired due to anemia, a deficiency of thyroid hormone or vitamin D.
2. Get plenty of rest and relax
The second step is also a logical one: enough rest. But it is important to choose the right moments. If you’re tired during the day, it’s tempting to take a nap in between. However, sleeping during the day disrupts your biorhythm. In the evening you get less need for sleep. You lie awake longer and before you know it worrisome thoughts arise. This will make you sleep worse or wake up too early.
Eliminating your afternoon nap is often quite difficult in the beginning. Still, it is more than worth the investment, because if your biorhythm functions properly again, you have much more energy during the day. Taking a break on the couch is fine, as long as you don’t fall asleep. Do you toss and turn in bed at night and can’t get to sleep? Then try doing a relaxation exercise. Think of something nice, for example a vacation. Some people unconsciously tense their muscles when stressed. Because the body is not relaxed enough, you do not fall asleep. A good exercise is to tense and release your muscles piece by piece. If you find it difficult to do all this yourself, listen to relaxation exercises.
3. Save energy for the fun stuff
More rest is also: making choices. Finding the right balance between doing things and taking rest is quite a quest for many people. In any case, make sure you have enough variety in your activities. Walking or reading all day won’t make you feel better. Rather, alternate things that require you to concentrate, such as work or administration, with time to exercise and social activities. If you are tired because you went to a birthday, walking the dog can give you energy again.
In any case, make sure you have enough time to do fun things. Even if you have little energy, you may still want to do the essentials, for example having your house ready or arranging practical matters. But if this means that you no longer have energy for fun things, this is not the right balance. So now and then let things go and go out with friends, go for a nice walk or just go into the city.
4. Put your muscles to work
When you are ill, you usually move a lot less and sometimes you are completely confined to bed for a while. Your muscle strength deteriorates quickly. In people who have had cancer, the combustion of energy in the cells sometimes goes less well than before. It feels like you can’t take another step. Due to the less efficient combustion in the cells, it can take longer to grow strong muscles again. Good exercise therefore helps against fatigue. But don’t overdo it. An overly intensive training program is counterproductive.
If you are an avid athlete, accept that it goes slower than before. Get plenty of rest and don’t waste all your powder in the morning. This will prevent you from being disappointed with your recovery. If it proves difficult, make an exercise program together with a physiotherapist that suits your situation.
5. Tackle Worrying Thoughts
Worrying about your health and recovery is extremely exhausting. We often push away fearful thoughts. Unfortunately, the thoughts usually do not disappear and the fear comes up at unexpected moments. Getting a grip on your emotions and thoughts helps to reduce fatigue. In cognitive behavioral therapy, an effective and proven method for severe fatigue, you learn to turn worrying thoughts into more helpful thoughts. For example, if you worry about whether you can pick up your old life again, it helps to find out what you can do. Make a list of what or who you need for your recovery. That gives peace.
Also with mindfulness-based cognitive therapy you learn to better deal with emotions such as frustration or anger and to accept uncertain thoughts. Because you become more aware of your body, you will recognize signs of stress more quickly and you can feel better if it becomes too much. This may mean saying no more often. Not everyone around you will always understand this. That can be frustrating, but guarding your limits is essential if you’re serious about tackling fatigue. If you can let go of having to explain to everyone how you feel and accept that not everyone always understands you, you will have more energy for fun things.
This article was produced in collaboration with Marije van der Lee, head of scientific research and health care psychologist at the Helen Dowling Institute. She conducts research into severe fatigue during illness.
Do you also suffer from severe fatigue after illness? Then look at www.fitterbij sickness.nl.
This article previously appeared in Plus Magazine February 2020. Want to subscribe to the magazine? You can do that in an instant!
Sources):
- Plus Magazine