Zombie state

          Towards the end of my fifth cycle of six I am experiencing the cumulative fatigue that I remember from last time, though this time seems more extreme.  Which I don't really get since I am only on one chemo drug.  Maybe Taxotere's cumulative effects are building from the six doses I had two years ago.  Lifetime accumulation... Just saying I'm tired doesn't really begin to describe it.  One of the women in my online support group described it better than I can and said we were welcome to share, so here is the most accurate description I have read or heard:

I have a few words to say about being tired.

After over five years of chemotherapy, fatigue is becoming a constant companion. While some drugs were worse on me than others, I have needed more sleep and it takes less activity to make me tired. Pre-cancer, I exercised one to two hours daily. Now I exercise 2-3 times a week on a good week, and not at all on others. I sleep 10-13hrs every night (more after chemotherapy, a bit less as it leaves my body). I do normal activities but need more frequent rest breaks. If I exercise (ride my bike, walk or take an aerobics class), that is pretty much all I do that day.

Chemotherapy fatigue is not amenable to rest. I mean, resting does not bring enough recovery to become fully physically active again. Some therapies cause outright exhaustion to the extent that I felt like a “zombie” all day. Others, who are in remission, may not ever get rid of the reduced energy and tiredness, even years after treatments have ended. Long term medications like femara and tamoxifen aggravate fatigue and cause joint pain. So even survivors are left with energy deficits. As we age, the rate of cell reproduction declines. I suspect that this is partially the reason we are so tired. Chemotherapy itself kills off healthy cells and it also accelerates aging overall.

Exercise is an oft-repeated remedy for tiredness. In addition, it has proven health benefits, including maintaining a higher rate of cell replication, heart health, aerobic capacity, strength, flexibility and balance. I know this to be true. As a former avid exercise enthusiast, a good brisk walk after work or a long car ride revived my energy. Recent studies have indicated that exercise can delay or inhibit 
cancer from metastasizing to other areas of the body.

Unfortunately, if I choose to exercise, I cannot do the housework or the yard work afterwards. I feel especially sorry for young mothers with cancer. How do they keep up with an active toddler who rises at 6 a.m. after waking her parents three times during the night?

My point is that calling it fatigue or tiredness is inaccurate if it has resulted from cancer and chemotherapy. It is not “normal” fatigue. It happens without any physical activity at all. It does not disappear after a good nights sleep. It overwhelms unpredictably (I need sleep now!). If a cancer patient pushes herself to keep up in spite of it, she may spend 2-3 days in bed recovering.

We could use a better word for it; we could use better education for the oncology and research professions; we could really use a useful remedy and we would be thrilled with a treatment that does not cause fatigue. 

        Monday I have the last (for now, and if scans look good) infusion session with the chemo agent Taxotere, which is the culprit in my current zombie state.  Six or so weeks after that I may be a little less dazed and confused.