Managing your fatigue

Many people find that fatigue is one of the most difficult symptoms to cope with. Whilst tiredness can be relieved by rest and sleep, fatigue is an all consuming and overwhelming feeling of total exhaustion. It is sometimes difficult for your family and friends to understand this.
This booklet was written to help you talk about fatigue. Why and how it is affecting you. Whilst we cannot "cure" fatigue we can work with you to help you manage your fatigue and reduce the impact it has on daily activities.

The causes of fatigue

The reasons why people experience fatigue are poorly understood, it is thought to be due to a combination of things.

Your medical condition

Many changes are happening in your body which affect the way it worked before. Your body has to work harder which uses more energy. Other symptoms such as pain and shortness of breath may also be making you more fatigued.

Treatment

The effects of medication, surgery and other treatments which you have had/are having can add to your feeling of fatigue.

Weight Changes

Your condition may result in you needing more energy for the normal body processes to happen. You may also have a poor appetite and food may taste differently so you are getting less energy from your food/drinks. Sometimes people can gain weight due to medication or have a build up of fluid, so everyday things take more effort.

Emotional impact

Feeling stressed and worried uses up a lot of energy and can affect how well you sleep, making you feel more fatigued. Fatigue can be an invisible symptom but is a very real one that can have a major impact on your life. Sometimes people struggle to understand how fatigue affects them. Fatigue affects different people in different ways. It may be helpful to tick the boxes of the areas that concern vou.

Understanding your fatigue

Energy conservation

Being able to conserve energy often helps you to do more of the things that are important to you. The main principles of energy conservation are:
Prioritising - Try to decide what needs to be done today, could some things wait until another day or be done by someone else?

Pacing - Know your limitations. Try to spread out light and heavy tasks throughout the day and do things in stages rather than all together. Remember to stop and rest when you feel tired. 

Planning - Try to plan ahead to prevent doing lots of activities in a short space of time. It may be helpful to keep a notepad handy to write things down e.g. appointments, key words to help job your memory. If possible, plan when family/friends are visiting so they don't all come at the same time which can be exhausting. 

If you need help with things at home then you may be able to ask family, friends and neighbours. Building a support network can make a big difference. If you always look like you are coping well with everything, your family and friends may not realise how much you need help. Or they may be waiting for you to ask for help.

You may find that some of the following suggestions help you deal with everyday tasks.

Washing and dressing

• An Occupational Therapist can help you work out the easiest way to have a bath/shower. Equipment like a seat may be suitable for you.
• Consider wearing a towelling dressing gown after a shower or bath as this uses less energy than drying yourself with a towel.
• Wear loose clothes that are easy to put on/take off. Have everything ready to put on and sit down to get dressed.
• Remember to pace yourself, this may mean changing your normal routine.
• It may be appropriate to have a carer help you.

Housekeeping

• Spread tasks out over the Try to do a little bit of housework each day rather than lots at one time.
• If possible, ask other people to do heavy work, such as gardening or taking the rubbish out.
• Sit down to do some tasks, if you A perching stool may be helpful.
• If possible, employ a cleaner to
• Use long-handled dusters, mops and dustpans where possible to avoid stretching and bending.

 Shopping

• If possible, go grocery shopping with a friend or family member for extra help.
• Use a delivery service. Most large supermarkets offer online shopping which can be delivered to your home.
• Make a list before you start, so you do not waste energy or time.
• Use a shopping trolley so you do not need to carry a heavy basket. A wheeled shopping bag may also be helpful when shopping and getting things
• Shop at less busy
• Ask shop staff for help packing and carrying groceries to the car.

Childcare

If you have a family, you might find it difficult to look after them while coping with fatigue. This can be especially upsetting when you are unable to do your usual family activities. To make things a bit easier you could do the following:

• Explain to your children that you feel tired often and will not be able to do as much with them as before. You may be surprised at how well they respond.
• Plan activities with your children that you can do sitting down. For example, you could read, play board games or do a puzzle.
• Try to plan activities where there are places for you to sit down while the children play.
• Try to avoid carrying small children. Use a pram or pushchair instead.
• Try to involve your children in some household
• Ask for and accept help from family and friends. For example, someone may be able to take your children to and from school.
• If you can, get a babysitter for your children sometimes and do the things you need or want to

Driving

Driving can be difficult and dangerous if you feel very tired. You may be less alert than normal, and less able to concentrate. Your reaction time will also be reduced.

• Do not drive if you feel very
• If possible, ask a family member or friend to drive
• If you need to get to hospital appointments, ask your nurse or doctor if there is any hospital transport available so that you do not have to drive.
• If you have to drive, plan your trip for when you know you usually feel more alert. It may also help to avoid driving at times when the roads are busiest.
• If you need to make a long journey, plan to break it up with regular stops or an overnight stay.
• If you feel yourself falling asleep while driving, stop in a safe place and take a break.

Preparing meals

• Try having ready-made meals or pre-cooked food when you are most tired.
• If you can, sit down while preparing
• Have the things you use most often within easy
• Prepare extra meals for double portions when you are feeling less tired and freeze them for when you need
• Try not to lift heavy pans when serving. Instead, take your plate to the cooker and put your food on it there.
• If you need to take things to the table, ask for help moving heavy items if you can or consider a wheeled                                                                     

A guide to eating if you have weakness and fatigue

 If the symptoms of your illness include weakness and fatigue your eating habits may be affected.

Some of the following tips may help you manage this better.

• Try having small, frequent meals with nourishing snacks in between. Aim to have something to eat every 2-3 hours.
• Soft food may be easier to eat because it needs less chewing. Try porridge, wheat biscuits, soup, ice cream, mousse, thick and creamy yoghurt, milk pudding and stewed fruit.
• At times, drinking may be easier than eating. Make use of full cream milk e.g. in milkshakes, smoothies, milky coffee, hot chocolate, malted milk drinks.
• Cold foods such as sandwiches, quiche or biscuits and cheese can be just as nourishing as a hot meal.
• Try to have a rest before meals. Preparing food can be really tiring. Use ready prepared meals and convenience foods to reduce preparation time. Many foods are now available in handy individual servings. Accept offers of help with shopping and cooking from neighbours, friends and family.
• Make use of home delivery services for shopping and meals (e.g. supermarket delivery, meals on wheels or frozen meal delivery).

Physical activity and exercise

There's good evidence that physical activity, such as gentle strengthening exercises combined with some walking, can help to reduce the symptoms of fatigue. Being active may help to boost your appetite and give you more energy. It can also improve your general well-being, so it's important to try to exercise a bit, even if you don't feel like it. It's best to try to get a good balance between being active, exercising and getting plenty of rest.

Before you start to do any physical activity or increase the amount you do, it's important to get advice from a healthcare professional.

You may be a little bit nervous about getting started - that's understandable. It's best to choose an activity or exercise that you enjoy. Try to maintain the amount of activity you do.

However, if you have fatigue, this may not always be possible. Remember that some exercise is always better than no exercise. Simple goals, such as walking from the front door to the back door, may be an achievable goal for you. But try to increase your level of activity and build up the amount of exercise you do a bit at a time