Fatigue

I have now had my 3rd round of Kadcyla. The first is given over 90 minutes to ensure that there is no adverse reaction. The doses thereafter are given over 30 minutes. The last 3 weeks, with the odd exception I have been beyond knackered. So I asked the great oracle (which is the internet and facebook) and there is a theory that giving it over 60 rather than 30 minutes reduces the level of fatigue. So this is what I asked for and got.

I decided that this time round I would do as little as possible immediately after treatment. This was quite easy as I am knackered. In fact day 3 I spent most of the day in bed asleep. The annoying thing is, that apart from the extreme fatigue, I actually feel quite good, no aches or pains. There is no way of describing how completely debilitating fatigue from cancer is. It is amazing how many people say to me, yes I'm very tired too. I know what they mean and I long to be that tired.

There is an open letter from a breast care nurse who unfortunately was diagnosed with breast cancer earlier this year. It is a long list of apologies, the most telling of which is, " I didn't get that when you said you were tired, you really meant so much more. Sure there are words like exhaustion and extreme fatigue - but there should really be a separate word just for cancer patients, because it's crippling. Really. Some days you really wondered how you'd trudge forward. I'm sorry. I didn't get it."

I am hoping that this initial complete collapse of my energy will improve. There is always the steroid route, but then although it does boost energy levels and appetite, it is a short term fix and furthermore, there is a huge crash when the steroids are stopped.

Anyone who tells me that a little bit of exercise helps with fatigue will be best advised to move out of my immediate vicinity, as I will summon up what very little energy I have and probably thump them,

Shrinkage, Yoga and False Sense of Security

Quite a few people over the last few months have commented upon my height or rather lack of it. I have also noticed that things I used to reach with ease are now a little further away. When I went for my usual blood test and pre-assessment I asked them to measure me. The upshot is I have shrunk by half an inch, which when you are only 5 foot 2 inches, is quite a lot. However, about 9 years ago I started doing "old lady" yoga and over the first year I grew by half an inch. So I am of the opinion that  I haven't shrunk so much as slouched, as I have done little or no exercise, yoga or otherwise, for about a year.

As it happens I have resumed my "old lady" yoga, since I now feel that my body is stable enough and not so painful. I have done two sessions. The first one was hard, but I was very gentle and listened when my muscles said "Nope, not doing that." The second session, which was 5 days after treatment was much, much harder, but I did complete both sessions and they were totally worth it. Although, I suspect that I enjoy the relaxation part much, much more than before. I am hoping that yoga will perform its heightening miracle again.

The drug I am on, as I have said before, is Kadcyla. Its side effects are minimal. The main one being constipation which I find easier to cope with than the alternative. The biggest problem with these minimal side effects is that they do lull me into a false sense of security. I had treatment on Thursday and was out of the unit before lunch, which is unheard of. I had a snooze that afternoon. On Friday I popped to the shops and the bank, in the car and again had a snooze in the afternoon. Saturday I did a bit of shopping, had a snooze in the afternoon and then went out for an early dinner. Sunday, I did nothing much and had yet another afternoon snooze. Monday, I went to work, left early-ish and had a snooze. Tuesday I did yoga in the morning, a spot of shopping and a snooze in the afternoon. Wednesday, I got up as per usual and felt bleugh. I was supposed to have my usual weekly lunch with my mum, but thought better of it and spent the day in bed. I slept fitfully, had a spot of lunch and slept some more. When I finally got up I felt much better. I'm not sure if it was the cumulative effect of doing stuff in the days immediately after treatment, or the cummulative effect of the last 8 months of treatment. Either way, my day in bed was clearly what I needed. What I will do after my next treatment is...nothing at all.