It depends on a number of things on what comes next. In hindsight i may have been tired, but did not notice. I am a person who just keeps moving. I ask for a hematologist following my breast cancer treatments as my blood numbers were not increasing finishing treatment but slowly decreasing. At the City of Hope, I was provided a doctor who suggested a bone marrow biopsy. He too found the MDS. I had the 5q deletion and a TP53 mutation in addition to another mutation. I was given a watch and wait or bone marrow transplant. I might also add that my MDS was Low-Medium. Based on Statistics for how many progresses to leukemia, and the fact my genetic test also diagnosed BRCA2, I thought for a minute and send BMT please. That day i was activated on the Bone Marrow registry.
I have read on this sight how people get transfusions or start with low dose chemo. One experience i have for fatigue was during my chemo treatments for breast cancer. I walked through 13 rounds of chemo, worked from home and was living life. The 13th round was Adriamycin and that got me. I was telling my sister on the phone how tired i was that day and she said that is not tired, you are fatigued, and you need to call City of Hope's triage line. I got my fiend to drop me off and got into the emergency room. I thought they would check me over and send me home. Blood test, chest scan and vitals. The Doctor in charge came in after an hour or so and i asked him if i would be going home soon. He said NO, your blood numbers are extremely low, you are going into the hospital. We will take care of you. I was in their 4 days as i also had a fever i was not aware of at 103. The nurses needed to treat me and order a blood infusion. I was diagnosed with Pancytopenia.
Fatigue needs to be reported to the medical team. I am sure there are suggestions. I would ask in those 3-month visits, what would be the next step in treatment. I was 63 when I had my bone marrow transplant.