Fatigue management.

I am a 75 year old male diagnosed with Non-Hodgkins Lymphoma (specifically IgG-secreting Lymphoplasmacytic Lymphoma) and was on of a schduled 6 ycles of Bendamustine & Rituximab chemotherapy. Cycle 6 did not occur due too my 'hematologist/oncologist' team cancelling it as chemotherapy was deemed ineffective on me. My paraprotein level had not shown any, or much, improvement as it had stagnated and plateaued at a level considerably below anticipated. November 2023, I was placed on Zanubrutinib (Brukinsa) which I am still taking. Initially Zanubrutinib stopped the progression of my paraprotein level; however, that same level never regressed either. I was considered stable during this time. Unfortunately, after 2 years, it appears Zanubrutinib has stopped working on me as recent trends appear to indicate.

I had extreme fatigue and little, or no, internal energy while I was being treated with chemotherapy. The fatigue and energy seemed to ameliorate noticeably at the start of Zanubrutinib; however, the extreme fatigue and the lack of internal energy has returned now.

I have found it helpful when I am able to become somewhat more active (which is not easy with the fatigue). Dealing as best as possible with the extreme fatigue and lack of internal energy I have found is a never-ending battle.

@qsjack Walking and rebounding (mini-trampoline) have worked wonders to reduce my fatigue.

I met with a medical counselor before chemo, who advised me that movement, even though it might seem counterintuitive, was a great way to combat fatigue.

I already owned a rebounder and continued bouncing during and after treatment. I had a walking routine in place before my diagnosis. The hardest part was making myself walk when the couch was so cozy.😆 However, once I got out the door, I had to make myself go back home.🤭

I find it best to find something that has a low barrier to participation. I'm sending you good energy.🤗
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Here's some info about rebounding if you've never heard of it. Please don't hesitate to contact me if you have any questions about rebounding.

YouTube Videos about Rebounding
Cancer Rehab PT - Title: Rebounder Exercises for Lymphedema and Lymphatic Drainage - For Beginners

try getting treated with targeted therapy, not chemo. With the advent of targeted therapies tailored for various stages in CLL , chemo has been phased out.

Exercise helps, even going for a short walk. Balance and light resistance training is good. Mostly one has to pace themselves, take naps, consider meditation, get enough sleep, and control stress as much as you can. Any escapes are good, TV, hobbies, talking with friends.

Is the problem motivation or physical exhaustion?

The body is a marvelous machine, but it needs food to generate energy to move. If nothing tastes good, try new foods that you have not experienced before -- healthy foods, without seed oils, nor loaded with sugars (or refined carbs which quickly turn into sugars).

You might find new foods tasty. Or on the flop side, you won't ruin by association foods you've always enjoyed.

If the problem is motivations: find people you interact with and ask them to encourage you to take a few extra steps, get the blood flowing, or offer a smile. You can do it. Others have made it -- you can too!

Focus on how you're recovering, not on the pain, discomfort, or exhaustion itself. Look forward, not down. What can you do. Then, do borrow a commercial tag line:

Just do it!

And finally, get some rest.
Turn off the boob-tube.
Turn off the lights or close the curtians.
Flip up the recliner, lounge on the couch, or go lay down in bed.
And relax and get some sleep. Let your body restore itself.

Later get up and go again.

Hi Chris,
I am 10 months post stem cell transplant for leukemia and have persistent fatigue. Unfortunately our wonderful cancer doctors are not always wonderful about helping with fatigue, so you really have to advocate for yourself. Here are some tips in that regard 1. Ask for lab tests for fatigue like ferritin, thyroid complete panel, vitamin D, B12, B6, cbc, cmp and more- do a quick search to find more 2. Get a referral to meet with a cancer rehab physical therapist to get an exercise routine (yes I know you don’t feel like you can do it but at least you’ll have it and can do bits of it.) 3. If your diet isn’t great then meet with a nutritionist 4. Get fresh air every day even if it’s only a five minute walk. 5. Try to find hobbies and friends to spend time with 6. Finally if test results are normal and none of the other things help then you can meet with a psychiatrist or other doctor to talk about getting a medication to help give you energy (things like provigil or adderall). My understanding is only psychiatrists prescribe these types of meds - it’s not because you have a psychiatric issue. This is only a short term fix but it may get you to a place where you can start doing things and hopefully your body will get stronger and your fatigue will lessen. That’s what I’m doing now - step 6 - it helped take the edge off the fatigue so I’m more able to be more and quality of life is better. Good luck. Fatigue is difficult and only those who have it truly understand how hard it is.

Some suggestions ;
1-Complete hormone panel
2-Daily walk
3-Dietary changes, no seed oils, use butter,ghee, and tallow. Stop all processed foods.
No sugar because sugar feeds cancer cells.
4-Mental changes, develop positive outlook, stop TV go back to reading.