Fatigue & Stuff- Linda Cuaron Speaks to Support Group

liver411

Date:  Mon, 4 Nov 2002 11:32:41 -0700
(This information is from my notes of June 15, 1999. Linda Cuaron RN, MN,
Patient Care Consultant for Shering Oncology Biotech, came to speak to our local support hepatitis support group in Boise, Idaho. Accuracy of this
information is not guaranteed. Steve Bingham.)

1. There has been much recent research on fatigue. Fatigue is often an
issue with people who have hepatitis and/or those who are undergoing
hepatitis treatment.

2. All things that cause fatigue should be considered:

~~shallow breathing
~~anxiety
~~fever - Fever can affect the metabolism of nutrients, Vit B1....
~~diarrhea
~~pain
~~depression
~~inactivity - Decreased activity is a downward spiral-- the more you rest
or sleep, the more fatigued you get and then you want to sleep some more. You "can't sleep fatigue away." Cuaron cited a study where subjects
reported that they were much less fatigue after moderate exercise
than before exercise. Hospital patients need 3 days to recover at
home for each day they were lying in the hospital.
~~environmental influences - such as traveling a lot.
~~lack of sleep - June is a bad month for sleeping because some people
can't sleep with the sun lighting up there room early each morning.
Most people in Alaska where daylight hours in the summer are very long
have black-out curtains on their bedroom windows.
~~medications can cause fatigue

3. Keep a fatigue diary where you stop 5 times each day and rate fatigue
from 1 to 10. Notice any trends.

4. Sometimes you can ease fatigue during the day by taking a break from
what you're doing and walking around.

5. Interferon therapy can cause anemia which causes fewer red blood cells. So you need to utilize all the remaining blood cells by increasing your
nutritional status and by breathing deeply.

6. People on hepatitis treatment usually wake up feeling well, but,
morning being their busiest time, they lose steam after a couple of hours.
Try to avoid the morning rush by delegating tasks to others, fixing simple
breakfasts (be sure to eat breakfast), sitting instead of standing. Our
society sometimes dictates that we stand when it would be more healthy to sit (Airline ticket agents wouldn't think of sitting while on duty but it
would decrease their fatigue.)

7. While sitting at the computer, stretch your legs out as much as
possible. Your legs shouldn't make a right angle at the knees.

8. Sometimes doctors don't want to talk about fatigue (and other symptoms of hepatitis and side effects to therapy). In that case, ask your doctor to refer you to someone who WILL address the fatigue, such as physical therapists or nutritionists.

9. Water is important. We all need 2 liters of water a day-- 3 liters
during the summer. We all walk around dehydrated. Our cells are like
little sponges and "you know what a dry sponge looks like." No other
fluids are as good as plain water, and some fluids actually delete body
moisture, such as coffee (caffeine) and ginseng tea. For every cup of
caffeinated beverage you drink, you need to drink 2 cups of water.
Carbonization and some juices (cranberry) are bladder irritants and create
the need for more water. Why don't we drink more water? Answer: We don't like water, it's boring, our city's water tastes bad, like other beverages better...

10. Some experimental things that docs sometime give for fatigue are
Vitamin B12 shots, ritalin, and paxil, but Cuaron wasn't recommending these things. Marinol, "marijuana pills", can stimulate appetite and relieve
pain, nausea, vomiting, but there are probably other better medications
that can do the same thing. (Patients who have smoked marijuana in the
past tend to respond to marinol without getting a high, but if the patients
have never tried marijuana previously, they are apt to have a bad "trip" on
marinol.)

11. Exercise even when you don't feel like it. Each day have an
achievable goal even if its walking for 5 minutes.

12. Ginger capsules (not ginger tea) can relieve mild nausea.

13. Cytokines. Hepatitis and interferon causes the body to release
cytokines. Cytokines are what cause many of our side effects, such as
arthritic symptoms, skin rashes....

14. Immune systems are like fingerprints-- no 2 patients' immune systems
are alike.