#48 Five Fatigue Busting Strategies

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Fatigue is one of the most common complaints from breast cancer survivors and with good reason. 

Not only do we experience fatigue during treatment, but it can last and have an impact on our lives for a long time afterward.

In today's show you'll hear five strategies that you can use to increase energy and reduce fatigue in your life. 

You may think the answer lies in sleeping more, but if you've already tried that and it isn't working for you, you may be focusing on the problem more than the solution.

Learn what you can do to explore  new ways of approaching managing fatigue after cancer treatment that are 100% natural.


Nancy's List

National Comprehensive Cancer network in their standards of care for cancer related fatigue

Episode 15- MTHFR the Good and the Bad

Episode 44- Hydration, Fatigue, Glowing Skin and Weight Loss

Read Full Transcript Below:

Hello, and welcome to Episode 48 of the breast cancer recovery coach. I am Laura Lummer your host and today we are talking about five fatigue busting strategies.


Now I've got to tell you fatigue is one of the top two frustrations, let's say top three frustrations that I hear about most commonly from breast cancer survivors. And I'm going to go out on a limb here and say that the top three are going to be fatigue, pain, and weight gain. And those can fall in any order depending on what your experience was.


But fatigue is a big one, and especially if you've been through chemotherapy, radiation, and if you are on hormone therapy as an ongoing part of your treatment. So, we're going to talk in detail about that today, that hopefully will help you take some steps to be able to improve your energy, increase your energy and reduce some of that fatigue.


Before I get too far into it. Just a quick note, a quick plea I'm going to put out there if you're a regular listener to the breast cancer recovery coach, and you haven't stopped to give a review wherever it is that you listen on iTunes, Google Play, I-Heart Radio, wherever I would really, really appreciate it. If you could just take them moment today, leave a few stars leave a review. And that just helps so much to let other people know that this show is out there and help them find the information that might help them as well.


And if you haven't subscribed, just hit that subscribe button or tell Siri, subscribe and she'll do it for you right on your iPhone.


Okay, so let's get right into this because I actually have a lot to talk about today. So, fatigue is obviously an issue in treatment if you're dealing with chemotherapy radiation, like I said, or recovering from surgery. Because don't forget that when you're coming out of surgery, gosh, we have this tendency to be very disconnected from our bodies and to expect this instantaneous recovery and it's just not the way things work. So, surgery, think about it, your body got cut open, stuff got moved around, cut out stuffed in, that is a lot of inflammation and there's a lot of healing involved, and healing takes rest and recovery.


So, you can definitely experience fatigue after surgery. But there are more factors to fatigue than you may think. And today, I'm going to dig into what those are and what you can do about them.


So, a little story here. A couple weeks ago, I attended the IDEA world fitness convention. I go there every year. It's amazing. But one of my favorite lectures this year was titled: The neuroscience of behavior change, how to train the brain to create healthier habits. Now, if you listen to this show regularly, you know, I love science. And neuroscience is an area I cannot get enough of. It's so fascinating, because getting your brain on board is mandatory for creating behavior change.


Now the life we live and often the suffering we endure is directly related to the way we think, and the ability to change our brains, which is called neuroplasticity can literally change your life. And that's why my coaching is always based on mindfulness and self-awareness. It's incredible what you can change in your life if you change the way you think and approach different situations.


Okay, so back to this lecture, it was given by Dr. Julia DiGangi and I was so impressed by her. I literally signed up for her neuroscience program. While she was speaking, it was fantastic her presentation. And she made a statement during a presentation that I've been really working to apply to my own habits over and over again since I heard this.


So, she said that one of the things you have to realize is that the problem does not equal the solution. And what that means is that sometimes we get so fixated on the problem itself, that we think we're working on a solution when we're actually obsessing on the problem.


So, here's an example of mine. If you listen to this show, then you know, if you've listened for any period of time, you know that losing the weight I gained during chemotherapy has been a huge, painfully frustrating area for me. So, when you gain weight, what's the first thing your mind goes to? Eat less, move more, right? Eat less, exercise more. You want to create a calorie deficit. If you burn more than you take in, you should lose weight, right? But what happens when that doesn't work?


Well, for me, I started to spin out a little. I change the type of food I was eating. I lost sight of eating intuitively, and I started eliminating every carbohydrate other than vegetables in my diet. Some women I talked to have done the same thing. They go low carb or low fat, or dairy free vegan, and then the weight still doesn't come off.


And then that rabbit hole gets deeper and maybe you try fasting or juicing or cleansing. Maybe you switch up your workout, you do more cardio, or more resistance training, or higher impact or lower impact. But we're still focused on the two things we were initially looking at. Eat less, move more, right?


I'm guilty of falling into this pattern, and it with my background and my education, I know better, but I still do it. My brain fixates on figuring out why what should be working, isn't working.


So, what happens here is that you train your brain to develop this pattern of supporting failure of reaching your goal.


Meaning... that you start telling yourself, Well, I can't even lose weight, nothing works for me. Something may present or someone may present a new solution to you, but you just poopoo them and you say, it doesn't matter because I can't lose weight. I've tried everything. And so now you're so focused on the problem that you can't see and you're actually not working towards a solution.


So other things that impact waking might be gut health, sleep, hydration, hormones, age genetics. And these can all, especially genetics can be impacted by cancer treatment too. But if you're stuck on calories in calories out, you might be overlooking the one thing that could actually solve your problem.


At one point, I got a Fitbit to track my sleep because I started realizing, you know what, I need to look beyond this. There's something else is the issue here.


And I realized I was only getting about five hours of sleep on most nights.


I would go to bed early, and I get up early, but I would lay in bed and I'd read, and I tossed and turned, and I had restless sleep more than I realized.


So, I was now feeling tired all the time. But still, I resisted sleeping longer, because I work out at six in the morning, and I didn't want to miss my workout because what might happen if you move less? You might gain weight.


But that makes no sense at all, because I'd already been working consistently, and the move more piece wasn't causing me to lose weight.


So, do you see how I become resistant? And my brain is like, No, no, you got to keep moving even though moving isn't the answer. So, let's shift this focus for a moment from weight management to fatigue.


Like weight gain. Fatigue has many factors. But what's the one thing you focus on when you feel really tired? Sleep, right? Of course, it just makes sense. We want to stop and rest and when we sleep, or we rest, and it doesn't leave us feeling refreshed. We get super frustrated.


I get asked all the time. How do I get rid of this fatigue? And you know, I'm going to shoot straight with you here ladies, because I always do. There may be some fatigue you cannot get rid of and you're going to have to learn to work with and live with. The Dana-Farber Cancer Institute says that there is no "normal" pattern for fatigue after cancer treatment, and that some people will experience lower energy for years after treatment. So just like you can't go back to "normal" quote, unquote, I'm doing air quotes here, normal after cancer treatment.


But just as you can also create and learn to accept the new you after cancer treatment, you can manage and potentially get rid of fatigue after treatment. But you have to start looking at all of the solutions versus just focusing on the problem.


And it really truly is a problem ladies, according to the National Comprehensive Cancer network and their standards of care for cancer related fatigue. It says not only should fatigue be assessed, documented and treated before, during and after treatment, but patients and their loved ones should be informed that fatigue can persist after treatment. And they recommend that disability insurance include coverage for the continuing of effects of fatigue.


Now I've included the link to this document in the show notes for this episode, if you're interested in reading through it or discussing it with your doctor, just know that you do have to create a free account on their website in order to access these documents.


So now that you know you're not crazy, and that intense fatigue is related to treatment, let's talk about some solutions other than just sleep, but then we'll come back to sleep to be sure that we don't get stuck on the problem which is just feeling tired.


Okay, since scientists and physicians really don't understand the exact reason why cancer treatment causes fatigue, or why it can hang around for so long. There's lots of aspects that we can look at.


  1. Medication- Especially aromatase inhibitors can cause fatigue as a side effect and they can also cause pain and pain increases fatigue.


Now, let's stop for a second in my saying, don't take aromatase inhibitors all capital Little letters. No, no, ladies, I do not give medical advice. I'm simply saying it's important to recognize that these medications can contribute to fatigue. So that way you manage your life in a way that might reduce the severity of that fatigue. And one way of doing this is to work with your doctor or work with a pain specialist to reduce the pain and fatigue that you're experiencing.


  1. Stress- If there's anything that I hope you learn from going through cancer, it is the importance of self-care. The understanding that we often create our own stressors, as I just said a minute ago, and we often have the power to reduce that stress in our life.


Do we take advantage of the power to reduce that, that's a different story. So, here's what I mean in terms of stress and fatigue. Let's say that you had a certain lifestyle and certain routines before cancer. Now after treatment, you're struggling with fatigue that sometimes prevents you from living the way you used to live, or managing all the things you used to manage in the same way at the same level of energy, right?


Now you feel stressed out, because you cannot get to all the social engagements and fulfill the work expectations and clean the house and do the laundry and you fill in the blanks. So now you feel stressed, because you're worried that others are disappointed in you, and that you're not living up to their expectations and the stress you're creating by trying to do it all and worrying about not doing it all is actually creating more fatigue.


Do you see how this is focusing on the problem and not on the solution?


If you identify with this on some level, I'd like to ask you to ask yourself, what would really in truly happen if you dropped one thing?


Okay, here's an example: Now, I know that I need one complete day to take care of myself, a whole day. That could mean sleeping in, going to yoga and coffee with my sister, binging on movies, going to lunch, researching podcasts, whatever it is I'm in the mood for. But no outside commitments, nowhere I have to be for someone else. I need this day to shop, prep food for the week, get the laundry done, which I actually don't get the laundry done, make sure my husband gets the laundry done. Pay Bills....whatever needs to be done, happens on that day, so that I'm not running around like a chicken with my head cut off during the week, or going hungry because I didn't get food ready, etc, etc. Things fall through the cracks If I don't take that time to take care of myself and the things I need.


Now, I used to say I needed that time and then like book over it again, and again, and again. Because something would come up, someone would ask me to do something. And then I either stayed up too late to take care of what I needed to get done. Or I had a stressful week trying to catch up with what I didn't do. I knew what I needed for my selfcare and my peace of mind. I also didn't want to miss out or disappoint.


And although I may have enjoyed whatever it was that I gave up my time for, in all honesty, sometimes I didn't. Sometimes the entire time I was doing that other thing I was thinking about what I really wanted to be doing at home.


So now what I do is I block off the time I need for the month on my calendar, in my book and in my iPhone. And that time is a commitment to myself and it's as serious as any other commitment on the calendar. I know I need that time to balance my life, business and family and it's a rare exception for me to give it up. It's got to be something pretty important, or pretty fabulously fun.


Now, I know that this doesn't come easy for many women blocking off this time for yourself. But ladies, I'm telling you, for your optimal mind, body and spirit health, you must make time for yourself a priority.


So, here's a little exercise that I would love for you to do in this area. Make a list of everything that creates overwhelm and stress for you. And then next to each item. Write down what would happen if you didn't do that thing. Or if you reduced the amount of time you spent on that thing. Write the worst-case scenario, is the universe going to implode if you don't do this? Write the best-case scenario next to each item. Will you feel refreshed? Will you save money? Will you have more time, what what's the best thing that would come from you dropping a reducing that one thing. And then write an alternative way that you might be able to handle this thing, if in fact, it's impossible for you to give it up.


Here's an example: I hate going to the grocery store. And that sounds weird because I love to cook. But I don't like crowds. I don't like standing in line, and I don't like shopping. Now the internet is seriously the best thing that could have happened for me and shopping because I just don't enjoy it. So, here's what stresses me out over groceries. I need them every week and a week goes by fast, so it feels like I constantly have to get groceries. It takes at least two hours out of my day, two hours that I'm not enjoying. And I always forget something and most of the time it's my grocery list. So, then that causes me to forget groceries too.


What happens if I stop grocery shopping? Well, nothing good because we need to eat so really something I can't just stop doing. I could let my husband do it because he actually likes grocery shopping. But then I feel guilty because his schedule is just as busy as mine. And so, I feel like I have to do something more in some other area to make up for the fact that I sent him grocery shopping. Not good.


So what other solutions are there? Well, grocery delivery services abound. And at one point, I had to sit down and evaluate if buying $125 a year membership to Instacart and never having to go into Costco, the drugstore, the grocery store, I can even have my wine delivered to my door versus all the hours that I would spend planning and doing the grocery shopping.


It was no contest ladies and I'll tell you what actually save money. Because I have my list right in front of me. I buy only what I need online, and I am never tempted to buy extra things that I would normally pick up when I'm at the grocery store.


So even the couple dollar tip I give to the driver who drops it off is worth the time I would spend and the extra money, I would spend picking up additional items. So now I get other things done in that hour or two hours, that I wait for my groceries to be delivered. And if I'm tired, guess what? I will take a nap. That’s right.


The truth is, there are some things that are tough stressors to manage. Things like money, the health issues or going through, kids. So why not manage the things you can and lessen the total stress burden so that you have more time and energy to deal with the big important things.


Now I spend a little bit more time on this area of stress because ladies, we so often put too much stress on ourselves. You have to let go where you can. Reevaluate your expectations of yourself and others. And by that, I mean expect a little more from others, and let yourself off the hook where you can.


Okay, one final note here. Finances can be a huge source of stress during and after cancer treatment. And I have to acknowledge that. I want you to know that there are resources out there to help you ease the financial burden. I'm going to post a link to a website called Nancy's list in the show notes of this episode. And it's an excellent resource for support including activities for kids, lodging, co-pays, and transportation. Among other things, too. She's got a huge comprehensive list of inspiration and support resources for cancer patients and cancer survivors. So, if you need help, please check out this resource and know that part of your selfcare is accepting the help that others want to give.


These resources are out there oftentimes, because someone else has had to suffer through a similar stress you're going through, and they want to support others to pay it forward, so let them. Okay, this is an area that has a huge impact. So, I wanted to spend a couple minutes on it. So please take a serious look at the ways that you can reduce stress in your life.


Another area this is a little simpler to address is hydration. This is such an underappreciated part of managing fatigue. In my free download on my website, care the four steps to healing after breast cancer, I talk about keeping your body hydrated as an integral part of healing. And that's no joke. Hydration affects our bodies on so many levels.


So, refer back to my podcast episode 44, for more information on that. And keep listening for details on online challenge that I'm going to do to help you get your body hydrated to create more energy. But ladies, proper hydration is essential for good energy levels. And I'm not going to go into all the reasons why here because I did it in Episode 44.


But I don't want you to underestimate the power of a glass of water versus drinking another cup of coffee or picking up a piece of candy or getting a sugar, sugar burst of energy when you're feeling tired. Turn to water trust me on this.


  1. Exercise- Now I know it seems counterintuitive, and you may even be thinking ay yi yi, I've heard all this stuff, exercise food... Well you hear it, because it works. And if you're not doing it, I understand because it's challenging and it takes energy and focus, but that energy and that focus is the natural way to address this problem.


Okay, so if you are thinking Laura, I am way too tired to exercise. Trust me I get that. But a regular exercise program will increase your energy levels. It's that getting started is tough, but you've got to push yourself to get started. Exercise improves the fitness of your heart and your lungs, so you move more blood through your body. And blood carries oxygen, so you get more oxygen supply moving through you, and you feel more energetic. Exercise truly is medicine for your body and your mind. It improves your mood, your circulation, the production of feel good chemicals in your body.


In fact, Dr. Michael Craig Miller, who's an Assistant Professor of Psychiatry at Harvard Medical School says, that exercise works as well as antidepressants unless you're dealing with severe depression.


Now, there probably will be days when you need to rest just as I've said I needed to take rest days and you'll have to skip a workout. If you can exercise on most days of the week, this will more than likely have an impact on your level of fatigue. Shoot for 30 minutes of moderate exercise on most days. I don't want to say just three days because then you'll, I don't want to say three to five because you'll do three, but most days and start anywhere. Start with one. Start with two, I don't care but just get started. It will help you.


  1. Nutrient Deficiencies- You have to look at what you're eating. How much you're eating, are you eating enough? Are you digesting and absorbing the nutrients properly? Are you anemic? Maybe a b12 deficiency? Do you have an MTHFR variant that could be contributing to fatigue? And I did a podcast on that variant I think it was number 10 or 11. These deficiencies and nutrients are easy to find out if you're getting regular blood work. And if you're not getting regular blood work, you can ask your doctor for it. Some of them that genetic variants, you may have to ask specifically for that test.


But like hydration, nutrition is key to energy levels. If you're not eating until you're starving, or you have too many processed or sugary foods in your diet. If you're not eating in a way that keeps nice, even blood sugar levels throughout the day, rather than dramatic spikes in blood sugar, and then you wait until you're shaking again to get some food into you. That can contribute to fatigue.


So, I strongly suggest keeping a food record for at least three days. Two regular days and one weekend day, if you're battling fatigue. Now you don't have to be too detailed. You don't have to enter every calorie in every macronutrient. Try something simple like taking a picture of everything you consume with your phone and I mean everything coffee, water, cocktails, food, everything. But don't try to be a good girl when you're doing that.


Just eat what you regularly, normally would eat. When you see this photographic evidence of what you're giving your body to create new cells and produce energy, you may see an opportunity for improvement.


Alright, let's talk about sleep. Rest, downtime, just taking a break. I wanted to give you some other factors first that impact fatigue, so you don't think it's only sleep. But sleep is Uber important. And if you wake up with headaches, a drier sore throat, if you snore or have disturbed sleep patterns, you may want to get tested for sleep apnea.


Now, you don't have to be dramatically overweight to have sleep apnea as people commonly think you do. And the testing for sleep apnea has also changed a lot depending on your insurance. They'll bring the testing device right to your house, so you can do it from your home in your own bed. You don't have to be wired up at a sleep center anymore. But science is validating more and more this importance of getting eight hours of sleep a night. And if you have sleep apnea, you could be having very disturbed restless sleep and you don't even realize it.


Now, there are lots of sleep trackers, and apps that allow you to use your phone even to see how much you're sleeping and to measure the quality of that sleep. So now you may say, Oh, hey, I feel great getting seven, seven hours a night, Laura that's all I need. Or you might say, I don't feel good unless I get nine hours. And that's okay. Know what your body needs and then try to achieve that goal consistently.


So, I have a friend who takes care of everyone else, literally everyone else in the world till about 10 o'clock, maybe 11 o'clock at night. And then she does the things that fell through the cracks during the day until two or three o'clock in the morning. If this is you, this is not good sleep hygiene, and it will catch up with you. So, if you find yourself feeling like your brain is full of cotton and you're forcing yourself to push through the day, a feeling that I unfortunately am also familiar with, please consider these approaches.


This is lifestyle medicine ladies. Taking into consideration all these factors that impact fatigue, rather than stopping with that idea of fatigue is a result of treatment or medication. There are and it will might be that may be the initial cause of it. But these things if you really work on them can help to manage that.


So, let me recap.


The problem does not equal the solution.


So, if what you've been trying isn't working, try changing something else. But just change one thing at a time. Well, actually you can get blood work and then pick another thing to concentrate on too. You can do both of those at the same time because it's good to know what your blood says.


So, here is your fatigue fighting strategy list.


  1. If you're taking medications that are causing pain or fatigue, talk to your doctor about managing or reducing those side effects.


  1. Examine the things in your life that are causing stress and do the writing exercise I talked about to examine those areas. Eliminate, reduce, or delegate, whatever you can.


  1. Properly hydrate your body. Aim to drink one half your body weight in ounces of water every day. And don't say Laura, I'm going to have to pee all the time. If I do that, you're supposed to pee. It's a normal biological function. Really. So, unless you're wearing a romper every day, it shouldn't take that long to pee anyway, so you'll be fine. Drink more Water.


  1. Exercise regularly, 30 minutes a day on most days and yes, walking counts, but walk fast enough to break a sweat, so that you're training your heart and you're training your lungs to deliver more oxygen to your body and to your brain. So, you're not only helping with fatigue, you're helping with chemo brain, memory, all that that brain fog to go away.


  1. Ask your doctor to check for nutrient deficiencies, and then be really honest with yourself about what you're eating, really honest. If you're putting, processed sugary foods and drinks into your body on a regular basis, you must focus on changing this. It creates inflammation, which triggers your immune system, which requires energy, and it makes you tired in addition to the havoc that it wreaks on your blood and your organs. Make sure you're eating enough food frequently enough. Food is fuel. And every time you look at something you want to eat, I want you to hear me in your ear saying Girl, food is fuel, you are worth premium quality fuel.


This is what the next generation of your cells in your body is going to grow from. Feed them well, okay. Believe it or not, there are still many other things that can impact fatigue, other diseases, hypothyroidism, diabetes, but this is a simple list to start with.


So, when you've gone through this list, if you've checked off every box, and you still don't have more energy, definitely visit your doctor. And bring along with you all that you've done and all that you've been doing so that you can have a really valuable discussion with her on things that can be done to support your energy. And please take a nap when you need it. Sometimes we just have to acknowledge that our bodies have changed. We have to work on acceptance. And we have to say, I need a nap. I need some downtime. It's perfectly okay. Give yourself permission to do that.


Okay, so I told you I have a challenge planned. And I'm really excited about this because it's my first time of putting together an online challenge. And the objective of this challenge is to take you from exhausted, to energized by focusing on one area of this list to see how much it can actually help to improve your energy.


That area is hydration. And in this challenge, we're going to work together on habits you can create to get to your hydration goals on a daily basis. So, you're going to hear more about this next week. Make sure you go to my website and get on the email list so you don't miss the details that I will be sending out to that email list as well.


So once again, if you enjoy the podcast, if you haven't subscribed yet, hit that subscribe button wherever you listen. And a final note, remember that my online course, my mindfulness based wellness course to help you transform from where you are now to the healthy, vibrant life you want to be living is available to you now you can get it on my website at the introductory price of $37, which does change August 1. So, jumping get revivify while you can, it's a smoking deal. I'm adding some content changing it up a little and the price will go to $57 on August 1.


All right. So, go to LauraLummer.com check it out, download my free four steps to healing after breast cancer. It's the care program. You can get that for free on my website and do the exercises from this podcast. Look at all these aspects of your life because your lifestyle is your medicine, and I'll talk with you next week.




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