my husband has received 3 doses of Erbitux and undergone 6 sessions of radiation therapy. I know fatigue is normal but when is it too much. I voiced my concern to the nursing staff at the chemo clinic, but they just said fatigue is normal. He is basically this side of a coma. He is arousable, but would continue to sleep if I let him. He will shower himself, but didn't have enough energy to shave. His blood work was good. don't know if this is depression, or brought on by the chemo/radiation shcedule. Also, he asked today what type of cancer he had..... I realize he may get chemo brain, but we have basically just started treatment. He doesn't want me to say anything to the doctors because he doesn't want them to hold or stop his treatment. His response.... well when I wake up I will be all better! Help!!!

They are correct that treatment can cause fatigue, as well as cancer itself, medications, any underlying medical conditions, malnutrition, dehydration, lack of sleep, being bed ridden, no exercise, age, depression, psychological, etc. It's difficult to answer what is too much fatigue, and is best answered by his doctors, and by them doing an evaluation, physical exam, blood work, and correcting any deficiencies noted, and seeing some of the above mentioned items are properly addressed if not met.

As far as nutrition, as quick guide, you basically need 12-14 calories per pound of weight to maintain it. 15-17 calories to gain, between 1 grams of protein for each pound of weight, some say twice that for healing, recovery, and half your body weight in liquids every day, but can be higher, lower based on needs, and instruction by your medical team.

I conserved energy when I could. I used a shower chair to sit on when showering, used a walker, and sat on that when cooking, which was way after treatment, and used canned nutrition solely during treatment or ordered out.

Mention your concerns to his doctor(s), and your husband's loss of mental status, which may be of concern.

Good luck with everything.

You will hear this over and over... everyone is different and will respond in their own unique way. Some struggle from day 1 while others barely notice any side effects at all.

There could be many reasons behind why your husband is so fatigued. I would take a good look at his intake and start there, next check what medications he is taking.

For your husband to get thru the treatments with the best results, every single day he should be taking in a MINIMUM of 2500 calories and 48 oz of water. If he can get more in thats much better and can only help him. The day of and after chemo his water intake should be higher, like 64 oz of water. Some here will say that should be his daily water intake. You can also ask the doc or a nutritionist to help you with this.

Many medications will have side effects. Pain meds and even benedryl will make the patient tired.

As the treatments continue dont be surprised if your husband doesnt get progressively more fatigued. Radiation has a way of building up and even after he finishes the treatments it will still continue to work for a couple more weeks.

I remember when I went thru rads/chemo in 2007, it was all I could do to get out of bed. I would set the alarm to get up 10 minutes before my kids came home from school. I quickly got dressed and went to sit on the couch pretending I was there watching tv all day when I was really sleeping all day.

Treatments are rough! Wishing you both all the best with everything.

He sounds pretty normal. Many different responses. The harsh fatigue I had. The first weekly chemo was not bad. The. Second round had on my back for 5days. The third round and it 8 days down , just enough energy to get. This was the induction treatment which was followed by chemo and rads. The weekly chemo had minimal side effects.

I disagree Don, after only 6 rads he should not be anywhere close to what she is describing.

MLC, I'm with you, this needs immediate attention. Someone needs to find out what's going on, be it depression, meds, etc. Yours and his "journey" has really just begun and you need to get a handle on this NOW because believe me it can quickly (and usually does) get much much worse.

MLC - It really is SO important to make sure to check and re-check everything that is going on with meds, nutrition, liquids - what goes in and what comes out as well. Different people react differently so it's important for your husband's doctors to know this. Reactions can change to different meds. My son had such fatigue, and slept so much I got to the point of checking his breathing. I had to wake him to take meds and when he resisted my "telling him what to do", I made a chart of all the meds and his liquid and nutrition intake and made sure he checked anything off that he did so he wouldn't think it was his mother telling him what to do. (I had my own copy so I could verify with his.) On the chart I also listed all the doctors' names and phone numbers as well as the nice office assistants so that when I called them, I was able to let them know what was happening and I could mention the name of the last person I talked to at the office. This really helped. BTW - as your husband's caregiver, you have the right to talk to his doctors and express your concerns.

MLC,

The difficulty is the fatigue makes you want to lounge more which slows everything down in the body and makes you more tired. Without breaking that cycle by sitting up at least throughout the day and avoiding naps as much as possible, it starts affecting sleep patterns and that slows healing, increases pain and also contributes to many of the neurological deficits created from chemo and/or rads.

The important thing is keep the doctors in the loop just as you are. If you believe it is beyond just being whooped from the treatment, you need to be a bit more stern with the medical team. If it troubles you, make it trouble them as well, or nothing will get addressed. It's not the time to be timid.

As David says, get the attention now, it will get tougher with more rads.

The chemo I received each week during showed
no side effects. Chemo-rads was where rad did its number.

As stated if you feel bad, call the doctor.

Thank you all for your responses. We saw the radiation oncologist yesterday and she was not that concerned about the excessive fatigue. We see the oncologist tomorrow. Husband has perked up a bit, so maybe this was just a fluke thing.

That's good news, MLC - Hope your husband has many more "perked up" days!

MLC my view on doctors and nurses has changed during treatment. Previously I would go to a doctor, they would diagnose it, give me a pill and that would fix it.

For more complex things like cancer treatment, its like steering a ship. From experience I expect if I turn the wheel this much the ship will do this. But every ship is different, and they have to make course corrections to compensate, its not set and forget. Thats the difference with medical supervision over complex treatments. Don't be alarmed when things happen differently to what you expect. You are closely supervised during treatment and they can make adjustments to the treatment as you go. Make sure you and your husband voice your concerns and the medicos can assess the best course for you as you go.

MLC -
glad that your husband has perked up a bit. I think that if I had to go through that sort of therapy, I would want to sleep through it. Are you able to take a bit of a stroll outside? I firmly believe that one of the things that helped my husband the most was that we walked our old dog every morning. Getting some fresh air every morning is a boost to the body as well as the spirit.
Best wishes to you both!
Maria