I talk to a lot of cancer survivors with fatigue and this is what they say:
“I want my old energy back.”
“I want my life back.”
“I was an active person.”
“I’m too tired to do anything.”
I hear these statements over and over again, almost to the word. This is what inspired me to create a system to address cancer related fatigue, because if that many people are struggling with the exact same issue, something needs to be done.
But what I also hear in those statements are echos of catastrophe and wandering, a lack of confidence in and focus on how to move forward. Setting goals is a difficult task when you’ve never been here before, never been so tired you couldn’t think, and not quite knowing where you’re going.
In this blog post, I’ll break down specific steps you can take to help focus your efforts.
First, Assess Your Starting Point.
Let me tell you a story of two cancer survivors I worked with.
Mick is a 67 year old retired physician. He has always been in great physical shape. He was diagnosed with stage III colon cancer on routine screening colonoscopy. He had surgery and six months of chemo afterward. During the chemo, he jogged every morning with his wife. By the end of the six months he wasn’t jogging his usual distance and had to cut back to just 2-3 miles each day. His only complaint was mild fatigue, acid reflux, and numbness and tingling in his fingertips and the bottom of his feet. He rode his bike to and from his clinic visits and his chemo treatments.
Keith is a 68 year old retired mechanic. He is extremely overweight and has diabetes. He had a history of losing 20 pounds over two months and had worsening abdominal pain. He then developed uncontrollable vomiting and went to the ER where a stage III colon cancer was discovered to be blocking his intestines. He underwent emergency surgery and had a complicated recovery and a long hospitalization. His wound became infected after he was discharged from the hospital and chemo was delayed. He finally cleared his infection and then received five months of chemotherapy which was complicated by dehydration, fatigue, low blood counts, and severe nausea and vomiting. His chemo regimen was cut back so that he could tolerate it and was stopped early because he was losing too much weight and had severe fatigue.
I think you’ll agree, Mick and Keith have two VERY different starting points on their road to recovery. It’s realistic for both of them to conquer fatigue after cancer, but their very different experiences with cancer will inform very different trajectories of recovery.
Mick had fatigue after cancer but was in great physical shape and already had habits like exercise to help him bounce back.
Keith had a much longer learning curve. He was an unhealthy weight before cancer but was malnourished after chemo, so he had the challenge of losing weight but restoring his lean muscle mass with high protein. He also had to stick to a diabetic diet. That’s a hufe challenge!
Keith had also never exercised before and was physically deconditioned after treatment, so he had to work with physical therapy a long time to get him up to speed, then start a regular exercise program which he didn’t really have an established structure for in his life.
Nobody’s battle with cancer is better or worse and nobody is at fault for what happens to them during their medical or surgical course. It’s just important to realize where you’re starting from so you can appropriately pace your goals.
In other words, if you’ve had a rough trip, go easy on yourself. Give yourself a break.
Second, Quantify Your Goal.
“I want my old energy back” isn’t a goal.
It’s a wish and wishes don’t always come true.
Setting quantifiable goals is the only way to get anywhere in your quest for energy after cancer. So let’s put a number on fatigue so it can be tracked, analyzed, and improved.
If you’ve downloaded Brio’s Morning Checklist, you may be familiar with the 0-10 fatigue scale I recommend you use. Zero is no fatigue at all. Ten is “hit-by-a-truck-tired.” Said differently, ten is when you can’t get out of bed.
Every morning, noon, and night for a few days, rate your fatigue on the scale.
Then, look at your average. If you’re usually around a 6 in the morning for instance, set a goal like this:
“My goal is to consistently be 5 on the fatigue scale in the morning.”
Third, Be Realistic.
You might be thinking, “Only a 5! One point improvement on the fatigue scale isn’t good enough!”
OK, I get it. I know you want a greater improvement than one point, but it’s a realistic place to start and will set you up for success.
What if Keith set his goal, after all he’d been through, to get from a 5 to a 1 right away? That doesn’t make sense considering his starting point, right? For Mick, maybe it might make sense, but even for Mick I think a goal of a consistent 2-3 is better to start.
A cascade of small successes eventually adds up to a big win. But if you set your sights too high at first, it will set you up for failure and validate a sense of hopelessness. And hopelessness is not the direction you want to go.
Fourth, Set A Timeline.
To make a goal happen, you need to set a due date. Otherwise, it will be difficult to set a pace for yourself. Depending on your starting point, your timeline also needs to be realistic. Mick might have a timeline of 8 weeks to get from a consistent 5 to a consistent 2.
Keith, on the other hand, might need 4 months to get from a consistent 5 to a consistent 4. And that’s ok. Just think, in a year, he might be to a consistent 2 - that’s awesome for someone with his starting point!
Timelines can be tricky because they’re arbitrary due dates to help with accountability but they ARE NOT a finish line. If you don’t reach your goal by a certain time, that’s ok. Timelines are simply check points, an opportunity for assessment of your progress. If you didn’t reach your goal by the timeline, unity to make sure your goal or timeline is realistic and whether your efforts and methods are genuine and consistent.
Fifth, Reward Yourself.
When you reach your goal, you’ve got to celebrate! Organisms like us human beings respond positively to rewards. Condition yourself to enjoy the effort it takes to reach your goal.
I recommend making the reward itself something that furthers your wellness goals. An example of a reward could be a healthy cooking class or subscribing to a healthy food delivery program to better improve your nutrition. Or what about a few sessions with a private trainer to get even more fit, or a meditation retreat in an exotic locale?
Like I said, this sets you on a positive wellness feedback loop. Spend your monetary and energy resources on cultivating even more energy and wellness in your life.
I hope this blog post helps you understand the process a cancer survivor can take to set a defined, fatigue-related goal. To take it one step further, I’ve created a FREE Energy Goal Setting Worksheet. It’s a great tool to help you set the right goals, right now. You can use it over and over as your goals change and it includes an assessment tool to help you think about your goals, whether you reach them or need more work. Click the button below to download the worksheet.
Happy goal setting, Survivor!