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JessicaV · 08-27-2015, 07:29 PM

Hi Spitfire, I do understand your concern. But the fatigue may well have another explanation
I too have been fatigued for a long time after finishing Chemo in July 2014. You and I both had Docetaxel and Carboplatin in our TCH combination, and I am told that platinum salts are particularly prone to causing ongoing fatigue. They are known to cause neurological damage in hands and feet, ie neuropathy, and may well also cause some damage to brain cells, which makes it harder for the brain to then do its usual processes required for complex thinking. So after a while of working fine in the morning, cognitive fatigue starts up and makes everything you do, both mental and physical, very hard.

It is a bit like having a traumatic brain injury, which also causes fatigue. I am told it gradually gets better, but can take years. Doctors want to call it depression because it stops you doing things you enjoy, makes you reactive and frustrated and unhappy. But if you start with energy each day and then lose it, and that's when the problems hit, it is not depression which doctors/oncologists etc want to call it and to treat, (though I am sure it can lead to depression I think if not accommodated).It seems to be about learning to budget your energy to get the important stuff done yet still have joy in your life. Hard.
best wishes
Jessica

08-27-2015, 07:29 PM	#9
JessicaV Senior Member Join Date: Apr 2014 Posts: 206	Re: Is Fatigue a Sign of Mets? Hi Spitfire, I do understand your concern. But the fatigue may well have another explanation I too have been fatigued for a long time after finishing Chemo in July 2014. You and I both had Docetaxel and Carboplatin in our TCH combination, and I am told that platinum salts are particularly prone to causing ongoing fatigue. They are known to cause neurological damage in hands and feet, ie neuropathy, and may well also cause some damage to brain cells, which makes it harder for the brain to then do its usual processes required for complex thinking. So after a while of working fine in the morning, cognitive fatigue starts up and makes everything you do, both mental and physical, very hard. It is a bit like having a traumatic brain injury, which also causes fatigue. I am told it gradually gets better, but can take years. Doctors want to call it depression because it stops you doing things you enjoy, makes you reactive and frustrated and unhappy. But if you start with energy each day and then lose it, and that's when the problems hit, it is not depression which doctors/oncologists etc want to call it and to treat, (though I am sure it can lead to depression I think if not accommodated).It seems to be about learning to budget your energy to get the important stuff done yet still have joy in your life. Hard. best wishes Jessica __________________ 1997-2004 many cysts, many MG & U/S: polycystic breasts. Sept 2013 found lump,Cyst?? forgot lump. Dec 2013 GP check, Referred for U/S, MG,FNA. 7 Jan 2014 Radiology: Radiologist turned screen away from me. When asked she said "Not a cyst, very suspicious.See your GP asa results avail." Cancelled my psych clients for the week. 8 Jan 14 GP: 2.2cm IDC in 6cm DCIS field. FNA=malignant cells. Referred to Surgeon. Cancelled my psych clients for the month. 13 Jan 14 Surgeon said L mastectomy not lumpectomy, offered neoadjunctive trial, agreed adjunctive chemo after surgery a good choice for me. Booked Body scan and bone scan for staging (both fine) Surgery for16 Jan, 16 Jan 14 Surgeon also agreed in preop meeting to also remove 6cm fatty cyst in job lot. Good job done. 19 Jan 14 discharged home with 1 drain. 22 Jan 14 drain partly pulled out overnight, serious seroma (600 ml reducing removed every 2 days for a month) Serious staph infection because nurse said wait 3 days for yr surgeon appointment. 26Jan 14 pathology: 2.2cm Grade 3(3,3,2)ER-, PgR-, HER2+2 so to be confirmed by Sish test. Node negative. No vascular or lymphatic involvement. No metastases in scans. 30 Jan 14 HER2+ high amplification, 13 gene copies per cell. 21st Feb 14 Began 3wkly TCH adjuvant treatment at The Mount Hospital Perth, with 3monthly MUGA heart tests +Oncologist or Surgeon full physical check-up. Cancelled my psych clients for 6 months. Feb 14 First MUGA test: 71%, First C15.3 test: 20 7th March 14 began Neulasta self-applied injections 24hrs after each TCH treatment. Bonepain helped by spa, heatpacks and Claritin, reflux/indigestion helped by Somac. July 14 completed docetaxol and carboplatin, ongoing herceptin to 12 months. Severe cognitive deficit/fatigue after 1pm daily. Sept 14 Second MUGA test: 69% Cancelled my psych clients for 2014 Dec 14 Third MUGA test: 70% Second C15.3 test : 20 Cognitive fatigue delays return to work. March 2015 Tachycardia pulse 168, night in hospital. Cardiologist says no heart disease, ALIVE ECG attachment for my mobile phone now regular monitoring. July 2015 Worktrial, up to 8hrs per wk. Fatigue ongoing Aug 2015 Heart good, no evidence of cancer, just Fatigue. May 2019 Melanoma 1.5cm Stage 1 by right collarbone(was present as large freckle in 2014 and cut through by breast surgeon to remove fatty cyst at same time as mastectomy.) Melanoma removed leaving scar from shoulder to breastbone. In hospital twice for IV antibiotics. Told catagorically this could not be BC mets. Dec 2019 Still NED, still fatigue in late afternoon, but have my brain back in the early mornings. So most days I watch the sunrise and hear the birds morning chorus in my bush backyard and am glad to be alive and to be me still.