Fatigue and Other Symptoms After Meningioma Treatment

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Fatigue and Other Symptoms After Meningioma
Treatment

• Nancy Conn-Levin, M.A.
• Meningioma Awareness Day
• Boston, Massachusetts
• October 3, 2009

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What is Fatigue ?

• Fatigue is more than simply being tired
• Fatigue is a debilitating, persistent loss of
  energy and endurance
• Fatigue can affect the whole body
• Especially when this is a chronic or severe
  issue, fatigue can have a profound effect on
  quality of life

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Fatigue symptoms are unpredictable

• Different levels of fatigue, range from mild to
  severe
• All levels of fatigue can impact a persons
  ability to carry out activities of daily living
• Physical and cognitive symptoms may change from
  day to day, or at various times throughout the
  day
• Symptoms may include sudden, overwhelming
  feelings of mental, emotional or physical
  exhaustion

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Fatigue can affect each individual in many
different ways

• Physical and cognitive symptoms may intensify
  with added stress from lack of sleep, hunger,
  noise, crowds, new surroundings, and other
  environmental factors
• Fatigue may be more evident following demanding
  or unfamiliar tasks, or when tasks have to be
  completed quickly
• Decreased alertness or energy can emerge suddenly
  and without warning
• Fatigue can also lead to emotional reactions such
  as irritability, mood swings, anger or depression

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Fatigue is often misunderstood

• Common among survivors of many brain tumor
  varieties
• May develop following neurosurgery and/or
  radiation
• Sometimes amplified by other medical issues
• Can be overlooked when present with chronic
  illness
• May have a variety of causes and varied symptoms
• Sometimes difficult to find effective treatment
• Can be very challenging for patients and their
  family members
• Also challenging for many health care providers

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Fatigue can be difficult to confront and accept

• Few resources and support systems exist
• Especially when severe or long lasting, fatigue
  and related symptoms can be very stressful
• Some individuals are reluctant to admit their
  fatigue related challenges
• Invisible symptoms may be misinterpreted by
  others as apathy or laziness
• Fatigue may lead to family conflicts and
  relationship challenges when it is misunderstood
• Effects of fatigue may be embarrassing

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Why does fatigue develop?

• A variety of illnesses and other factors can
  either cause fatigue to develop or make symptoms
  of fatigue worse
• Anemia, side effects from medications,
  hypothyroidism, insomnia, depression,
  dehydration, poor nutrition, stress overload and
  chronic pain can all be linked to fatigue
• Sometimes fatigue is idiopathic (unknown cause)
• A thorough medical examination is always the
  first step in evaluating and treating fatigue
• Treating other illnesses or medical conditions
  can sometimes improve fatigue symptoms

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How can fatigue be manifested?

• Most discussions of fatigue focus on PHYSICAL
  symptoms and effects
• Reduced energy level
• Diminished strength or endurance
• Difficulty falling asleep or waking up overnight
• Changes in balance and coordination
• Lower capacity for work
• Muscle aches or weakness

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Attentional Fatigue Cognitive Symptoms

• Less well known, but can be equally devastating
• Reduced ability to concentrate and understand
• More challenging to process new information
• Difficulty with decision making and
• problem solving
• Organizational abilities may be diminished

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Other aspects of Attentional Fatigue

• May feel overwhelmed by ordinary activities
• Easily distracted, shorter attention span
• Brain Fog reduced mental clarity
• Unable to manage simultaneous tasks no
  multi-tasking
• More effort needed to meet minimal goals because
  of challenges focusing attention
• Individuals may have only a few of these symptoms
  or any combination

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Acquired Brain Injury

• Neuropsychological evaluation and testing may be
  used to document many of the functional changes
  related to brain tumors, neurosurgery or
  radiation treatments
• This testing can provide valuable information,
  even years after brain tumor diagnosis and
  treatment
• Cognitive deficits, impaired memory, fine and
  gross motor skill deficiencies, changes in
  information processing, verbal and communicative
  disorders and other symptoms of A.B.I. can be
  related to brain tumors

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A. B. I. Associated Challenges

• Brain Tumor Survivors can experience many
  signs of Acquired Brain Injury, including the
  following cognitive and physical effects
• Memory loss (especially short term memory)
• Difficulties with processing or retaining new
  information
• Changes in problem solving skills
• Diminished ability with mathematics
• Distractions from sensory input (noise, light,
  crowds, background movement, other ordinary
  activity)
• Changes in coordination, balance and agility

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Coping Skills can be appliedfor Attentional
Fatigue

• Reduce or eliminate distractions when possible.
• Be aware of self-care needs. Limit circumstances
  that worsen cognitive symptoms (i.e., when
  hungry, tired, stressed, distracted, etc.)
• Use reminders such as lists, notes, calendars,
  Post-its, recorded messages (tape recorder,
  answering machine, voice mail) or other memory
  aids.
• Simplify tasks whenever possible and divide them
  into smaller segments. Focus on one piece at a
  time.
• Cognitive rehabilitation can be helpful in some
  cases.

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Other Coping Techniques for Fatigue

• Improved Nutrition and Adequate Hydration -
  important for everyone!
• Light Exercise - as tolerated
• Sleep and Rest - include short naps as needed
• Energy Conservation - learn to pace yourself and
  carefully plan activities to conserve strength
• Relaxation Techniques - breathing, muscle
  relaxation, imagery, journal writing
• Dont hesitate to ask for help!!!

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Stress Management and Fatigue

• Reducing stress may improve symptoms and promote
  overall health
• Breathing exercises help increase oxygen levels
  throughout the body
• Visualizing relaxing scenes can promote feelings
  of being calm and comfortable
• Relaxation techniques can relieve physical and
  emotional symptoms of increased stress
• Stress Management techniques have other healthy
  benefits at all stages of life

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Coping With Invisible Challenges

• Fatigue, headaches, sensory overload and many
  other brain tumor related symptoms are not always
  apparent to the outside world
• Brain tumor survivors may find it frustrating to
  hear You look fine from others who do not
  understand their challenges
• Being honest and discussing your experiences can
  help other people develop more sensitivity to
  these issues

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Suggestions for Support Coping Resources

• Many local and national nonprofit organizations
  provide information and resources for brain tumor
  survivors and their loved ones
• Sharing these resources with your health care
  team will also help educate them about
  meningiomas and related issues, including fatigue
  and other symptoms

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Information and Education

• American Brain Tumor Association
  www.abta.org
• Brain Science Foundation www.brainsciencefoun
  dation.org
• Central Brain Tumor Registry of the US
• www.cbtrus.org
• National Brain Tumor Society www.braintumor.org

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Brain Tumor Support Groups

• Professionally led (nurses, social workers, etc.)
• Self-help groups (mutual aid organizations)
• Discussions, guest speakers, social connections,
  can become an extended family
• Available in many parts of U.S. Canada
• We all can learn from each other, regardless of
  where we are on the brain tumor journey!

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In summary

• If you are coping with the effects of brain tumor
  related fatigue, remember YOU ARE NOT
  ALONE!
• Coping techniques, positive self-care and working
  closely with your healthcare team all can help
  improve your quality of life

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A moment to remember

• Kim Chrane,
• A dear friend of the brain tumor community,
  whose 17 year battle with meningioma ended March
  6, 2009
• Let us continue to educate, empower and
  inspire in Kims memory!

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Thank you for being here today!
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Wishing you good health

• Nancy Conn-Levin, M.A.
• Health Educator
• Box 634, Oakhurst, NJ 07755
• email Mngioma634_at_aol.com