How to Manage Fatigue

Am I fatigued, or just exhausted?

Fatigue1All of us BigD-ers feel weary at times. I’m often most tired just before I dialyse. Some days I arrive at the unit, dragging one foot after the other, dead tired. Putting my needles in can be as marathon effort. And once I’m on, I sit back, suck a couple of ice cubes, close my eyes and I’m in dozy land.

But half an hour later, I wake, bright and rested.

Thinking about it, most times I’m physically tired from my physical activity throughout the morning – my early morning walk, house stuff, running around, computer work. By the time I get to dialysis, I’m exhausted and ready for a long sit-down. And the sit-down solves the problem.

Exhausted manOn the other hand, fatigue is a lingering tiredness that is constant and limiting. With fatigue, you have unexplained, persistent, and relapsing tiredness, that is not relieved by naps or long periods of rest. So how can we manage fatigue?

Guest post: How to Manage Fatigue

This pithy and practical guest post is from Constance Peng, Provisional Psychologist / PhD student at the University of NSW in Sydney, Australia. It has some great advice and ideas to help us BigD-ers put a little more energy into our day.

At least 60% of dialysis patients say they often feel fatigued

Fatigue makes it difficult to participate in enjoyable and meaningful activities, can lead to depressed moods and overall poorer quality of life. If you are one of the 60 per cent, and your doctor has not identified any medical reasons for your fatigue (e.g. anaemia, hyperparathyroidism), then it is worth thinking about making some lifestyle changes.

Studies have shown that dialysis patients who have poor sleep and are physically inactive tend to experience more fatigue.

Some tips to help you improve the quality of your sleep and increase your physical activity

Go to bed and wake up at the same time every day (even on weekends). This will train your body to know when it should be asleep.

Limit your daytime naps to 30 minutes and have them before 3pm, unless your doctor advises you to nap more often. Try not to nap during your dialysis treatment. However, if you do, remember that napping excessively during the day makes you more awake at night.

Sleep only when you are sleepy. If you cannot fall asleep within 20 minutes, get up out of bed and do something boring until you feel sleepy.

ActiveSchedule in daily exercise you can easily fit in between your dialysis treatments and other commitments. It can be as simple as 15 minutes of slow walking, stretching or gardening. Stick to this no matter how tired you feel.

Pump it higher!Practice pacing. If you try to do too much on days you feel good, then you will feel too tired the next day to do much. This is a called a “boom and bust cycle” and you will end up doing less over time. Instead, aim to gradually increase your physical activity over time. For example, you can increase the length of your daily walk by five minutes every fortnight. Stick to this plan no matter how tired or energetic you feel.

If you would like further information on how you can tackle fatigue by changing your behaviours and patterns of thinking, it may be worth speaking to a Clinical Psychologist, who can explore the underlying causes of your fatigue and use effective techniques to help you get more out of life!

The BeanThis article first appeared in The Bean, the newsletter of the Concord Hospital Renal Unit, Concord, NSW.  Thanks, Constance for sharing it with us!

If you would like read more of The Bean, or sign up, click here.

Yet another !*?*?*! adventure?

This time the adventure began when I went to the toilet. When I looked at the result I saw a black mass surrounded by red wine that I don’t remember drinking. My heart fell: not good.  I thought, will I tell Julie and have to go back to that damned ED? Or will I just stay quiet and hope it is a one-off?

I flushed and began to walk away when I needed to go again.

Same result, with more red wine. Actually, all red wine.  Er Julie, have a look at this. She looked at me with just a touch of anxiety, looked into the bowl and said: Pack your hospital stuff, we’re going to Emergency, no arguments.

Blood transfusion Number 1

Blood transfusion Number 1

I hate it when I’m, right. (more…)

Getting fit and staying fit on dialysis – bit by bit

1-fitbitIt is pretty well accepted all over the planet that being fit helps you to enjoy life more and is a major driving force for a longer life.  Not just BigD-ers; everyone.  And the two biggest challenges to our fitness are getting fit and staying fit.  We all face the same problems getting fit.  But staying fit can be a little trickier for people on dialysis.

This is because those of us who have made the effort to get fit between dialysis runs can get our legs cut out from under us by a spectrum of medical dramas that pounce on us from nowhere.  Dramas that people with full kidney function would either barely notice, or not need. (more…)

A little older in the shoulder

For the last few weeks I’ve had a sore right shoulder.  I think it started at the gym.

I have been going to a gym of some kind for years.  I did a little boxing in my youth (light welterweight) and played rugby for a while (no 8) in the navy and have always liked to keep fit.

But then my kidneys morphed into Mr Potatoheads, and the gym became a bridge too far. (more…)

Guest post: The Big Red Kidney Walk

Hi everyone.  Thanks for your messages and good wishes.  I am certainly on the mend, but it is an aggressive little bug(ger), and I think I have another week or so before I’m back to normal.

So, in the interim, a guest post!

The Big Red Kidney Walk is on again on 14 September, around Australia.  Kidney Health Australia put on the Walk every year.  It is designed to help raise awareness and funds for kidney disease across Australia. (more…)

Dialysis steal your moxy? Exercise and variety gets it back

(Sorry about the delay in writing.  I have been working on a post about the appropriate treatment for fistula haemorrhage, signs and symptoms, actions to take so that people can compare what should be done to what was done.  It is taking longer than expected, but it’s coming soon.)

For a range of reasons, I stopped going to the gym about six months or so ago.  I had aches and pains and a little arthritis, and it seemed to me that the gym wasn’t helping.  Also, my knees became wonky to the point where I couldn’t run for 30 minutes without ending up needing a Zimmer frame for the rest of the day (almost).  I had lost my Moxy – my style, my coolness, my confidence.  So I got the sulks and decided that would I drop my gym sessions and runs, and replace them with extra walks and more rides on my exercise bike at the BigD.  What difference could it make? (more…)

Feeling good on dialysis after a setback

Getting fit on the BigD can be a challenge, especially in the early days or after surgery or some kind of other medical or physical setback.  But there’s only one way: slow and steady exercise, letting your body gradually build up condition.

It’s been about four months since I’ve been to the gym, and I started again yesterday.  What a shock.  Talk about the guy who gets sand kicked into his face.  What a wimp.  I strain with tiny, girlie-sized weights and pretend not to notice when tiny girls pick up the man-sized ones. (more…)

Riding an Exercise Bike on Dialysis – Part 2

A while ago I wrote about riding an exercise bike attached to the BigD chair, and mentioned that there may be a more portable, more affordable option. Well there is, and it is.

After about six weeks struck low with some virus and a fractured wrist, I am now getting back into exercise. I have really missed it, for all the reasons I have written about before: handling the BigD less well, feeling tired and weak, fidgety, and most of all not sleeping well.

So as daddy’s little helper, I have purchased a mini exercise bike to use while I’m on the BigD.

The Magneciser exercise bike

It’s a Magneciser exercise bike (USA import) from Sportstek, 6 Park Road Oakleigh. Actually, Max and I paid for half each, so we can share it, but I picked it up! We paid just over $100 each, wholesale, which is OK.

It’s a funny little unit. Quite light (just over 7kg) and easy to move around, and simple to use once you get the hang of it. One design flaw is that because it sits in front of you, it tends to slide away from you if you are not positioned just right. However, this was easily remedied by buying a non-slip mat from a rubber ware shop (like Clarke Rubber, not the adult kind).

Exercising the exerciser

Exercising the exerciser

I ride it for the first half hour I’m on the machine. This has the proven benefit of improved phosphate removal due to increased muscle blood flow. Half an hour is enough. I have other things I usually want to do, and if I use it longer, I run out of time. While I pedal, I eat ice (for pleasure) and listen to podcasts on my MP3 player for entertainment.

One thing I have noticed: for me, it’s not such a good thing to work too much above my fitness level. Firstly, I get hot and sweaty, which is not great for my neighbours (or my street clothes, though maybe I should change into gym gear?). Secondly, for some reason, I find it hard to relax after I get off the machine. Maybe I’m just too wound up. It may be just me, everyone is different, but for now I will settle for a gentle, lightly sweaty half hour.

Other than that, I am getting fitter, my phosphate is going down and I’m feeling well. All-in-all a half hour well spent.

Verdict: these little peddlers are available everywhere, they’re reasonably priced and they offer real benefit. Give one a try!