This blog post originally appeared on The Patient Advocate’s Chronicle on April 18th, 2019.
I’m dragging and I can’t figure out why. My blood sugars aren’t right, and I feel like I have overcommitted on some projects. But this is different, not something that can be addressed with more sleep or caffeine. I know this because I am getting 8-9 hours every night and I have tried caffeine, which I don’t really drink unless I need it to not fall asleep at my desk. No, this is a long-lasting fuzzyheadedness that is affecting my productivity. I probably would have spent last weekend in a Game of Thrones watchathon anyway, but I shouldn’t have felt like I needed to. And on Monday, I was tired enough to trip over a free weight right in front of me, and I think I sprained my pinky toe. Even if it’s not sprained, it did bleed all over my off-white carpet.
Most chronic conditions come with some kind of fatigue. Anything related to the thyroid, heart or lungs, anemia, diabetes, high blood pressure, heart disease, psychological conditions, and so many more all have fatigue as a symptom. Most of mine do. But, sometimes it can cross the line into something more. How bad does fatigue have to be in order to be classified as more than a nuisance?
Mine is slowly taking over my everyday life. I’m the girl who can jump into pages and pages of dry legislation and tell you what it means, and who gets lost in a book for countless hours at a time. Now I can’t summarize a three-page memo.
Recently, I’ve read a few articles that talk about strategies to deal with it, but I don’t want to deal with it. I want it to go away.
Is it time to email my doctor? I was trying to figure out how many appointments in a row I’ve mentioned being tired, but I can’t remember. Makes me feel like my body is working against me.
The question is, what can she do to help? And if it’s all the stuff I already know how to do – fix blood sugars, lose weight -- but am struggling to follow, is it worth it to reach out and lean on her? Or should I continue to try to address it on my own?
I would argue that it is worth it. What if it is more than the usual stuff my condition does to me, or the usual stuff has shifted? What if it’s a different condition? In order to have the most effective relationship my provider, she has to know what’s going on, not just when I see her, but when something – like fatigue -- has gone beyond nuisance to interfering with my everyday life.
But how to approach it? Is it just a heads up because you are mentioning it between visits? Is it a statement of facts or do you add how it’s affecting your mental health?
Whether it’s a voicemail, email, or communication through a patient portal, don’t minimize. Be as thorough as possible, and state what you want from the communication. Try to give a timeline and describe the progression from nuisance to real problem. Let your provider know if you want to go in for an appointment (I do this when I feel out of control) or if you think you can get some relief through discussion. Hopefully your provider will respond in good time, but if they don’t, be persistent.
Even if fatigue is a part of your chronic condition, there’s no reason to let it take over.