[2021-02-08] Recovery time
I had a busy day today—at least by my current standards. After my morning walk with my husband, I made cookies for my sister and chatted with her for a few minutes outside my house when she dropped by to pick them up. This afternoon, I had a physically distanced, masked walk with my oldest brother. And I had my daily call with my mom. (Our focus today was arts and crafts—such as knitting, sewing, and quilting—and how my mom learned how to do them.)
By the time I sat down to write this post, I was pooped. As little activity as this is compared to what I used to do in a day, it's a lot and a reminder that I still have a lot of healing and recovery to do. In fact, I had a call with a surgeon this morning who told me that while an incision heals to 80% within six weeks, internal healing takes much longer. That conversation was prompted by the possibility that my abdominal pain last summer was caused by issues with my gallbladder. The surgeon recommended against any type of surgery (such as removal of my gallbladder) for at least a year after my total hysterectomy (removal of the uterus and cervix), bilateral salpingo-oophorectomy (removal of the ovaries and fallopian tubes) and omentectomy (removal of the omentum, an apron of fat that covers the internal organs). He also noted that chemotherapy can weaken incisions.
I had assumed—like many people, no doubt—that my energy level would bounce back within a few weeks of concluding my last chemotherapy treatment. That has not been the case.
Others who have undergone cancer treatment warned me to not push myself to get back to my old ways too soon. Dr. Le made a similar comment last week, indicating that it could take up to a year after chemotherapy for me to feel completely back to normal.
I found similar advice online. In Ways to help recover from chemo and how long it takes, Dr. Shelby Terstriep writes:
It is your last chemotherapy infusion or radiation treatment. Your family and friends are celebrating with you, you ring the bell, and then you move on with your life.
If only it were that easy!!
One of the hardest things I see people struggling with is "recovery time," particularly as it relates to fatigue from cancer treatment.
The rule of thumb I usually tell my patients is that it takes about two months of recovery time for every one month of treatment before energy will return to a baseline. Everyone is different but at least this gives you a ballpark. This is a lot longer than most people assume.
Rightfully so, people want to resume their "old life" their "pre-cancer" life and feel like they should get back to everything they were doing before cancer. What makes it more difficult is that people around you: your boss, coworkers, family and friends may think this too.
These unrealistic expectations can be VERY stressful on you (which may even steal more of your energy).
Applying Dr. Terstriep's measure, it would take approximately seven months for me to recover from chemotherapy given that I spent three and a half months on treatment (from October 1 to January 14). I may experience further fatigue as I start maintenance therapy, since fatigue is among the drug's most common side effects.
Dr. Terstriep's article, along with advice from my oncologist and other cancer survivors, explains a lot and helps me to understand why my energy level is so limited. I was telling my brother that I spend at least 9 hours in bed every night. Aside from walking (which is recommended for cancer patients), my physical activities are limited to light work around the house: baking, doing a load of laundry, and doing dishes.
Dr. Terstriep makes several recommendations, including this one:
Educate your family, friends, and coworkers. Even though you may appear to be "back to normal", make sure they understand the impact fatigue is having on your daily life and what your limitations are. Tell them things like: "My oncologist expects that it will be at least 6,9,12 months for my energy to really improve."
She also suggests that cancer patients avoid overdoing it on one day, even if they feel they have a lot of energy, since they could suffer worse fatigue in the days that follow.
I never asked my cancer doctors or nurses what to expect after the conclusion of my chemotherapy. As with so many things associated with my treatment for cancer, I am learning new things all the time. Most of all, I am learning patience, which is never a bad thing.
