Simple Tips To Manage Stress And Fatigue
By: Tsang Tak Yee Physiotherapist, SGH
Kou Seow Wei Physiotherapist (Vodder-Certified Lymphoedema Therapist), SGH
Sarah Sellam Physiotherapist (Certified Stress Management Clinician), SGH
Hozaidah HosainPrincipal Physiotherapis (Vodder-Certified Lymphoedema Therapist),SGH
Stress and Fatigue are the main complaints of patients undergoing cancer treatment. Although usually ignored, both stress and fatigue should be managed as it results in low quality of life using up resources reserved for a rainy day.
Stress can occur as a result of both internal and external events. These events cause numerous hormonal changes and interactions in the body affecting basic internal functions. As a result, a variety of signs and symptoms are commonly mistaken for non-stress related reasons will appear. These include symptoms such as headaches, digestive problems, sleeplessness, fatigue, tight/tense muscles, irritability, nervousness, forgetfulness and confusion.
Fatigue is another frequent experience of cancer patients when they undergo treatment. This is usually debilitating as they find themselves unable to carry out the activities that they want to or would like to do. While taking a rest may seem to be the most effective and convenient solution but too much rest or sleep may slow down the metabolic rate, decrease one’s energy level and reversibly increase the sense of fatigue.
Here are some helpful non-pharmaceutical tips to aid in reducing stress and fatigue.
Breathing exercise
Find a comfortable quiet place. Position yourself comfortably either by lying down or sitting up. Close your eyes. Focus on your breathing pattern. Put one hand on your upper chest and the other on your abdomen, just below your rib-cage. As you breathe in, feel your abdomen expand. Then as you breathe out, let your abdomen flatten. (deleted a sentence here) Your breathing pattern should be smooth, easy and regular with your shoulders relaxed.
Muscle relaxation exercise
Do the following activities independently. (deleted a sentence here). Repeat 5 times. If you experience pain or tiredness, stop the activity.
| I) |
Raise your eyebrows and make a furrow on your forehead, hold for five seconds and relax |
| II) |
Shut your eyes tight, hold for five seconds and relax |
| III) |
Open your mouth wide so as to stretch the muscles in your face. Hold for 5 seconds and relax |
| IV) |
Clench your teeth for 5 seconds and relax |
| V) |
Raise your shoulders to your ears for 5 seconds and relax |
| VI) |
Flatten and tighten the muscles of your stomach (flexing your stomach muscles) for 5 seconds and relax |
| VII) |
Raise your left arm, make a fist and tense your muscles. Count to five and relax. Repeat the same with your right arm. |
| VIII) |
Straighten your legs. Tighten the muscles of your right feet, leg and thigh. Count to five. Relax and allow the leg to drop down to the ground. Repeat once more on the left side. |
Regular aerobic exercise
Do a general warm up with gentle stretching exercises. 20 to 30 minutes of moderate intensity aerobic exercise which may range from walking, swimming to dancing is sufficient. Try to achieve around 60% of your maximum heart rate ( = 60% x [220-your age]) during the exercise session. Do this exercise at least 3 times a week. If you are not able to start with 20 minutes, even 5 minutes daily would suffice. Increase the time slowly at intervals of a week or two.
Aerobic exercise can help increase blood circulation , metabolic rate of the body, increase the internal functions of the body and decrease tension. It also releases “endorphin”, a naturally produced morphine-like chemical in our brain that helps to decrease pain and increase pleasure during and after exercise.
However for patients with cardiac problems and severe respiratory disease, do seek advice from your physicians or physiotherapists, and a modified exercise programme, more suited to your condition, may be used if necessary.
Good sleeping habit
Developing a good sleeping habit in order to get good quality sleep is crucial. To achieve that, try the following:
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Make a habit of sleeping at a specific time each night
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Decrease surrounding noise
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Stop any strenuous activities two hours before you sleep
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Limit the duration of short naps to less than an hour
These measures will need practice and some getting use to, but following them would help reduce the stress and fatigue level of any patient. Do remember to check with your doctor and/or physiotherapist before starting any exercise programme.
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