[Bessie]

I've been undergoing chemotherapy for several months now. I go to see my doctor every four weeks, and it seemed that each month I was getting more and more exhausted. When I tried to talk to him about this, he suggested I get more rest. "Just take it easy," he said, "at your age, it's normal to be slowing down some." I have to tell you, I was a little offended by the casual way he said this. I've always been an energetic person, but I found I was even too exhausted to do things I have always liked to do. Then one week, I was so tired, I started staying in bed. That made me feel very depressed. My niece came to visit me, and seemed alarmed that I was doing so poorly. I told her I was just too tired to get up. She called and made an appointment with my doctor and said she would drive me there the next day. Before going I thought about my fatigue. It had started right after I finished my first round of chemotherapy. It had gotten worse every month. I made a list of all the things I could do and enjoyed doing before I started my treatment. Then I made a list, a very short list, of what I could do now. I took those two lists with me and told the doctor that I wanted to be able to do those things again -- I wanted my life back. This time, he heard me and ordered some additional tests to help understand my fatigue.

[Bessie]

The nurse came in and did what she called a "fatigue assessment." She not only went over what I could and could not do, but she also asked a lot of things, like how I felt emotionally, how much stress I was under, what I was eating, and how I slept at night. Then she asked me about my support system, did I have people who could help me if I needed help? People who could take me places or get me to appointments? I told her my niece is my biggest support, but that I also have friends at the church and senior center.

[Bessie]

The nurse said that I was a little anemic, and that that could be part of my fatigue, although fatigue can be very complicated. I did get a prescription to help with my anemia, but just as importantly, the nurse helped me develop an exercise schedule so that I could build up my physical activity level. She told me I might want to try some dietary supplements to maintain my nutrition, and she suggested that I might want to talk to someone, a therapist, about my depression. While talking with her, I realized that I had been depressed ever since my cancer was diagnosed. While my outlook is good, I do find it hard to go for my chemotherapy each month. Instead of seeing a therapist, I decided to join a cancer support group at the community center. It's a special kind of group that uses journal writing to help people cope. I really enjoy it, and I'm back to attending a few other social events and having friends over for lunch. I'm beginning to feel like my old self again.

[Narrator]

Physical problems can lead to emotional problems. When you are in pain or overly fatigued, you may become depressed. This seems to increase your pain and fatigue even more. There are some clues for telling if you are depressed. For example, you may be feeling sad. You may be unable to concentrate. You may lose interest in your usual activities -- stop going places, reading the newspaper, or watching your favorite shows on television. You may find that you're sleeping a lot more or that you don't feel like getting up and getting dressed during the day. Or, you may have difficulty sleeping at night. You may also have changes in your eating habits -- maybe you just aren't interested in food or maybe you're eating all the time. You might start feeling helpless or hopeless or begin thinking that life no longer has much meaning for you. Some people even begin wishing they would die, or think about taking their own lives. They fear that no one is listening to their needs, that they are becoming a burden on their families. If you are feeling this way, call your doctor, nurse, or social worker and make an appointment. Tell them how you're feeling. They can help you get your pain, fatigue, and depression under control.
 
[Narrator]

If you have signs of depression, don't wait to get help. In addition to making you feel more miserable, depression can actually interfere with the healing process, which is the last thing you need when you are trying to recover from cancer. It might also help to remember that hope changes as situations change, and there is always something to hope for. Try this exercise. Take out a sheet of paper and start a list numbered from 1 to 10. Write down 10 things that you are hoping for this week. These hopes may be general, like having a better quality of life, or specific, like feeling well enough to go to church on Sunday. Review and update your list once a week. Check off hopes that you have achieved. Look at the remaining hopes and ask yourself if each item is still important to you. If it is, keep it on your list. If not, replace it with a new hope. Remember, that a hopeless person becomes a helpless person, so it is very important to always have something to hope for.

[Narrator]

In conclusion, cancer is a common problem for many older people, but simply being older should not add to the burden of the disease. This audio program has focused on issues that have special meaning for older cancer survivors. Don't forget to look in the accompanying booklet for important telephone numbers and Internet addresses for additional resources to help you. The six Basic Skills audio program of the Cancer Survival Toolbox also have many ideas and suggestions for improving your skills in becoming your own best advocate. We encourage you to listen to these audio programs and practice -- and use -- the skills that they cover.

[Narrator]

This concludes our program, Topics for Older Persons.

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