Is it fatigue or am I just tired?

Home Again...

"Twig" gate in the Texas Hill Country. photo by Lucy Wiley (c) 2012

It was 10 days getting back to "normal" from the China trip. Fatigue has been my worst enemy for many years, now. Being tired all the time means I have no zest to start or complete projects. I just have no energy. Especially in the heat of summer.

I've tried ginseng (made me dizzy,) other oriental herbs (a bit of help sometimes,) acupuncture (helps more,) anti-depressants (help a bit,) exercise (helps a bit,) yoga (helps more) and stimulants like caffeine (keeps me from sleeping, makes me irritable,) vitamin-B-12 (helps a bit.) Now and then, I have a glorious day that reminds all the other days are more or less blah.

You might think a lot of bits add up to "normal," but apparently, things don't work that way.
If I get completely exhausted - almost anyone on a 20-hour flight will - it takes days to be anything like normal. I've fought fatigue a couple of decades. A cancer patient at 67 probably can't expect to feel like Super Woman. Still, I can't accept my condition. I want to DO something about it.

But I learned something on this trip. So long as I get enough sleep (8 hours is fine) and I am excited about what I'm doing - I can keep going indefinitely. But when I stop, it all catches up to me and I am exhausted for days, weeks. I don't know that the ratio is but a good estimate is at least one day of exhaustion for every day of pushing myself. So, I was on the China trip 10 days. Took 10 days to get rested enough so I didn't have to sleep 12 hours at a time.

To make things worse, I have insomnia.
So I have to knock myself out with some combination of pills to get to sleep and stay asleep for any time at all. If I do drop off without medication, I sleep two hours - tops. Then I am awake or semi-awake until I take a drug. And the combination has to change all the time because after a couple or three nights of the same combo - it quits working at all.

I've tried just staying up all night and that doesn't work, either. I drift into a semi-sleep that truly is awful.  I'm so groggy when I get up that I don't get up. I stay down. Anything is better than that. Hence the meds.

I asked Dr. Woltering why 'noids are so fatigued and he said, "I wish I knew!" 
I wonder now how much chronic fatigue actually is undiagnosed NETs. My symptoms got a lot worse after an attack of Epstein-Barr. My oncologist recently prescribed something called Nuvigil. It costs $50 co-pay. I decided to find a cheaper way. Ritalin is supposed to do the same thing but it is not as smooth. Ritalin I can get for about $5 per 30-day supply.

Anybody had experience with these meds? Got a solution for carcinoid-related fatigue? Let me hear from you. Toddling off to bed, now. Tonight's combo is Ativan and Lunesta. Just one or the other alone no longer works.

  Spineless cactus outside my door. Photo by Lucy Wiley (c) 2012