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Tuesday, October 20, 2009

The Difference Between "Fatigue" and "Tired"

In slightly over a month, it will have been 18 years since I had my first baby, 17 years since bringing my first baby home from the hospital, 18.5 years since starting down the parenting pathway. In that time, I've been more tired than in the mumble-mumble previous years of my life.

Seriously, ignore the parenting magazine articles that tell you how to get a good night's sleep. Parenting is difficult and tiring. No two ways about it. You might get more or less sleep at different rest areas in the path, some parts are more difficult than others, some are physically demanding while others are mentally and emotionally demanding, but I really doubt that I will ever again sleep like I did pre-parenting. Even when my kids are grown and moved out, I'll still lose sleep with compassion and concern. I know now that my mother didn't sleep like a log while I was facing challenges in my life, even as a fully fledged adult with my own children. I'm sure the thought that I was up with a baby with asthma also kept her awake across the state.

Add to the general challenges of parenting, the additional challenges of working full time as well as working in a field that lends itself to odd hours, procrastination, and uneven workloads, and well...I'm well acquainted with being tired. Quite familiar. In fact, you might say tiredness and I are close friends. Tiredness is a way of life.

It's not just me, either. I think most of my colleagues are as well acquainted as I am. In fact, caffeine is our drug of choice. It might be the official drug of BGSU. If they drug tested us, they'd be best off giving us Starbuck's cups to pee in. If the administration wants to squash the movement to unionize, offer us free coffee and other forms of caffeine. We'd throw down our banners, rip off our pins, kow-tow to 10% cuts, just give me more energy in the form of caffeine.

So, we all know what it means to be tired. According to several web definitions, "tired" means "depleted of strength or energy; in need of some rest or sleep; fed up, annoyed, irritated..." Implied in these definitions, I believe, is the quality of impermanence. We are not tired to the point of collapse. Something that is depleted can be replenished. Someone who is annoyed will not always (one would hope) feel that way. If one is in need of rest, rest at some point can be obtained, and until then, we suck our caffeine and pretend that this is the way we are supposed to feel. Although research shows it really isn't possible, we "catch up" on sleep. Replenishment.

Fatigue, on the other hand, as I am finding out, is quite different.

Fatigue is the "decreased capacity or complete inability of an organism, an organ, or a part to function normally." When steel is fatigued, bridges collapse. You don't replenish fatigued steel. You must deconstruct and then reconstruct that part of the bridge.

And that is what this round of chemo has gifted me with: A much better understanding of fatigue, the fatigue of the chronically ill. A couple of semesters ago, I had three students who all had lupus. I gave lip service to accommodation for their fatigue. I felt great pity for young women to be suffering from this disease, and I tried to be understanding. But I really had no way to understand what it really meant to be "too tired" to get out of bed. That's because I was thinking in terms of "being tired" not "being fatigued."

I get it. As you all know, this past round of chemo has been hard. Each round has been different, but the one constant has been that I'm more "tired" than previous rounds. No duh. I've been, for all intents and purposes, poisoned four times now. Chemo drugs are toxic. They stop the division and growth of cells. No one denies that. Even the most conventionally oriented medics encourage drinking large quantities of liquids on the day of and days immediately after chemo to "flush the toxins" from your liver. By definition, a "toxin" is "a poisonous substance."

If you had food poisoning every three weeks, you'd get worn down. Heck, we've all seen what happens to students who ingest too much alcohol weekly for week on end. They get sick, worn down, and tired.

Big time toxins cause big time wear down. AKA Fatigue.

Here's the difference between "tired" and "fatigued." Tired means wanting to do something, but choosing not to. There have been times I've laid down on the couch in my street clothes, thought, "I should get up and change and get ready for bed...I'll do it in a minute" and awakened hours later still in my street clothes, light still on, teeth not brushed, and chosen to simply turn off the light and go back to sleep. I might say I was "too tired to get up" but really I chose to get up. I made a reasoned choice, most likely. At this stage of my life, if I get up, I might not fall back asleep!

On the other hand, just a little while ago, I got out of bed to get something, stood up, closed my eyes, and, for quite a bit of time, stood with my eyes closed in the middle of my bedroom, unable to open them, unable to remember what had prompted me to get out of bed (it was to get my glasses so I could see to continue working on this), unable to even remember if I was fetching something in this room or if I needed to go to another room, unable even to remember anything. I just stood there with my eyes closed. Literally asleep, and yet confused, on my feet. It was only swaying as I started to lose my balance that prompted me to open my eyes. And I still couldn't remember why I'd gotten up in the first place.

Earlier today, what prompted me to put out the call for subs teaching was hitting the wall while teaching my second class. Generally, I have the most enthusiasm and energy in that class. It meets at an ideal time, 9:30. Prior to that, it's too early for optimal Dawn energy (my name lies) and the class after that frequently finds me slowly wearing down, counting the minutes until I'm finished. But I'm generally on top of my game at 9:30. However, today, I just hit a wall. In the middle of a sentence, when I was pacing around the room, demanding students to spit out possible criteria for making clothing choices, then whapping them with different scenarios where reasoned judgments would differ, I just had to stop. I had to sit down. I couldn't go on. I was stuck. I could barely talk. I certainly couldn't reason. Walking around the room caused me to break out in a sweat.

I got home at 1:00 and was in bed until 4:00. I slept part of that time, but much of it was just lying here. If I sleep too much during the day, I don't sleep at night. Tired isn't the same as fatigued. I can be as fatigued as I want to be, but that doesn't have much to do with sleep.

Amanda has graciously offered to take my classes tomorrow. I'll chill all morning. I have a MUGA scan in the afternoon (cross your fingers that all is normal, or I have to go off the most effective chemo drug). I know I can make it through Thursday, and then have nothing on Friday. Somehow, knowing I have "nothing" days helps get through the "something" days. No soccer this weekend. Just rough drafts to comment on. I'll be SO much better by next week.

But man, this fatigue is really eye opening. You know those natural disaster movies where bridges collapse. The steel moans, the concrete buckles, there are high pitched metallic noises? That's really what it's like. I root for the bridge, then suddenly, it snaps and is no more. It is not a bridge any more. It's a pile of metal and concrete, totally unable to serve its purpose. That's how I've felt this week. Totally incapable of serving my purpose.

1 comment:

Theresa Williams said...

Remember in the old St. Martin's texts, the assignment "Writing About a Concept"? This is the best concept paper I have ever seen. You pass. :-)

Another eye-opening post. Keep them coming.

Enjoy your morning off tomorrow and I'm sending good thoughts for you and your procedure tomorrow.