Fitness

[kiwiCanuck]

I've done 1 round of chemo (FCR) and have had cll for 3 years. The fatigue is one of the hardest things to deal with. After a half hour exercise, I'm exhausted and have to nap. How do you folks keep fit? Does anyone have a solution for this? Would energy drinks help?

[lankisterguy Volunteer]

Hi kiwiCanuck,

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It is a long reply- but please read this entire explanation of the possible causes of fatigue:healthunlocked.com/cllsuppo...

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Len

[bennevisplace]

Even if you go into it as fit as a fiddle, a course of FCR is going to drain you. For me each cycle was 7 days trashed, 7 days picking up and 14 days more or less OK. But each cycle saw less of a recovery. Half an hour's exercise then a nap sounds a good daily routine for now. The naps may get longer.

Fatigue goes with the territory, but so does something more pernicious: infections allowed in by neutropenia. Careful with raw foods etc, sound the alarm if you start to run a temperature.

[GMa27]

During my FCR I didn't exercise at all. Just a few walks each week. I think that is too much for our bodies. I let the chemo do its job & rested a lot. I didn't suffer from fatigue except for occasional day here & there. Mostly just a kind of tired. After the first week of each chemo, I would get my energy back but never over did anything.

I was lucky & was able to stop after 3 rounds. Was tested & reached remission. My experts didn't believe in you have to have all 6 cycles if marrow was clear. Nodes were gone. Waited 5 months then had port removed. Wanted to be sure that my blood work remained stable. My hematologist wanted it out 2 months after I finished chemo. But a few more months was ok by me.

Don't force yourself and do things only when you feel comfortable. Your body is going thru a lot so listen to it. 🙏💕

[SofiaDeo]

Please remember that treatment affects some healthy cells as well as the "bad" ones. So your body is not only trying to clear out metabolic debris from the bad and good cells killed, it is also being stimulated to make more new ones of the good guys. So most of your energy is going to these, preferentially. There will be less available for non-essential skeletal muscle, and if you try to do the exact same intensity workouts, you will feel drained. Maybe consider doing lighter exercise during treatment, enough to get blood flow to aid in waste removal and nutrient transportation, but not strong muscle-building ones. Ingesting caffeine or other drugs to force yourself to be able to continue these workouts is ultimately counter productive IMO.

Consider only exercising like walking/stretching during days 1-5 of the cycles, and more in the following weeks until the cycle repeats. Light weights to maintain tone, if you are really buff & want to maintain that. Remember you need to make neutrophils and other cells, or the therapy will be interrupted. So don't push workouts to exhaustion, take naps as needed, and up your nutrition if allowed (I know some disease states strictly monitor protein and possibly other nutrients). You need more nutrition that what you "normally" eat to make extra RBC's, platelets, neutrophils, and other things affected by your treatments. So you will need some extra nutrition to maintain current muscle tone as well as make new healthy blood components. As bennevisplace noted, neutropenia/infections can be serious, so you need energy/nutrition around to make neutrophils, especially. Also maintain good hydration, to flush out the metabolic waste without affecting kidneys.

You likely will be able to resume "normal" workouts after therapy is done. If you broke a leg, you would need to adjust workouts while it healed. Well, right now you need to adjust a bit while your "broken" immune system/CLL is "healing".

[LeoPa]

You could try to space it out and do a few light exercise sessions several times during the day. 2-3 minutes each. I did not have chemo but I imagine it is very taxing on the body so take it easy.

[rvles]

I did 6 rounds of FCR in 2018. I have been doing regular exercise for many years. I lost fitness during FCR and it took roughly 9 months after the end of treatment to return to something resembling my previous level. However I did manage to continue exercise during FCR, although I had to wait a 5 days or so after the last infusion of before I could resume. I would cycle, though more slowly and not as far as previously, and I would take walks. For the first four months, I felt better after each round and was able to ride/walk farther as time went on, although still not as far or as fast as before treatment. The last two rounds of FCR were much more difficult, all I could do was walk or do a light exercise/mobility program called Classical Stretch which I found on PBS television but can be found on the Internet at classicalstretch.com I tried to do something to keep moving every day, except for the first few days after a round of infusions when I did not feel well.

After the last round, my hemoglobin levels plunged to 80, and I was out of breath just going up the stairs. A blood transfusion helped, but it took some months after the last treatment for my hemoglobin level to recover sufficiently to start regular aerobic exercise.

That being said, people react differently to FCR. Each of us has to adapt to the way the treatment affects us. You can experiment by varying the type of exercise, the duration, the intensity to find the combination that works for you. The most important thing is to keep moving every day, regardless of the intensity or duration. Hope this helps.

[kiwiCanuck in reply to rvles]

Thanks. It does help quite a bit.

[Salohcin]

I’ve just finished my sixth and final session of FCR which has gone pretty well. Regards exercise I was told at the start by my specialist and great advice from others on this group, just listen to your body. If you feel up to exercise then take some, if not and you are tired then don’t. As others have said above I found that treatment week and most of the second week were often not good but weeks three and four were fine and I exercised most days even if it was only a couple of miles walk, fresh air is great medicine. I didn’t push things. Hope your treatment goes well