By definition Fatigue is extreme tiredness resulting from mental or physical exertion or illness.

It is a condition which is a feeling of constant tiredness and can be physical, mental or a combination of both. It can affect anyone and most adults will suffer at some point in their lives.

Symptoms of fatigue are;

• Chronic tiredness or sleepiness
• Headache
• Dizziness
• Sore/Aching muscles
• Muscle weaknesses
• Slowed reflexes and responses
• Impaired decision making & judgement
• Moodiness, such as irritability.

Fatigue can also be due to a variety of medical conditions such as;

• Anemia
• Thyroid Conditions
• Diabetes
• Lung and Heart Disease
• Fibromyalgia
• Stroke

Or it can be caused by the following;

• Physical Exertion
• Lack of Physical Activity
• Lack of sleep
• Being overweight or obese
• Periods of emotional stress
• Boredom
• Grief
• Taking certain medications, e.g. antidepressants or sedatives

Stroke and Fatigue

I’ve taken info from The Stroke Association website and also my own experience.

After a stroke, many people will suffer with extreme tiredness. This is known as post-stroke fatigue.

Post-stroke fatigue is not like normal tiredness. Unlike usual tiredness, fatigue won’t necessarily improve  with rest and it isn’t related to how busy or active you’ve been.

It is not understood why stroke survivors experience fatigue but likely to be a combination of physical and emotional factors.

In the first few weeks and months post stroke, the brain and body are healing. The recovery process takes up a lot of energy and it is normal to feel very tired.

Physical problems will also mean that your energy is being used in different ways. Simple tasks like walking or talking will use up more energy than they did before a stroke.

Emotional issues, such as; depression & anxiety, can also lead to tiredness and fatigue.

Post-Stroke fatigue is more than feeling tired. You may feel that you constantly have no energy and constantly feel weary.

It’s likely that you’ll need to rest every day or nearly every day which can make it difficult to take part in every day activities. An example of this would be needing to stop a therapy session or stop a visit from someone early because you feel tired.

The fatigue can also last a long time, even if you have made a good recovery. There are people on some of the facebook support groups who still suffer with fatigue 10 years later.

Because fatigue can be unseen and not obvious, it may not be understood to others. It may have an impact on your relationships and your life. Others may not realise how genuinely tired you are.

Fatigue usually gets better, but it can take months before it begins to lift. As I mentioned, unfortunately for some, fatigue may cause an issue for a long time, however, they may find ways to cope and manage it.

There are no real treatments for post-sroke fatigue but there are ways to manage it.

Your GP may be able to check if there are any medical conditions that could be adding to your fatigue. They can also review the medication you’re on.

It may be that there is something you can do or your GP can suggest to help improve your sleep.

Physical activity can help with fatigue. Although it may be difficult, a survivor should try to do some every day starting slowly and building up.

It is very important to listen to your body and not ignore fatigue. It can take time so you need to be patient. Be kind to yourself and don’t force yourself to do everything you used to do straight away. Make sure you rest when needed.

What was/has been my experience with post-stroke fatigue?

• 

I would say I have definitely suffered Post-Stroke fatigue and possibly still am.

Straight after surgery, most of the 2 days afterwards I spent asleep. I didn’t sleep well though. The first night I was woken up every 2 hours for my obs to be done, the day after I kept slipping in and out of sleep, maybe for an hr at the most. I was obviously recovering from surgery, but I was having conversations as well with medical staff, the doctors and my parents, sister and boyfriend so I felt tired.

2 days after surgery, they let me try and walk. Again, on top of the other things I’ve mentioned, I was then physically tired from trying this. I was eating that day too so my digestive system was starting up again which can use up a lot of energy.

I then spent just over a week on another ward. During my time here I probably slept every day during the day and my sleep during the night was on and off. During the day I probably slept at least an hr, maybe longer and on a night maybe 2 hrs at the most at a time.

I was doing more on the ward. Had showers which were physically tiring – the first couple I had to sit down because I was too tired and my left arm was tired too. I was speaking to more people, doing my physio exercises, trying to walk around more, taking in information from doctors and nurses, sessions with physios and occupational therapists. All of these things tired me out as well as having visitors twice a day. I would close my eyes between afternoon visitors and tea. Sometimes after I’d had a shower and gotten dressed in the morning, I’d rest before trying anything else. Sometimes I slept other times I just shut my eyes and listened to the noise.

It’s hard to know when you’ve overdone it. 4 days before I left hospital, a couple of friends visited. I think I’ve mentioned in a previous blog that we walked downstairs, out the back door and round to the front before sitting whilst they had a drink. We weren’t long but after about 30 mins I was glad to be making my way back to the room with my partner, I just felt like I needed to get back to bed for a sleep. I saw a couple I knew on the way back and I could sense my speech was a bit slower as well and I was aware that Rob could sense that I needed to lie down again. I slept for a good hour after that and needless to say I think it had been too much.

There were a couple of nights where I actually slept better maybe 3/4 hrs at a time and to be fair still felt tired the next day. I slept well one night after I’d been told the stent was blocked. I thought it might have had the opposite effect because I was worried about it, but the following day the doctor asked if I’d been emotional and I had after the news of the stent and she said that was probably why I had slept better.

All in all by the time I left I was doing more and could manage more. The day I left I’d been waiting for news regarding my blocked stent and what that meant, I had some blood taken and it was quite a quick turnaround that I was leaving. My parents and partner were coming at 2pm to visit and once I had the all clear from the consultant in Leeds I was pretty much going home. I was emotional leaving. I’d had the second journey in a car since my stroke and when I got to my parents I was wiped out and had a sleep on the sofa.

Since then I’ve suffered different symptoms when I think I’m hitting more fatigue than tiredness. These have been over the (now) 4 months since my stroke;

• Feeling weary, like I wasn’t really present and a bit zoned out
• Sometimes, randomly, I’ll feel completely wiped out
• Mild headache sometimes which does go if I rest my eyes
• Loss of concentration
• Forgetting words on occasions
• Forgetting what I’m going to say
• More clumsy

In honesty, I’m not as bad as I think I could be but I do still think I suffer a few of these things when more tired on occasion.

I don’t wake up and spring out of bed. I still wake up at least 2/3 times during the night for whatever reason. I feel a bit more energetic after I’ve run but at the same time later that day I will feel tired. I haven’t felt like I’m lugging myself around unable to walk etc.

Sometimes I might feel tired randomly which could be something catching up with me. I’ve done daft things like putting rice cakes in the fridge, which could just be one of those things, or might be tiredness. I made some juice yesterday morning and this morning new I had some left. I opened the fridge and the bottle I knew I’d put it in wasn’t there. I was confused as I knew I’d poured it in the bottle. I looked in the cupboard where I’d have put the bottle if it was clean and it was in there 🙄 🤣.

I think being in lockdown has obviously given me more time to rest. When I was at my parents, I got used to what I was doing there and increased things slowly. Physically over 8 weeks I only built up to an easy 30 minute walk.

When I moved home, I was obviously doing more around the house, I was going for longer walks as well and I’ve built up my running over the last 2 months as well as pilates. With pilates, I take it easy but push myself where I know I can. I leave out or adapt other things we do. Whilst running, I will walk if I need to. I do take everything slowly and I guess I’m gradually adapting to what I’m asking of myself.

Lockdown has forced me to take things even slower. I think the next biggest challenge will be to reintegrate myself back into work when it’s open and working on a plan with management on what I might need and doing reduced hours to get me back into it slowly.

Most days are good, even if I do still feel sleepy or tired and if I have days, like I did on Wednesday where I felt wiped out, I allow myself to sleep. That evening I slept on an off for 2 hours before I went to bed.

I hope sharing my experience with other survivors will give them some reassurance that they’re not alone and that we might be effected at different levels but there’s probably similarities.

I hope this gives an insight into another area a stroke survivor may struggle and that you’ve enjoyed my blogs over the last month during Stroke Awareness Month, sharing what I feel is important, as well as my experience.

Thank you for reading and I’ll upload my next blog soon! 🦋☺🦋