Managing fatigue and tiredness
Fatigue is a common symptom of multiple myeloma and can be a side effect of some of its treatments. Extreme tiredness can also be caused by a drop in the number of red blood cells in your body resulting in a condition called anaemia.
Feelings of fatigue include overwhelming tiredness or exhaustion, shortness of breath, poor memory, low moods, the inability to concentrate and difficulty sleeping.
Always tell your treatment team if you are experiencing any of the symptoms of fatigue as they may be related to anaemia, which will need to be treated. The team may also discuss certain options to help you manage your fatigue.
What you can do to help cope with fatigue
Eat a well-balanced diet with iron-rich foods, and drink plenty of fluids. If you are having trouble eating, ask your doctor to be referred to a dietitian. Get enough sleep, and get into a routine by going to bed and getting up at the same times every day. Take gentle exercise each day – this can actually help to improve your energy levels. Plan your daily activities and allow yourself rest periods during the day.
Reducing the risk of infection
Multiple myeloma interferes with the immune system (the body’s natural defense against infection and illness). Some of the drugs currently used to treat multiple myeloma can also weaken the immune system. You may find you are particularly vulnerable to infection – you get more infections and they last for a longer time. Signs of infection include a raised temperature (above 38 Celsius), feeling feverish and unwell, shivering, rash, cough or sore throat, diarrhoea, redness or swelling around a wound.
If you develop any signs of infection, you should call your nurse or doctor immediately as it maybe important to start appropriate treatment.
What you can do to reduce your risk of infection
Wash your hands regularly and avoid touching your mouth, nose and eyes. Carry and use an alcohol-based hand gel (available from a chemist) to keep your hands clean when out and about. Try to keep away from anyone who has recently been suffering from (or close to someone suffering from) an infectious disease such as chickenpox or flu.
Managing kidney problems
The main cause of kidney damage is the multiple myeloma itself. Some medication can also affect the kidneys. You may experience symptoms associated with kidney problems including constantly feeling thirsty, feeling sick and needing to urinate frequently.
Talk to your nurse if you are experiencing any of these symptoms, as they will be able to help you or refer you to a doctor.
What you can do to help protect your kidneys from damage
Stay well hydrated and try to drink 2–3 liters of water a day (if you are on dialysis, you should speak to your nurse or doctor).
When feeling unwell or stressed, you may find it difficult to eat well, but it can be especially tough during and after your multiple myeloma treatment. Some medication and treatments may alter your sense of taste, and you may not feel like eating much. If your treatment has changed your eating patterns and taste, it may help to eat small portions every 2–3 hours until you feel better. There may be times when your doctor recommends some changes to your diet. For example, when you have an increased risk of infection, some foods are higher risk and should be avoided. However, some foods can raise immunity and energy levels, which you may be encouraged to try.
If your appetite is poor, a nurse or a dietitian can give you more advice on the best way to increase the healthy calories in your diet. They may also be able to recommend dietary supplement drinks to take between meals.
Equipment and minor repairs to your home
Is it difficult to get up the stairs already? Is taking a shower becoming a burden? All this can be managed. There is special equipment available on the market and your home can be adjusted to your new situation. Specialized companies offer a wide array of usable tools and equipment. Here is a list of some of the equipment available: lift for wheelchair, bathroom accessories with customized bath and shower, shower with seat, toilets for the disabled, handrails, beds for the disabled with specially adapted mattresses. Ask your physician about the possibilities to rent such equipment (e.g. crutches, wheelchairs). Find out about all options available to you.