Looking after your health - part 1

Stay cool: Keep rooms well-ventilated and wear light clothing made of breathable fabrics like cotton.

Cool packs or fans: Use a fan or cooling device during a hot flush.

Avoid triggers: Caffeine, alcohol, spicy foods and stress can worsen flushes. Figuring out and avoiding things that trigger problems can help.

Medical treatment options: Medications like low-dose antidepressants (e.g venlafaxine), medroxyprogesterone or gabapentin may be prescribed to reduce flushes if they’re severe.

Lifestyle changes: Regular exercise and stress management techniques, like mindfulness, yoga or breathing exercises, can help reduce the frequency and intensity of hot flashes. You can try pursed-lip breathing (breathing in through your nose and slowly out through pursed lips) and belly breathing (breathing deeply into your stomach) to help calm your mind and body.

Prioritise rest: Plan, prioritise and pace your activities so you have time and energy to do the things you enjoy. 

Energy conservation: Break up tasks throughout the day and avoid doing too much at once. Keep a fatigue diary to work out when you feel most energetic and when you're more tired, and plan your activities around that.

Stay active: Gentle exercises like walking, swimming or yoga can improve energy levels and reduce extreme tiredness over time. Start small and often, set achievable goals, and ask for help when needed.

Sleep hygiene: Follow good sleep habits, like going to bed and waking up at the same time each day, avoid things like caffeine, and make sure your sleep space is comfortable.

Planning: If you have a partner, you might need to plan sexual intimacy instead of expecting it to happen spontaneously.

Adaptation: Try other ways to be physically close, like massage or showing affection in non-sexual ways, to keep your connection strong.

Exercise: Exercise is important for general health, managing extreme tiredness, and mood.

Sexual positions: Try different sexual positions. Some make it easier to keep an erection.

Treatment: These treatments may help your erections:

• Tablets
• Penis injections
• Pellets or cream
• Vacuum pump
• Penile implant

Your healthcare team can advise which ones might be suitable for you.

Counselling or therapy: Speaking with a therapist or joining support groups can provide emotional support and coping strategies.

Mindfulness and relaxation techniques: Practices like meditation, deep breathing or yoga can help reduce stress and emotional ups and downs. You can try pursed-lip breathing (breathing in through your nose and slowly out through pursed lips) and belly breathing (breathing deeply into your stomach) to help calm your mind and body.

Stay connected: Keep in touch with friends, family or support networks. Being isolated can make emotional struggles worse, so it’s important to stay connected with others.

Medication: If emotional changes become severe, such as persistent depression or anxiety, your doctor may prescribe antidepressants or other medications.

Resistance training: Incorporating strength exercises, such as weight lifting or resistance bands, helps maintain muscle mass.

Protein-rich diet: Make sure you're eating enough protein to keep your muscles strong. Good sources include lean meats, fish, beans and dairy.

Consult a fitness professional: Working with a physiotherapist or personal trainer experienced with cancer patients can help create a safe and effective exercise routine.

It's been a process of learning and adapting. I think with the fatigue, it's pacing myself, learning to pace myself, learning not to take on too much in a day, trying to make sure that I'm getting a balance of different activities in a day, not doing too much of any of them. So doing some things where perhaps I'm sitting down, some things where I do go out, but maybe I only go out once a day.

One of the things that the medication can do is to cause muscle wastage and to affect bone density. So the bone density, I am actually on some calcium tablets, calcium and vitamin D3 tablets as well, to try and keep those in check. But keeping as fit as I can with resistance training, doing weights as much as I can.

But it's often recommended with the drugs to keep as fit as you can. So I do have an exercise regime. I find meditating quite useful and that may well help the brain fog as well.