Atypical Fatigue

Abstract

Mrs. S is a 63-year-old retired teacher who returns to the office for breast cancer follow-up. She was diagnosed with intraductal carcinoma, and her treatment included a modified radial mastectomy followed by four cycles of doxorubicin and cyclophosphamide. Her tumor was estrogen receptor-positive, progesterone receptor-positive, and human epidermal growth factor receptor 2-negative by fluorescence in-situ hybridization. Chemotherapy was completed nine months ago, and she is taking adjuvant tamoxifen. She has recovered quite well; her only complaint is fatigue. She states, "I expected to be tired during and immediately after chemotherapy, but I thought I would have all my energy back by now. I still feel the need to take a nap in the afternoon. In fact, I feel sleepy all the time!" Mrs. S's medical history is significant for moderate obesity and hypertension for 10 years, which is controlled with the angiotensin converting enzyme inhibitor lisinopril. She has not exercised since her breast cancer diagnosis but has been trying to lose weight with dietary changes. She believes that tamoxifen is hampering her weight-loss efforts. She takes no other medications.

Development and Validation of Archetypes for Nursing Problems in Breast Cancer Patients

“…또한 미국 Intermountain Healthcare의 CEM (Clinical Element Models) 8) , EHR핵심공통기술연 구개발사업단의 CCM (Clinical Contents Models) . , 유방절제술과 항암요법 후 피로를 호소 하는 환자 29) , The patient's pain history was noteworthy for chronic musculoskeletal pain including chronic low back pain and bursitis in her shoulder on the side ipsilateral to her breast cancer. …… The pain was dramatically worse during periods of cellulitis.…”