Long-time Austinite Lametrica Johnson was an energetic mother of two, full-time employee, active in her church's ministry and volunteer for many community projects before March of last year.

"I was a spontaneous, outgoing person and very active," she says. "I loved women's outreach programs and was involved in many community projects. But I had to give them up once I started treatment."

Lametrica was diagnosed with breast cancer. Her treatment included surgery, chemotherapy and radiation. Like almost 90 percent of patients who receive chemo and radiation, she quickly found herself chronically fatigued, so tired that all she could do was get through it. Even when the first round was completed and her prognosis looked good, she was still exhausted.

"I would shut down at 4 p.m. everyday. I mean be in bed, under the covers, watching the news." Even a good night's sleep did not restore her.

"This is a huge issue," says Dawn Parsons, RN, manager of the Seton Cancer Care Team. "We have come a long way in managing the side effects of chemotherapy and radiation treatments such as vomiting and infections. The overwhelming problem today is fatigue."

The challenge is a major concern for cancer organizations, including the Texas Cancer Council. The Council set up a grant program to fund expenses and materials to provide rehabilitation and stress management services to help patients cope with fatigue.

Dawn's group was a grant recipient and is now providing free services to qualifying Central Texas cancer patients either still in treatment or in post-treatment but suffering from fatigue. The grant covers the cost of treating 80 patients the first year and the Cancer Care Team will pursue a second year of funding.

A Rehabilitation Plan For Cancer Survivors

"We are attacking the problem in two ways," says Drew Summers, PT, senior physical therapist at Seton Medical Center Outpatient Rehabilitation, lead therapist for the program. "We work on conditioning and strengthening and there's a stress reduction component. Research has shown that people who are physically active and exercise at a moderate level of intensity can have a significant reduction in fatigue."

The first step is an assessment of a patient's physical status, including range of motion, strength and flexibility. Aerobic capacity is evaluated to give therapists a good idea of where to begin.

Each program is tailored to each patient's limitations and customized so that it addresses weakness or tightness in legs or shoulders. Patients come to therapy sessions twice a week for five weeks. During that time, they receive guidance for a home program.

"We teach them to be their own coaches, giving them the tools they need to continue at home. A lot of it revolves around a walking program. We help determine what exercise they need to do, how often and at what intensity."

The program's goal is to reduce the patient's perception of fatigue by 30 percent and help each individual become independent with a home program. A patient's satisfaction with their own quality of life is measured at the beginning of the program and again at the end. Another goal is to increase the patient's perception that their quality of life has improved by 30 percent.

Today, Lametrica Johnson is living a more active life, if not quite as active as the one she had before cancer. She now goes to bed at 9 or 10 p.m. instead of mid-afternoon. And she says she has a lot more energy after rest.

"I'm proud of how far I've come and proud of myself," says Lametrica. "This is one of the best things that has happened to me. Now, when I wake up in the morning I put on my tennis shoes and go for a little walk, maybe a little further than the day before. The guys taught me how to listen to my body, to not do more than what I need and to try to increase. I pray I will be able to keep it up."

Fatigue Program Information

The program includes rehabilitation services along with stress reduction counseling.

"We are easy to access and user-friendly," continues Dawn. "Physical therapy services are available at Seton Southwest Hospital, Seton Northwest Hospital and Seton Medical Center Outpatient Therapy in Central Austin. Treatment is individualized so it begins from where the patient is right now."

The stress reduction component is a six-week program. Patients learn and experience a variety of relaxing and stress-reducing techniques that will work in their daily life. These include yoga, reiki, a Japanese technique for stress reduction and relaxation, meditation and awareness, and stretching and breathing exercises.

The Fatigue Program is free to all cancer survivors currently in treatment or in post-treatment but still suffering from fatigue. Prospective participants must be healthy enough to exercise and must obtain an order form from their doctors confirming they can safely participate in therapy. You can print the form and take it with you when you see your doctor.

If you or someone you know would like more information, call the Seton Cancer Care Team at (512) 505-5515 or view the Rehabilitation Program for Cancer Survivors brochure .