Leroy, I appreciate that you wrote you daily column even though you are so fatigued. I appreciated it.

Sent by Cathy Wilder | 4:08 PM ET | 10-13-2006

My fatigue is mentally as well as physically exhausting. It is indescribable to people who have no experience with it. I've noticed people will say things like "when the chemo pain is too much to take I will support your decision if you go off it." This comes out of the blue because actually the chemo now is nowhere near as bad as the first drugs were. I haven't really complained about it either. Sometimes when people think they are saying something to make me feel better I want to scream your telling me to give up. My husband and daughters deserve to have me fight and when my pain becomes too much I will then decide what I want. Encouragement goes a long way when you are following a path that is less traveled and you want the security and support of those you love to stand behind you and leave the decisions to us the people who have to live with them.

Sent by Ann | 4:09 PM ET | 10-13-2006

Leroy:

I'm sorry that you are feeling fatigued. I know what youre referring to the fatigue goes beyond simply being "tired."

Moreover, I understand your sentiment about "...living everyday to its fullest." In my opinion, living everyday to its fullest doesnt require that one run through a meadow and smell all the flowers while gazing at the blue sky and euphorically exclaiming, "Life is great!" On the contrary, life isn't always great and sometimes, when youre stuck in the desolate and barren wasteland of nausea, fatigue, and exasperation, being able to notice the beauty of the autumn leaves is a remarkable example living life to its fullest.

I hope tomorrow will be a better day for you.

Sent by Michael Everett | 4:37 PM ET | 10-13-2006

Mr. Sievers, I just want you to know that your blog is the first thing I go to each and every morning upon arrival at work. I applaud your consistency and dedication, regardless of your physical/mental state. Your words are a miracle to me, a special gift that I receive each day. Your words and descriptions are intuitively understood by me and I am sure many many others who have similar experiences. I know those feelings of the days after chemo and the depth of the fatigue and the "chemo-nesia". (Breast cancer stage 2, been chemo-ing since June) It is what it is... and we travel through it, sometimes down a dusty, grey road with few colors. Thanks so much for being there for us everyday.

Sent by Sherri | 4:38 PM ET | 10-13-2006

As hard and discouraging as it can be, you just have to listen to your body and not push yourself too hard during chemo. There are so many listless, dull, low energy days in the rhythm of the chemo cycle. These drugs are really hard on our bodies, so we have to give ourselves as much leeway as needed to process them.

I was getting a chemo infusion when another patient broke/spilled one of their chemo containers. The haz-mat guys in full body suits showed up to clean up the spill. That was a sobering reminder to me about how toxic these drugs are, as I sat there watching the clean-up while those fluids were being pumped right into my vena cava.

Sent by Maggie | 4:39 PM ET | 10-13-2006

Some doctors prescribe Ritalin for fatigue.

Sent by Irene | 4:41 PM ET | 10-13-2006

Sent by Shane Schiermeier | 4:43 PM ET | 10-13-2006

Nobody can do everything; do what is important to you. Stop and smell the flowers, take a nap in the sun, read a good book, laugh with friends. Life is how you enjoy it. A hungerly needed nap is OK — sometimes we need some extra sleep. I hope you took a nap and enjoyed it.

Sent by Amy | 11:43 AM ET | 10-16-2006

My 28-year old much-beloved cousin died of a rare cancer that is supposed to affect only children in the first three years of life. She lived a distance away from me so we communicated by telephone. I remember so clearly when she told me she was "so tired." Her tone of voice more than the words chilled me. About two weeks later she died. This was in the mid-80s.

Your blog has educated me, as well as the Ivan Noble blog on the BBC a year or so ago, about the different journeys that cancer patients travel, as well as some of the similarities of those journeys from person to person.

I know that you and others who have this awful disease generally do not want "special" attention. But anyone who faces their own certain mortality instead of a "someday, somehow" nebulous (denied) certainty, deserves a large measure of respect. You all also deserve that measure of empathy — but those of us still not profoundly understanding our own mortality sadly have trouble with the empathy.

I do so much pray for your strength, resiliance and comfort as you and your family deal with this. I cant give a name to "this" because I just cant imagine planning for a premature death in my family.

You and by extention, all the people living with cancer whom I know, are constantly in my prayers. Thank you for the service youre providing with the courage to write about the ups and downs, fears and courageous days.

Sent by Gail | 12:00 PM ET | 10-16-2006

I have had a day like you today where the fatigue seemed to penetrate through my bones. But I feel things happen for a reason and on a day like this, I am more grateful to God for all the other good days I have had and for the little blessings in life.

Sent by Aisha Zafar | 12:25 PM ET | 10-16-2006

The fatigue/sleep thing seems paradoxical. I'm tired all the time, no matter how much I sleep. This was certainly true and much more pronounced during chemo. Now, nine months beyond my first rounds of chemo, my sleep rhythms are still out of kilter. I've tried Ambien, Restoral, and am now using Ambien-CR, which is the best. But, I want to sleep normally. Am hoping a normal sleep pattern will restore in time. Am trying to get more exercise, but that was so, so difficult during chemo. It helped, but it was hard to make myself do stuff — like walk out to get the mail or feed birds.

Be good to yourself.

Sent by Anna | 12:26 PM ET | 10-16-2006

Leroy — I just finished filling out more forms for Social Security Disability. Maybe I should have just referred questions about my physical abilities/limitations to your blog. I have one more treatment after 16 months of weekly chemo. It will be a joyful celebration if only because I have that time back. Except I just got a phone call from my oncologist that my blood counts are low and I need to see the physicians assistant on Monday. I feel like I have been sent to the principal's office for misbehaving. So, yes, even though I'm not working I have to just gut through the day. Hang in there, Leroy and all of my fellow survivors; we have this day to enjoy even if it's just watching the world go by.

Sent by Robin | 12:29 PM ET | 10-16-2006

Dear Leroy,

As a person who has been there, I find your thoughts very interesting and good. My cancer has taught me about what is and has been important in my life, people, friends, family and the beauty of nature (which i ignored often before). I never asked why me when I was given the dreadful news for the reason that I am just as likely as anyone to, as you say, have one's body turn against them. I must say that I had a fear of going to sleep because I thought I would not wake up to to my wife and the beautiful days. I was and am not afraid of dying. I suppose my death will be harder on those I leave behind than on me. So far I remain here and I can't explain why. Those who explain it away religiously are only speculating.

Sent by Roger Sherman | 12:32 PM ET | 10-16-2006

For some reason, reading your blog post today brought Viktor Frankl to mind (author, Man's Search for Meaning) so I read through some things, and found quotes that exemplify your embodiment of, and interaction with, your cancer and all its consequences. I thought the following ring true:

"Everything can be taken from a man but... the last of the human freedoms — to choose one's attitude in any given set of circumstances, to choose one's own way." Page 104. I think that you are certainly doing that and I know it is not easy.

"The meaning of our existence is not invented by ourselves, but rather detected." Page 157. The courage and openness with which you are interacting with people (and I would bet you do it in your personal life as well if you do it in such a public way) exemplifies openness that I would bet allows you to engage with this idea.

"What matters, therefore, is not the meaning of life in general, but rather the specific meaning of a persons life at a given moment." Page 171. Leading to this idea which I think perfectly dovetails with what you have spoken/written in several occasions on your blog. And finally, you strike me as a man who has engaged, ongoingly engages, etc. with what it all means so I offer the following words of Frankl. Knowing personally what this can mean to a soul, I offer the following words of Frankl:

"We can discover this meaning in life in three different ways: (1) by doing a deed (2) by experiencing a value and (3) by suffering." Page 176.

Sent by Sandra Yudilevich | 12:40 PM ET | 10-16-2006

Leroy: I just want to reiterate what Michael said about living everyday to its fullest... sometimes it's just very simply watching the leaves turn, watching the birds at the feeder and birdbath, then taking a nap. After a stem cell transplant earlier this year, and now a maintenance drug that is hopefully warding the cancer away (for a while), I find that my own energy is unpredictable and short-lived. But when I do get an energetic day, I usually choose to overdo it, even if it means a nap day the next day. Thank you for your articulate and intimate thoughts. You have helped me immensely.

Sent by Mary Catherine | 12:43 PM ET | 10-16-2006

Your blog has helped me see that everyday is precious and everyone needs to take something special away from each day. That means calling your children that are grown, saying thank you to strangers and appreciating the "good" things that have happened in our lives. Thank you for sharing your experience. I wish all the best for you!

Sent by Gail Gardner | 12:45 PM ET | 10-16-2006

Wow! I know what you mean about that kind of fatigue. I don't have cancer — or at least I don't know it yet if I do, but I do have chronic lung disease, and the lack of oxygen can also incite that type of fatigue. You have my sympathy entirely. It's so frustrating not to be able to accomplish even the normal routines of living without exhaustion.

Sent by Mary | 12:49 PM ET | 10-16-2006

Please rest as much as you need to right now and know that your blog community want you to tend your needs above all else. We'll be here when you have energy to write, and we'll be here sending support when you don't.

Blessings!

Sent by Sarah Knorr | 12:52 PM ET | 10-16-2006

I don't quite know if we are talking about the same thing, but I will relate my experience. Since May I have had the feeling that the cancer was with me again. All the feedback I was getting from my oncologists office (and they are the experts, after all) was that I was okay, NED (no evidence of disease). Also from people who love me and don't want me to leave, I was hearing their hopes that I was wrong. Even in my cancer support group, I was told to hang on to hope. I kept feeling like there was impending doom, sword of Damocles, waiting for the other shoe to drop just around the corner. Still, I got the same feedback from my oncologist — to the point of feeling like I was getting a "don't call us, well call you" message. Fine, so I was crazy. But I stopped calling them. I figured that, "Okay, something feels wrong. Maybe it's not cancer, but something is still wrong. Let's get to the bottom of this." I went to my family doctor.

Turns out I'm not crazy. There is something wrong and it is the cancer. I was feeling very paranoid while my internal reality was not matching the feedback that I was receiving. I feel much more at peace now that my two realities (internal and external) match. The way is clear. I understand.

The lesson in this for me it to trust my gut. This is a lesson that has been repeated over and over in my life and I still have trouble trusting my gut. And I want to say to my mother, I get it! The whole cosmic joke thing!" Yes, the universe has a sense of humor. In order to get the message to trust my gut instincts, the message had to come through my physical gut, not just once, but twice. First through my digestion, then the lump on my tummy. Ok, Mummy, I really do get it. Thanks for the insight. I love you. I'll see you soon.

Sent by Stephanie | 1:02 PM ET | 10-16-2006

Thank you. Thank you. Thank you. For your words. For your openness. For your willingness to share — especially when the fatigue is overwhelming. Or when you don't know what to write. Or you don't feel like thinking. I hope we readers never become a burdensome obligation. On the days that we do, I hope you can take a guilt-free break. We look to your words for insight, guidance, camaraderie, distraction, focus, escape and confrontation... for many things but through them we have come to care for you and your well-being. Take care of you. Not just for you... but, as selfish as this feels to type, for all of us, as well.

Sent by Sandi | 1:05 PM ET | 10-16-2006