ABSTRACT
This chapter presents a case study of John, Who is a 54-year-old man who had a surgery for a carcinoma of the colon. Drowsiness, tiredness, lethargy, fatigue and weakness have different meanings for different patients. Many people use some of these terms interchangeably. Fatigue is perceived by patients as more severe and persistent than tiredness. Patients describe a number of accompanying sensations: lack of energy, exhaustion, restlessness, boredom, lack of interest in activities, weakness, dyspnoea, pain, altered taste and itching. John and his family may feel there is no point in planning ahead, while professionals may assume the fatigue is due to the illness and cannot be changed. Lethargy is a feature of feeling low in mood and of a clinical depression. Drowsiness occurring in minutes, hours or days needs urgent review. Possible causes are drugs, severe infection, hypoglycaemia, hypercalcaemia, haemorrhage and hypoadrenalism.
