Fatigue is a feeling of being very tired or weak. It is different from normal tiredness. It often does not go away with rest. It can affect your body, your mind, or both. 

Why does fatigue happen after CAR-T?

Many people with myeloma feel fatigued after receiving CAR T-cell therapy. This is common and can happen for several reasons:

• The cancer itself. Myeloma can affect the immune system, which can lead to tiredness.
• Inflammation. CAR-T can cause inflammation in the body, which can make you feel fatigued.
• Low red blood cell count (anemia). CAR-T may lower the number of red blood cells. These cells carry oxygen, and when there are fewer of them, you may feel weak or short of breath.
• Stress from treatment. Living with myeloma and going through CAR-T can be physically and emotionally stressful, which adds to fatigue.
• Lymphodepletion. The short course of chemotherapy given before CAR-T can contribute to fatigue.

How to manage fatigue after CAR-T for myeloma

Fatigue may not go away right away, but there are steps you can take to feel better over time.

Medical support

• Ask your doctor about treatments for anemia, such as blood transfusions or medicine.
• Inflammation may be treated with anti-inflammatory medicine. 

Healthy habits

• Eat nutrient-rich foods, even in small amounts.
• Do light physical activity, like walking or stretching, if your doctor says it’s okay.
• Try to get enough sleep and rest during the day if needed.

Emotional support

• Talk to a mental health therapist to help manage stress or sadness.
• Ask about medicine for depression or anxiety if you’re having a hard time emotionally.
• Join a myeloma support group to talk with others who understand what you're going through.

Everyday strategies

• Balance your activities with rest. Don’t overdo it on your good days.
• Use simple tools like planning your day, taking breaks, and asking for help when needed.