There are some symptoms or difficulties that are common in serious illnesses.
Common symptoms or difficulties include:
- pain
- shortness of breath
- fatigue - tiredness that does not get better with sleep or rest
- feeling sick (nausea) or getting sick (vomiting)
- changes in appetite
- constipation or other bowel changes
- sleep problems
- changes in mood
You may not be able to stop some symptoms completely. But there are ways to manage symptoms so you can live as well as possible.
How your care team can help
Your GP or hospital doctor will ask you about your symptoms and how they affect your life.
To help manage symptoms, they may:
- help you find changes to your routine to reduce symptoms and use less energy
- recommend programmes or courses to help you live well with your condition
- explain activities or techniques to manage the symptoms
- refer you to a specialist who can help - for example, a physiotherapist
- prescribe or recommend medicines - including medicines to have in case you suddenly need them (anticipatory medicines)
- refer you for counselling or talk therapy
Tell your GP or hospital doctor if your symptoms change suddenly.
If you are getting support from a palliative care team, they can help you to manage your symptoms.
Pain
Everyone's experience of pain in different. Not everyone who has a serious illness has pain.
Your GP or hospital doctor will ask about any pain you have, for example:
- where the pain is
- when it started
- what it feels like
- how severe it can be
- the effect it has on you - for example, if it worries you or stops you sleeping
- things that make the pain feel better or worse
They may prescribe medicines and recommend other things that help reduce pain.
There may be times when you cannot tell people if you feel any pain. But healthcare workers will look for signs of pain.
Medicine for pain
The type of medicine your doctor prescribes depends on the type and amount of pain you feel.
They will explain the benefits, risks and side effects of any medicine they prescribe. They will also explain the best way to take medicines and how to manage any side effects.
Medicines that can help with pain include:
- painkillers you can buy without a prescription, such as paracetamol and ibuprofen
- opioids, such as codeine or morphine
- medicines for nerve pain, such as antidepressants or anti-seizure medicines
- medicines to reduce cramps
- steroids to reduce inflammation
- bisphosphonates for bone pain
You may need to try different medicines or combinations of medicines to find what works for you.
Most of these medicines come as tablets. But you can get medicines in another way if you cannot take tablets. For example, if you have problems swallowing or often get sick (vomit).
Other ways to take medicines include:
- liquids or tablets that dissolve
- through a feeding tube
- patches you put on your skin
- gels or creams you put on your skin
- suppositories - medicines you put in your bottom
- injections
- through a syringe pump - a small pump that injects medicine continuously under your skin
Other treatments to help with pain
Other treatments that can help with pain include:
- occupational therapy - to help make everyday activities easier
- physiotherapy - to help you stay active or recommend exercises
- counselling or talk therapy - to ease anxiety and stress that can make pain feel worse
- anaesthetic or steroid injections
- nerve block injections
- surgery
- radiation therapy or chemotherapy
Other ways to reduce the effect of pain include:
- heat therapy - such as using a hot water bottle or having a warm bath
- cold therapy - such as using an ice pack
- activities that relax you - such as listening to music, meditation or mindfulness
- exercises to manage stress
- complementary therapies - such as massage
Shortness of breath
You may feel short of breath because of:
- your condition
- an infection
- side effects of treatment
Shortness of breath can develop gradually or it can come on suddenly. The treatment depends on the cause and how it affects your life.
Your GP or hospital doctor may:
- recommend techniques or exercises you can use when you feel short of breath
- help you to plan and pace activities to reduce shortness of breath
- refer you to a physiotherapist or occupational therapist
- prescribe medicines to help your breathing
Things that help with shortness of breath
Feeling short of breath can make you feel tense, panicked or anxious. This can make your shortness of breath worse.
When you feel shortness of breath, try to:
- stop speaking and moving
- give yourself time to recover your breath
- relax or distract yourself by focusing on a picture or a view from the window
- lean forward - you can do this sitting or standing
- take slow and deep breaths from your tummy
Exercises that help with shortness of breath
Taking slow, deep breaths from your tummy can help to ease shortness of breath.
Fatigue
Fatigue is different from tiredness because it is not relieved by sleep and rest.
If you have fatigue, you may:
- feel exhausted or weak after activities you used to do with little effort
- find it hard to concentrate
- fall asleep for small amounts of time in a way that is unusual for you
- become more irritable or frustrated than usual
- feel less motivated to do everyday things
Your energy level can change from day to day. Fatigue can happen 1 or 2 days after an activity.
Mental and emotional activities affect fatigue as much as physical activities. For example, completing a form or dealing with a child's temper tantrum.
Tell your GP or hospital doctor if you find it hard to cope with tiredness. They may refer you to an occupational therapist or physiotherapist. They can help you to manage your fatigue.
Ways to cope with fatigue
Match your level of activity to your energy level and rest before you need to.
Try to:
- plan a balanced routine
- break down activities into smaller tasks with rest breaks
- rest between tasks, even if you think you do not need to
- spread out tasks over the day or week
- focus on things that you need to do or are important to you
- ask for help with tasks if you need it - this can give you time to do things you enjoy
- organise your home so that the items you use a lot are close to you
- explain to others what you can do and what happens if you do too much
- plan for longer rest after activities you cannot change - for example, a big family event
It is good to do some physical activity if it does not make you feel worse afterwards. Talk to your GP or hospital doctor if you are unsure about activities you can do.
Feeling or getting sick
Your condition or medicines you take may make you:
- feel sick (nausea)
- get sick (vomit)
Tell your GP, nurse or hospital doctor if you often feel sick or get sick. They may prescribe anti-sickness medicine.
It may also help to:
- have small meals or snacks every 2 to 3 hours instead of large meals
- eat dry foods, such as toast or crackers
- sip cool, fizzy drinks
- distract yourself with something you enjoy - such as music
- get some fresh air
Changes in appetite
You may have changes in appetite or problems eating because of:
- your condition
- side effects of medicines
- feeling sick (nausea)
- problems swallowing
- problems with your mouth, for example mouth ulcers
- low mood, depression or anxiety
- coughing
Talk to your GP or hospital team if you have trouble eating. They can give you advice or refer you to a dietitian or a speech and language therapist.
Things that help with appetite changes
To help with appetite changes:
- choose foods that you enjoy and can eat
- have small meals every 2 to 3 hours instead of large meals
- keep a range of snacks at home for when you do not feel like a meal
- eat soft foods if eating makes you tired - for example, porridge or stews
- have drinks instead of solid foods - for example, smoothies, soup or yogurt drinks
- eat when you have energy
Constipation or other bowel changes
Constipation can happen because of:
- your condition or illness
- side effects of some medicines
- changes to what you can eat or drink
- changes to how active you can be
- a lack of privacy - for example, if you are staying in a busy hospital ward
To prevent constipation, it can help to:
- eat foods with fibre - such as brown rice, wholewheat pasta, fruit and vegetables
- drink plenty of fluids
- stay as active as you can
Laxatives can also help if you cannot do these things or they do not work. Your pharmacist, GP or hospital doctor can give you advice about laxatives.
Sleep problems
Causes of sleep problems can include:
- symptoms that are not under control, such as pain or getting sick
- anxiety or worry about your condition and life
- changes to your usual routine or where you sleep
- side effects of medicines
If you have problems sleeping:
- talk to your GP or hospital doctor about symptoms or side effects that affect your sleep
- try ear plugs or an eye mask if noises or light keep you awake
- try some tips for better sleep
Mental health difficulties or mood changes
When you have a serious illness or condition, there is no right or wrong way to feel.
Mental health difficulties or mood changes can include:
- anxiety
- low mood or depression
- confusion
- feeling angry or hopeless
Tell your GP or hospital doctor if you are worried about these feelings. Getting help early can reduce the effects on you and your symptoms.
Things that can help improve your mood
Counselling or cognitive behavioural therapy (CBT) can help with mental health difficulties. For example, anxiety or depression.
You could also try to:
- notice your thoughts and feelings and let them happen
- write down how you feel
- tell someone how you feel - someone you know, a healthcare professional or a listening service
- join a support group
- identify what you can control in your everyday life
- set aside time to do something that makes you feel good as part of your daily routine
- think of things that have helped you through difficult times before
- try exercises to manage stress in moments where you feel a lot of stress, anxiety or worry