Four months on and I am still wiped out by three in the afternoon. Is this still the treatment or is it just me?

Slightly sheepish thread this, because next to people here waiting on scan results my problem is just being tired, and tired is not exactly an emergency.

But it is four months since my AVM treatment and I still hit a wall every afternoon. I do a morning, I do lunch, and by three I am done, properly done, sit in a chair and stare done. I have never been like this. Bloods were normal, everything else checks out, and my GP raised an eyebrow and said it was probably the radiation, which is not really an explanation.

What I want to know from people further out is whether this lifts, and roughly when. Because at the moment I am pacing my whole week around one bad hour.

Mine was at its worst somewhere in the first couple of months and then thinned out gradually rather than stopping. I remember being furious about it, because there is no wound and no scar and nothing to point at, so it feels like you are being feeble about a treatment that took an afternoon.

By about five months I had stopped planning around it. Not gone exactly, just no longer the thing that shaped my day.

Over a year out from mine and I can tell you it does not stay like this. What I could not have told you at four months is when it would change, because it happened so slowly that I only noticed in hindsight, on a day when I realised I had not thought about the afternoon at all.

The invisible part is the worst of it. If I had a plaster cast people would understand why I am not myself. Instead you look completely fine and you are counting the hours until you can sit down.

Not treated yet so take this for what it is worth, but my mother had radiotherapy elsewhere years ago and the fatigue was the thing that surprised her most too, long after everything else had settled. It seems to be the side effect nobody puts on the front of the leaflet.

Susan, please drop the sheepishness. Fatigue is the thing people write to me about most often and the thing they most often apologise for raising, which tells you how badly it is signposted beforehand.

My own version was much like Mark's: heaviest early on, then a long tail that faded so gradually I could not name the week it stopped. What helped me was giving up on the idea of pushing through it and instead putting the demanding parts of the day before lunch, accepting that the afternoon was for quieter things. I wrote the honest version of that up in fatigue after Gamma Knife, including the part where I kept expecting to have earned my energy back by a particular date and kept being wrong.

One thing I would say is not to file every symptom under fatigue without mentioning it. New or worsening symptoms months out are worth reporting, not because they usually mean anything, but because your team would rather look and shrug than not be told. Yours has already checked your bloods, so tell them the shape of it too, that it is afternoons specifically and that it has not shifted in four months.

Mine improved when I started walking in the mornings, which felt completely counterintuitive when I was that tired. Short and flat to begin with, nothing heroic. I am not claiming it fixed anything, but the afternoons got less absolute.

Three weeks on from posting and no dramatic change, though rearranging the day the way Ruth describes has made it much less miserable to live with. Mornings for anything that needs a brain, afternoons for the kettle and the garden.

Mentioned it at my review as well and it is written down now, which was the useful bit. No answers, but at least it is on the record rather than something I was quietly enduring.