MS & Fatigue

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MS fatigue is considered by most of us (MSers) to be the worst part of living with this chronic illness.

It is estimated that anywhere from 85 to 95% of MSers experience MS fatigue at one time or another during the course of the illness. For those of us that live and cope with MS fatigue every day, it doesn't come as a surprise that it is one of the primary reasons for people with multiple sclerosis (MS) to work part-time or quit working.

On really bad days, dealing with MS fatigue is unbelievably difficult and makes even meet the basic needs a huge task.

Most people do not (or cannot) understand what's the big deal with this MS fatigue? But, how do you explain and describe an overwhelming tiredness that makes everything, no matter how small, much more difficult to accomplish.

A really important piece of information that you must know and be aware off is the need to control your body temperature as much as you can. Heat, humidity and warm weather have a very peculiar effect on must MSers.

Learning to control and manage your body temperature is a must if you don't wish to experience, what many consider the most common symptom in MS: MS fatigue.

In layman's terms, the messages that our brain transmits to the rest of our body do not flow smoothly and quickly across our nervous system, as it did before MS. The slowing down of all messages is due to the multiple scars located in the patches were the myelin has been affected by the disease.

MS fatigue affects both motor and cognitive ability:

Cognitive fatigue is the slowing down of mental functions while performing repetitive tasks.

Sometimes, your mind feels like it is stuck on first gear making it almost impossible to respond to a sudden question or accomplish any fast thinking like you used to.

The United States Social Security Administration recognizes the impairment resulting from MS fatigue as a factor contributing to disability in patients with multiple sclerosis (MS). One basic criterion used by many doctors to distinguish MS fatigue from other forms of fatigue and the fatigue caused by other multiple sclerosis (MS) symptoms, establish the presence of symptoms of fatigue during 50% of the total days in a period of a minimum of 6 weeks.

What does MS fatigue feels like?

Everyone has experienced days when you feel very, very, tired. Right?

The feeling associated with MS fatigue has certain characteristic that makes it unique:

- It happens everyday

- It can suddenly show up even after having had a very good night sleep.

- It tends to get worse as the day moves forward.

- Heat and humidity tend to make it worse.

- It appears suddenly and without any signal or warning.

- It's harsher than what most people experienced when talking about being fatigued and most of the time it gets in the way with normal activities in daily life.

For some folks, there are additional related symptoms, like:

- Your arms and specially your legs suddenly start to feel very heavy. And when I say heavy I mean "cement boots heavy". Taking a short walk to the kitchen from the family room turns into a really challenging task!

- Any problems or difficulties you might have had with your balance, your vision or your speech (slurring) will most likely get worse.

- You'll have a tough time keeping focus and concentrating.

- Unsteadiness and dizziness are very common.

- Headaches.

- You may feel sick, sort like having the flu.

- Strong feelings of depression.

There are many factors causing MS fatigue. They are grouped into: primary fatigue and secondary fatigue.

Primary Fatigue Is the result of the disease process. The basic reason for it is the demyelination in the central nervous system.

This fatigue is best described as an overwhelming feeling of tiredness that is not directly related to increased activity and is also known as Lassitude.

Heat sensitivity fatigue comes from the heat intolerance many of us with multiple sclerosis (MS) experience due to hot or humid weather. Raising our body temperature through exercise or exertion can have the same effect.

There is also something called "short-circuiting" fatigue, where affected nerves of individual muscle groups, such as your legs, tire after a short walk or your hand after writing.

The good news is that the majority of the time we can fight this "short-circuiting" fatigue as well as the heat sensitivity fatigue by putting on a cooling vest.

Secondary Fatigue is not caused directly by the multiple sclerosis (MS) itself, but is a result of multiple sclerosis (MS) symptoms or trying to compensate for them.

- Sleeping disorders are common in folks with multiple sclerosis (MS), the reason being frequent spasms, depression mixed with anxiety, pain, and urinary frequency during the night (nocturnal).

- Sleep can also be disturbed by the side effects of certain medications (corticosteroids like Solu-Medrol.

- Need of extra efforts to balance muscle weakness (mainly the legs) that make it more difficult to walk and keep your balance.

- The side effects of some medications can also cause fatigue, including those taken specifically to treat multiple sclerosis (MS), like the interferon family of drugs which are made from beta-interferon (Avonex, Betaseron and Rebif).

- Additionally fatigue can be the resulting side effect of certain drugs used to treat some MS symptoms like Baclofen, Valium and Zanaflex frequently prescribed for the treatment of spasticity or the drugs Klonopin and Neurontin used for pain.

Others include medications for high-blood pressure, allergy medications and others containing antihistamines and anti-anxiety drugs.

Depression could be the reason for your feeling incredibly tired.

- Sometimes, the depression itself is the result of the fatigue and also, several medications used to treat depression can lead to fatigue.

- Lack of proper nutrition also causes swings in blood sugar level leading to general tiredness.

- Lowering of body defenses by infections, urinary tract infections as well as common colds or flue can increase fatigue.

- Not exercising regularly can greatly contribute to fatigue.

Here are 12 ways to combat MS fatigue.

Remember that it is the seemingly insignificant little things that we do every day that makes the difference.

Always remember to read or ask your doctor about any side effects that can cause fatigue from the medications you are taking, including anti-depressants.

Drink lots of water every day. Dehydration opens the door to you feeling tired and drained. You might be one of those folks that doesn't drink water or drink very little, because of the inconvenience over having an over active bladder. I can definitely relate to that, but it's better to deal with the "pain in the neck" of having to look for the nearest bathroom, than dealing with the consequences of dehydration.

I always carry with me a bottle of water and I keep them in the fridge so is nice and cold.

Another plus to doing this, is that water will help you to eliminate toxins in your body. So, don't scrimp on this one and make it a part of your MS diet.

Try to breathe right. Getting used to not breathing correctly and taking short and shallow breaths, will reduce the amount and quality of oxygen going to your cells. As a result you start feeling exhausted very easily.

Start exercising. You have heard it before: doing regular exercise raises your energy levels. So as the Nike TV ads say........Just do it!

Depression causes fatigue. As simple as that so, keep moving forward, and let me add, taking a step back? Not even to gain more impulse. You must come to terms with your new reality, take a deep breath and move forward with YOUR LIFE.

Heat exacerbates any disabilities you might have. Whenever it is too hot outside, I can go from an almost normal, everyday, walking to barely being able to stand so, if I don't pay attention to my body I can get in trouble. That is why I use a coooling vest and take up to 3 cold showers during really hot days.

Variety is the key here. Try changing your daily routine or better yet, make new plans for your future. Start learning something new, another language perhaps or that thing you always wanted to learn about, write that book you dreamed of writing. It does not matter what it is, everybody needs variety in life.

MSers like us, have leg spasticity, cramps or frequent late night trips to the bathroom that keeps us up at night. Try getting as much rest as you need. A good place to start is with re-teaching your body to go to sleep every night around the same time. You need to compensate for all those precious lost minutes.

Nutrition is very important and controlling your weight will help you deal with fatigue. Start your MS diet and with the right exercise routine, you will start to feel the difference.

Learn to conserve your energy by learning to pace yourself. You can start by planning and following your plan or your prioritized To-Do list. It is just as important to have a balance in life, as it is to balance your fatigue. Prioritize the things you want or need to accomplish and learn to manage efficiently your energy.

Do not skip breakfast. When you wake up every morning, the sugar level in your body is at the lowest so grabbing a good breakfast will definitely give you an energy boost. Not eating anything in the mornings will most likely contribute to you feeling fatigue early on during the day. An excellent source of energy is inside foods rich in iron. Add fortified cereals, beans and more fish to your MS diet

Amongst the most frequently prescribed medications to deal with MS fatigue we have:

Symmetrel (Amantadine Hydrochloride)

Modafinil (Provigil)

Neither one of these medications is approved specifically by the U.S Food and Drug Administration (FDA) for the treatment of MS fatigue.

Each one of them has demonstrated some benefit in clinical trials.

I tried Amantadine (early on my multiple sclerosis (MS)) and Provigil a couple of years ago. With Amantadine I didn't feel any change what so ever - don't forget that multiple sclerosis (MS) is different for each of us - and with Provigil I felt a small improvement on my MS fatigue by raising the level of energy early in the day but it didn't last long. Nowadays my neurologist has prescribed Adderall XR. Most days it is helping me but, as with most things in MS fatigue, it is very hard to put your finger on it.

I am a 46 years old fellow that has been living with Multiple Sclerosis (MS) for the past 14 years. Totally aware of how tough is for fellow MSers to convey to family members and others what they are going through, decided to try to help other MSers and created a website: http://www.MS-multiple-sclerosis-symptoms.com/

I lived in the United States for almost 15 years and now lived in Managua, Nicaragua with my wife and daughter. By applying many of the tips given on the website, I am living well despite having MS.



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