one of the most common and annoying problems for people with MS. It is
a difficult one to understand for others, since it is not manifested by
a highly visible symptoms. It can often be treated very effectively once
its cause can be determined. Four specific types of fatigue are seen in
MS, and sometimes more than one is found in a single individual.
- Fatigue #1
is the tired feeling that everyone has after working hard. It is a natural
type of fatigue, and implies a good days work rather than anything negative
medically. Obviously a good nights sleep is the solution to managing this
type of fatigue.
- Fatigue #2
is the " worn out" feeling that occurs when a person is depressed,
often accompanied by poor appetite, sleep disturbances, and feelings of
poor-worth. It is treated with anti-depressant medications, frequently
accompanied by counseling or therapy.
- Fatigue #3
can best be illustrated by visualizing a person with MS who walks three
blocks, and has a slight limp after the first block, drags the leg affer
the second, and needs to stop after the third. Fatigue results because
the nervous impulses that control the leg muscles are worked beyond their
capacity. The best way to manage this type of fatigue is to allow for appropriate
rest periods to allow a return of strength.
- Fatigue #4
is a lassitude that is unique to MS, and the type that is meant by the
term "MS fatigue." It is an overwhelming fatigue that can come
at any time of day without warning, so that suddenly one feels extremely
sleepy and could in fact go right to sleep. The drug Symmetrel (amantidine)
has been found to effectively manage this type of fatigue, although the
manner in which it works is not yet understood. Stimulants such as Cylert
(pemoline) and Ritalin (methylphenidate) may provide relief, but they have
the unwanted side effect of causing difficulty in sleeping.
(Adapted from Symptom Management)
be conserved in almost all of our daily tasks in the kitchen, around the
house, in the yard and at the workplace. Here are 8 specific suggestions
for easing common chores. They will spark your own thinking on practical
ways to minimize your energy levels.
I. Use wheeled
utility carts or trays to transport numerous and/or heavy items.
2. If storage
cabinets are deep and hard to reach, use lazy susans or sliding drawers
to bring supplies and utensils within easy reach.
3. Slide heavy
items along work surfaces, rather than lifting them.
4. In the
kitchen or workroom, use a damp dish cloth, or a sticky substance such
as Dycem to keep a pot or bowl in place while stirring or a piece of machinery
in place while working on it.
5. Use adaptive
equipment, such as cx-tended handles for dusters or brushes, to avoid bending
use leg and arm muscles rather than back muscles when lifting an infant
7. In a work
situation, arrange desk and chair heights to facilitate maintaining proper
posture, reducing slumping of shoulders and neck flexion. Use a chair with
good back support.
8. Sit while
dressing whenever possible, dress the weaker side first; when undressing,
undress the strong side first.
- · Don't fight
fatigue-work with it. Recognize that it's not you; it's the MS.
Fatigue usually hits hardest in the afternoon. Arrange to do your strenuous
activities in the morning.
Heat affects fatigue. Don't plan too much activity in hot weather.
Sometimes fatigue can induce depression. There are drugs to help in such
Exercising those muscles not affected by MS can help relieve overall fatigue.
Educate your family and friends about the fatigue factor. Once they understand,
you will have new coping allies.
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