Does My Fatigue Medication Actually Help
As the medication I use to help me manage my fatigue is a controlled substance, I have to actually drive to my neurologist’s office so he can physically write me a new prescription when I need a refill. Yesterday was one of those “trip to the doctor’s for a refill” days, and while he was writing me a new script, he asked me, “So, would you say that this actually helps?”
Seeing The Big Picture
With so many pieces to this puzzle, your healthcare team is here to help you see the big picture and understand which factors are affecting your fatigue. Heres who can help:
MS Provider
- Pinpoint the sources of your fatigue
- Determine which medications might be contributing to your fatigue
- Help manage pain or spasms caused by spasticity
- Prescribe medication to help relieve MS lassitude
Physical Therapist
- Recommend a physical activity and exercise program to increase your energy
- Recommend tools and mobility aids to help you conserve energy
Occupational Therapist
- Teach energy conservation strategies for daily activities
- This can include ways to modify your environment, simplify tasks, and make the most of the energy you have
Mental Health Professional
- Identify and treat mood changes that may be affecting your energy level and your sleep
Sleep Specialist
- Diagnose and treat any primary sleep problems such as sleep apnea that are interfering with your sleep
Urologist
- Diagnose and treat urinary problems that are disrupting your sleep
Fatigue is a reality when you live with MS, but there are ways to solve the puzzle! You can reduce that fatigue, manage the energy you have more effectively, and get the things done that matter to you.
Utilize your healthcare team, your support system, and additional resources found on our website, to better fight fatigue.
Fatigue Due To Medication
Many of the medications commonly used to treat MS symptoms can cause or worsen fatigue as a side-effect. Particular medications to note include interferons, steroids , antidepressants and medications for spasticity or pain.
Usual treatment
Because the range of medications that may aggravate fatigue is wide, it is important to talk to your GP or neurologist if you have concerns about any medication you are on. Note: Drugs that assist with sleep may cause sedation and drowsiness during waking hours, which can be confused with fatigue. If you have any concerns, talk to your GP or neurologist.
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Other Approaches To Managing Fatigue In Ms
Exercise can have many benefits for people with MS. It may include improving fatigue as well as strength, flexibility, balance, cognition, mood, and bladder function. Tai chi, yoga, and water-based exercises are among the types of physical activity suggested for people with MS. Always talk to your doctor before beginning a new exercise regimen.
Some people with MS find that fatigue worsens with heat. Keeping cool as much as possible may help with MS fatigue. Some people with MS find cooling equipment such as scarves, fans, and vests to be helpful. The Multiple Sclerosis Association of America offers a program to distribute cooling equipment to people with MS for free.
Some members of MyMSTeam report worse fatigue when they smoke cigarettes. According to the National Multiple Sclerosis Society, smoking can also affect the way MS medications work and hasten the progression from a relapsing to progressive type of MS.
Some MyMSTeam members say they feel better when they take nutritional supplements, such as vitamins or herbal products. Before adding any new supplement to your diet, talk to your doctor first. Some supplements can cause dangerous interactions with medications.
Many people with MS fatigue learn to use energy-conserving techniques. The Multiple Sclerosis Association of America recommends energy-saving tactics including:
What Causes Fatigue In Patients With Multiple Sclerosis
The exact cause of MS-related fatigue is still unknown. There are several theories on the subject:
- One theory is that fatigue is related to the general activation of the immune system. Chemical messengers are called cytokines these levels are higher in patients with MS and may be higher still in patients with fatigue. One way of describing this is that you may feel like you have a virus all of the time.
- Another theory is that people with MS may have to use more parts of their brain to do the same task as someone without MS in essence, they are working harder.
- Another theory is that fatigue is related to reduced electrical transmission of signals in the brain.
Whatever the theory, we know that fatigue from MS is a very real part of the disease.
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Axonal Loss And Altered Cerebral Activation
As conventional measures of T2 lesion volume and atrophy have fallen short in providing a basis for fatigue in MS, many investigators have relied on non-conventional neuroimaging techniques to shed further insight. The demonstration on positron emission tomography of decreased regional glucose metabolism in the frontal cortex and basal ganglia of fatigued MS patients has suggested that neuronal dysfunction in these regions may play a role. Magnetic resonance spectroscopy studies have shown significant reductions in N-acetylaspartate/creatine ratios in multiple brain regions among fatigued MS patients in comparison to non-fatigued MS patients, suggesting axonal loss as a contributing factor., MS-related fatigue also may arise at least in part from compensatory reorganization and increased brain recruitment, as functional MRI studies that have demonstrated increased volumes and patterns of activation in the cingulate gyri and left primary sensory cortex in fatigued MS patients compared to non-fatigued patients.
What Can I Do If I Have Fatigue
Although fatigue cant be cured, there are techniques that can be used to reduce the impact it has on your daily life.
There are two main aspects of managing fatigue.
- Ensuring you have the best levels of energy available eg, through eating healthily, staying active, getting enough sleep, reducing stress and improving your mood.
- Learning how to use that energy in the most efficient way eg, by planning in advance, prioritising and delegating tasks, and pacing yourself.
Although the key person in fatigue management is you, health professionals, such as an MS nurse, occupational therapist or physiotherapist, can support you through this process and help you develop strategies to manage your fatigue.
Do reach out to them if fatigue is an issue and you need some advice and support you don’t have to manage fatigue on your own.
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A Diagnostic Approach To Fatigue
An open ended question, followed by a series of more focused inquiries will often prove to be a productive approach. This should be followed by screening for other confounding conditions such as sleep disorders or depression. A systematic approach to the assessment and treatment of fatigue in patients with MS is summarized in .
Fatigue Is Often The Most Debilitating Ms Symptom
You see, despite being such a common aspect of life with MS, we really don’t know much about this symptom. Fatigue is often considered by many people living with MS to be one of the most debilitating symptoms they deal with on a regular basis. Even with all the physical and cognitive disabilities that MS has left me with, I would say that fatigue is what holds me back the most in my day to day life. Because of this, I am pretty dependent on the medications used to help manage fatigue, which is what I want to talk about today.
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Using Your Energy Efficiently
As well as making positive lifestyle choices to increase the energy you have, the other side to managing fatigue is to use that energy in the most efficient way. You need to:
Plan ahead and balance your busy diary between essential everyday tasks and fun activities to boost your mood. Try to prioritise so that you can use precious time wisely.
Delegate you may find this hard at first as you mistakenly think this is a loss of control, but actually, delegating allows you to take back control and focus on what is most important. Think of yourself as the CEO of your life, delegating lower priority tasks. Likewise, consider how everyday tasks can be done in a more time-efficient way.
Pace yourself and rest when you need to. By saving energy you can put it towards what is most important to you.
How Is Ms Fatigue Different To Ordinary Fatigue
MS fatigue is more than the tiredness that everybody feels after exertion or missing a good nights sleep. This type of tiredness can still affect you, but MS fatigue goes beyond that.
MS fatigue can be physical and mental it saps energy in an instant and can stop you from completing tasks. MS fatigue can be very debilitating and, unlike ordinary fatigue, it can take a long time to recover from.
MS fatigue is often overwhelming. It can happen at any time without warning or without any apparent reason. Some people say they experience MS fatigue after gentle activities such as writing or reading and they immediately need to rest.
Others say that MS fatigue happens after physical exertion, such as taking the dog for a walk or doing the shopping. For others, MS fatigue can happen after cognitive exertion such as working on the computer and completing mentally-demanding tasks. You may also experience MS fatigue when you wake up, in some cases every day, even after a good nights sleep.
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Tip : Conserve Your Energy
Energy conservation isnt just important for the environment. Its also a key principle for those with MS.
Whats your best time of day to get things done ?
If you notice that you feel less fatigue in the morning, take advantage of your extra energy to complete tasks such as shopping and cleaning. You can then conserve your energy later when you feel more fatigued, knowing youve already accomplished key tasks for the day.
People with MS may be especially sensitive to heat. As a result, they may experience more fatigue when they become overheated or are in a warmer environment. Try these techniques to cool down:
- Use air conditioning as needed, especially in the summer months.
Recognize And Manage Depression
Depression can be a major problem in MS. And depression often contributes to fatigue. Symptoms include changes in appetite or sleep, irritability, and a feeling of hopelessness or guilt.
Make sure to discuss your depression with your healthcare provider because it is treatable. Counseling and medication can help your depression and may alleviate your depression-induced fatigue as well.
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My Tired Is Not Your Tired
Fatigue. Most people with chronic illness especially MS experience this. My energy levels vary from one day to the next. I am tired of being tired . There are days when getting out of bed is challenging, and times when I literally have to force myself to do anything. Chronic fatigue can be very frustrating.
What I often find disturbing is when people diagnose me, and proceed to tell me why I am tired. They say you need to rest or youre depressed, and although there may be some truth to this at times, it fails to elucidate the correlation between MS and disease-related fatigue.
It seems that the majority of people cannot comprehend that MS-related fatigue is a totally different beast than just being tired. They dont understand what it means to lay down all day and still lack the energy or the desire to lift your head. Attempting to explain the difference becomes tedious, so most of the time I allow the words to go in one ear, take what I need and allow the rest to exit the other.
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Second, for those who do not have MS or chronic illness, please refrain from deducing our situations and experiences to what you think they are or should be. You cant begin to imagine all that we endure. Our tired is not your tired.
I believe empathy is the most essential quality of civilization.
Take Breaks And Pace Yourself
Pacing yourself and taking breaks during the day can help you stay healthy, says Wentink.
When Im drained and continue to push, I think Im putting myself at risk for getting sick, he says. When I feel fatigued, I take it as a sign that I need to step back and take a break.”
Symptoms tend to get worse when severe fatigue sets in, says Wentink. I try to slow down before that happens because I dont want to bring on a relapse, he adds.
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What Does It Mean For A Fatigue Medication To Work
Now do keep in mind, this is all based on my own experience with these medications. I am 100% sure that not everyone will totally agree with everything I have to say because we are all different. I’ve said it a million times before and I’ll say it at least a million more times what works for one doesn’t work for all. If it did, we probably wouldn’t have such a large assortment of medications to choose from. As well, if you are thinking about starting one of these medications for the first time , I think it’s important to start one with the right expectations. Ask yourself, what does it mean for a fatigue medication to “work”?
Other Causes Of Fatigue
Some fatigue experienced by people with MS is not actually caused by the MS. For example, a person might feel fatigued due to poor sleep, infection, medications, or depression.
Medications taken to solve other problems can contribute to fatigue. If you look at your pill bottles, some say, May cause drowsiness or Do not operate heavy machinery while taking this medication. These warnings indicate that the medicine is sedating, i.e., it can make you tired. Medications that are used to treat bladder dysfunction, spacticity, and pain can cause fatigue in MS patients. If this is the case and you are experiencing fatigue, a good place to begin is to review all of your medications with your physician.
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A Little More Strength To Carry The Weight
In my experience, it’s not like you take a pill and, just like that, no more fatigue until the pill wears off. When I take my medication, the fatigue is still there, but it becomes easier to work through it kind of like how cold medication doesn’t eliminate a cold, but it may help reduce the symptoms of one. If you think of fatigue like the weight of a huge boulder on your back that you have to walk around with, I would say that these medications don’t really remove the weight of the boulder but instead give you a little more strength to carry it. The heaviness in my body caused by my fatigue is always there, but these medications make it a little less difficult to not be crushed by it. At least that how it feels to me.
Take Good Care Of Your Overall Health
Maintaining a healthy weight and optimal blood pressure and cholesterol levels, and avoiding type 2 diabetes can all help with MS fatigue, says Dr. Conway.
“A healthy diet and a regular exercise program can really help, says Cohen. If you are physically out of shape and overweight, everything you do requires more energy.
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Solving The Puzzle Of Ms Fatigue
Do any of these feel familiar?
Im so tired, I cant even think.
I get myself up and dressed and then I need a nap!
I feel like a limp noodle.
I just wanted to get one thing done today, and Ive already hit a wall.
I feel like Im slogging through mud all the time.
It can be overwhelming and baffling, but fatigue is manageable. Its a puzzle made up of many parts.
Secondary Fatigue And Well Being
Coping with fatigue can be draining. Thus, feelings of tiredness and exhaustion can lead to more feelings of tiredness and exhaustion. However, maintaining a healthy lifestyle can help you cope better with fatigue. Keeping physically fit is very helpful and it is possible to develop a balanced programme of activity that takes account of any limitations. A physiotherapist can help with specific exercises, but they must be aware of the potential limitations MS imposes.. Managing time and energy and minimising stress is also important. Whether at work, home or elsewhere, conserving energy and taking periodic breaks will make a big difference to how much can be done each day. It may be useful to plan each weeks work, social and late-night activities in advance so that the most important activities take priority. Maintaining a healthy and balanced diet is important for everyone, but especially for people with MS. Be aware that excessive alcohol can increase fatigue and toxins like nicotine should be avoided. Each days activities should include opportunities for relaxation and moments of high energy should be balanced with adequate rest periods.
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It’s Not A Simple Answer
Before answering, I had to pause and think for a few seconds because I found this question to be so interesting. As an MS specialist who has been prescribing his patients this stuff for years, he obviously knew the objective facts as to whether or not it’s efficacy was clinically significant, so I assumed he was asking for my subjective opinion. I told him that for me, it wasn’t as simple as “yes” or “no,” and that’s what made me want to write today’s post.
How Ms Fatigue Is Different To Other Types Of Fatigue
Ordinary fatigue is described as a sensation of muscular tiredness and weakness. It is the tired feeling everyone experiences after an excessively busy day or a lack of sleep. It is the type of fatigue that is usually managed by rest and a good nights sleep. Ordinary fatigue is quite different to the fatigue experienced in MS.
Fatigue associated with MS is described as an overwhelming sense of tiredness that can occur at any time of the day without warning. MS-fatigue usually occurs more rapidly, lasts longer and takes more time to recover from than ordinary fatigue.
MS-fatigue can occur for no apparent reason or after relatively mild exertion, such as a short period of walking, writing or reading, with an immediate need to rest.
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