GREAT piece on MS fatigue

[doublevision1]

Fatigue In MS: What It Is, What It Does, How To Manage It

By J. Lamar Freed, Psy.D. (updated 3/2005)

J. Lamar Freed  is a clinical gero-psychologist in the northern Philadelphia Suburbs.  He sees older adults and consults at retirement communities.  He has been diagnosed with MS since 1993.
Every introductory article on Multiple Sclerosis (MS) that I've read mentions that many people with MS get fatigue. Health care professionals usually are informed about this effect of the disease as well. Despite this recognition, fatigue has not been taken as seriously nor viewed as profoundly as what the experience of people with MS merits. Fatigue is a symptom of MS. But it is much more than that. Fatigue underlies and influences many of the other symptoms experienced by people with MS and profoundly influences their quality of life.

The brain's myelin-covered nerve cells send commands and information from one part of the brain to another or to other parts of the body. The essential mechanism of MS is that this communication is impeded or blocked by the destruction of the myelin sheath that surrounds and insulates the cells. These communication cells serve as the superhighway to make messages travel quickly and easily. When the myelin has been destroyed or damaged, the information must bully through on less efficient channels which are often not ideally constructed for the task. It is like getting from New York to Washington without driving on I-95. Depending on the locations and number of these myelin depleting lesions, communication within the brain may be profoundly disrupted. As happens with any drive that lasts too long, fatigue is one of the results.

Fatigue is both a mental and a physical experience. The experience of fatigue may be felt as a feeling of general tiredness, but it also can be overlooked. It can show itself immediately or, at times, it can be delayed for days. Like everything else about MS, it is highly variable from one person to the next. The primary treatment for fatigue is rest.

Physical fatigue often is experienced as a bone-numbing tiredness. It is a tiredness that belies description. It can make movement seem impossible and the requirement for movement overwhelming. Fatigue is to blame when someone with MS can walk without visible difficulty in the morning and by evening need a wheelchair or may be unable to get around at all. It is also fatigue that can make one's ability on one day differ dramatically from ones ability on another.

Attempts to uniformly classify types of MS fatigue have not been developed by researchers.  Nevertheless, there is universal support that the fatigue experienced by people with MS goes beyond that of people without the disease. While it may be seductive to think that the fatigue of someone with MS is merely an exaggeration of normal fatigue, MS fatigue is qualitatively different. It is an oversimplification to say that a shopping trip for someone with MS is like running a marathon, or that a day at the beach resembles climbing Mt. Everest. The experience of neurological fatigue is unique, influencing many aspects of ones abilities and one's subjective experience.

This fatigue is also highly variable. There are some with MS who do not experience fatigue as a primary symptom. Someone can have profound gait disturbances and no fatigue, or paralysis or complete numbness of a limb without experiencing unusual tiredness.

This is because the location of MS lesions vary significantly. The accident of a small, strategically placed section of myelin loss can cause the complete isolation of a section of the body from the brain. It cannot respond to the brain's commands. The rest of the nervous system may have little or no damage and require no more energy than usual.

For most people with MS, the random lesions do not initially hit such critical places and the diagnosis of the disease comes after numerous lesions occur throughout the brain and spinal chord. This accumulation of lesions -- the multiple potholes and cracks in the superhighway system -- leads to the physical and mental fatigue experienced by so many with MS.


......read the rest of this paper at:

http://www.lamarfreed.net/fatiguems.html

[Lulu54]

This plain language explanation of MS is great - I really appreciated reading it and hope everyone else here will at least bookmark the link and take the time to read and share.

His other pieces are good as well.

[amethyst7292]

Excellent. Thanks so much!

[rendean]

Thank you DV for posting this wonderful article!!! What a great read and resource!!

Very much appreciated,
ren

[candy158]

Thanks for posting this, it is so incredible to fel validated with someone.   It also shows us how important it is to talk to our Dr's about it, and NOT to let them just sweep it under the rug.  I describe the fatigue as..... ( people in a coma say when they come out of it, that they heard things, but could not respond) .... that is kinda how I feel, just laying in bed, feeling unusually heavy, and not able to move my arms, and my head feels so heavy.  

So, I loved the article, and thanks again for posting it ...

(((HUGS))))
Candy

[debgen]

GREAT article JJ! I am forwarding it to people so they can get more of an insight to my constant fatigue.

Thanks :)
Deb

[twopack]

Additional articles by Dr Freed may be found here:
http://www.lamarfreed.net/indexnet.html
where it states, ".... all MS websites and organizations may link to, copy and distribute Dr. Freed's articles without expressed permission, but not without attribution."
(Thanks to DV for doing just that.)

Other subjects covered include MS and....  
depression,
anxiety,
stress,
finding a therapist,
the family,
work barriers,
pain,
neuropsych testing, and
managing medications.  

An article titled “What To Tell Your Children” by Dr. David Palmiter is also available from the page.

[supermum_ms]

WOW!!

This is simply a fantastic read, it really does tell it like it is and i'd highly recommend anyone who is dealing with fatigue, to get those around them to read it so that they too can understand what fatigue means to a lot of MSers.

Thank you...........JJ