b'Medicine & ResearchA s k t h e M S Nu rs eA s k t h e M S Nu rs eCherie Binns is a MS-certied nurse living with MS. She is the patient healthcare liaison for MS Focus and a member of the MS Lived Experience Advisory panel for the Foundation. Her monthly column addresses the issues of living with MS.Dear MS Nurse,worse in hot weather and is there a medicine I am 70 years old and just got out of a coupleto take for it? Kimberly K. of months in rehab. I am so tired. Is there anyBinns: Heat can ramp up symptoms. It is medicine for this? Janet M.called Uhthoffs sign, identied by 19th century Binns: Unfortunately, no single antifatiguephysician Dr. Wilhelm Uhthoff. Even a quarter medication did better than its counterpartdegree of the bodys core temperature rising placebo (in some trials) and none of them areis enough to worsen symptoms for many recommended to be taken each day as dailyindividuals. I nd that cooling your internal use tends to perpetuate long-term fatigue.bodytemperature withice-coldbeverages The good news is that increased activity withand cooling it externally with a cooling vest or some daily exercise has been shown in multiplebelt can loosen the hug or get rid of it altogether. trials to improve fatigue in almost all personsGenerally, medications are not given for the who were in exercise trials.hug, but some people take a dose of Tizanidine Dear MS Nurse,(Zanaex) to quiet the worst of the discomfort. I am 54 and was diagnosed six monthsDear MS Nurse, ago. I still have four kids at home and have soDo you have any tips or tricks to chill out much to do and so many people depending onspasticity?Erica K. me. Is there any natural treatment I can take?Binns: A regular stretching routine can be I cant have an MS medication which has sideinvaluable in managing spasticity. Hold each effects that make it harder for me.Sherrie M.stretch for a minimum of 20 to 30 seconds Binns: We have not found any supplementsand repeat several times a day. This only takes or herbal therapies that manage MS. Lifestylethree to ve minutes at a time and can often changes such as eliminating food additives andminimize or eliminate the need for medication sugars helps, as does a regular daily activityfor spasticity. It is important you do stretches and exercise plan. There is an overwhelmingjustbeforegettingintobedasnighttime body of evidence that individuals who are notspasticity can interfere with sound sleep.onadisease-modifyingtherapyandonlyDear MS Nurse, treating their MS naturally have increased disease activity and faster rates of progressionIhavebeenonProvigilforfatiguefor of disability versus those on a DMT. The newermore than a year now. Even when I take the medications, especially the B cell therapies,maximum dose, I cant stay awake during the generally have no signicant side effects andday and I have trouble sleeping at night. Is interfere minimally with our schedules withthere something else that might work better? only twice-a-year dosing. Mary G. Dear MS Nurse,Binns: Although most doctors who prescribe Why is it that the MS hug always seemsmedication for fatigue write a prescription for msfocusmagazine.org 46'