Page 1 Page 2 Page 3 Page 4 Page 5 Page 6 Page 7 Page 8 Page 9 Page 10 Page 11 Page 12 Page 13 Page 14 Page 15 Page 16 Page 17 Page 18 Page 19 Page 20 Page 21 Page 22 Page 23 Page 24 Page 25 Page 26 Page 27 Page 28 Page 29 Page 30 Page 31 Page 32 Page 33 Page 34 Page 35 Page 36 Page 37 Page 38 Page 39 Page 40 Page 41 Page 42 Page 43 Page 44 Page 45 Page 46 Page 47 Page 48 Page 49 Page 50 Page 51 Page 52 Page 53 Page 54 Page 55 Page 56 Page 57 Page 58 Page 59 Page 60 Page 61 Page 62 Page 63 Page 6419 msfocusmagazine.org Fatigue is one of the most common and most bothersome symptoms experienced by people with MS; the word itself – fatigue – does not adequately express the magnitude of the problem. We live in a busy, multitasking, “go, go, go” kind of world. Everyone gets tired, but the fatigue experienced by people with MS is different. By definition, it affects a person’s ability to carry out their daily activities. Fatigue can be a direct result of a person’s MS, or it may be because of other factors, such as disrupted sleep, deconditioning, mood disturbances, medications, or other medical problems. (Keep in mind that fatigue may be due to a combination of these factors.) Fatigue that is a direct result of MS comes in two flavors: lassitude and nerve fiber fatigue. Lassitude is an overwhelming tiredness that comes on for no apparent reason. It has been described as, “swimming in a fur coat.” Others say it feels like someone has thrown a lead blanket over them. People with lassitude know they want to get up and go; their body, however, says otherwise. Nerve fiber fatigue, on the other hand, does have an identifiable cause. This type of symptom is typically brought on by exertion or heat exposure. A typical example of this type of fatigue would be walking difficulties that worsen on a hot day or the farther you walk. Talking about fatigue When I discuss fatigue in the exam room, I frequently start the conversation by asking about sleep. Disrupted sleep is shockingly common in the MS community. If a person with MS says they are just as tired when they get up in the morning as they were when they went to bed, we may be dealing with disrupted sleep. Obstructive sleep apnea is more common in people with MS. (See page 26 for more on this topic.) Many common Running on Empty: Dealing with Fatigue By Ben Thrower, M.D. Symptom Management