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 6421 msfocusmagazine.org in the brain and spinal cord is normally transmitted quickly and efficiently across myelinated nerve fibers. When nerve fibers are stripped of their myelin (demyelinated), these signals are no longertransmitted quickly. With exertion and/or heat exposure, the electrical transmission may stop altogether, a phenomenon called conduction block. Rest and cooling will put things back in order. It’s important to know that exertion and heat exposure are not causing any permanent damage. Developing a Treatment Plan So, as you can see, fatigue is common and somewhat complex in MS. Developing a treatment plan is a personal matter and depends upon what factors are contributing to fatigue in a given individual. Lassitude may improve with medications, including amantadine, modafanil, armodafanil, or stimulants, such as methylphenidate. An over-the-counter supplement, acetyl carnitine, was shown to help in some people. Physical and occupational therapists offer training in energy conservation. This may help the person with MS work smarter and not harder. (See page 24) Nerve fiber fatigue can be minimized with cooling strategies, like using a cooling vest or cooling hat, as well as medications like dalfampridine and 4- aminopyridine. Sometimes, a combination of cooling accessories and medication is the most effective course. Regular exercise and sleep, healthy eating, and avoidance of smoking are all good health tips for everyone, but may be especially important for people with MS. Talk to your healthcare team about fatigue. Help them out by describing how fatigue affects you, what it feels like, what makes it worse, and any new medications you are taking. While fatigue in MS can have major effects on your quality of life, it is important to know that you do have treatment options. Facebook Feedback is your chance to share your experiences related to topics covered in the MS Focus Magazine. “Like” our Facebook page at www.Facebook.com/MultipleSclerosisFoundation and watch for our next Facebook Feedback post. Request to join our Facebook group at Facebook.com/groups/msfocus. How do you cope with fatigue? Dulci Repke Hill: I'm hyperactive by nature, so when I wake up exhausted, I can't handle it. I reach for my prescription medication and I do so much. Then I can be at peace later on doing less. Dawn Moquin Craig: My issue is that my fatigue is not gradual – it comes on like a bomb! One step and I’m fine, and the next I feel exhausted. But I try to listen to my body in case there are any early signs. Being only a year and a half into this, I'm still learning management skills. Rick Coate: Listen to my body and take a nap if need be. I also take medication.