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 6424 msfocusmagazine.org Symptom Management Fatigue Management: Tips and Tricks to Conserve your Energy By Tracy Carrasco, OT/L, MSCS We know that up to 90 percent of all individuals with MS report that they have experienced fatigue, and more than 50 per- cent admit it is their most disabling symptom. This “invisible symptom” is the most common cause of disability. MS fatigue can be grouped into two categories: primary and secondary fatigue. Primary fatigue (lassitude) is that which is caused by MS itself. Secondary fatigue occurs as a result of a symptom, medication, or other condition. As Dr. Thrower mentioned in a previous article (see page 19), some of these secondary sources include sleep disturbances, spasticity, medication side effects, decondi- tioning, obesity, urinaryfrequency, depression/ anxiety, and temperature sensitivity. Often- times, these secondary sources of fatigue can compound one another. For instance, fatigue is a symptom of de- pression which may lead to inactivity, which may increase spasticity, which may lead to difficulty sleeping, which can then increase fatigue. This is called the cycle of symptoms. Breaking the cycle of symptoms may seem overwhelming, but there is help. The first step is to track your daily activity in a log, which will help identify problem areas. Ask yourself these questions: • What does a typical day look like? • Are there certain days of the week that are more fatiguing than others? • What are your most energy-consuming activities? • What time of day does your fatigue set in? Next, further analyze your fatigue. • How do you feel when you are fatigued? Give it a rating from 1-10 in severity. • What triggers your fatigue? • What helps to relieve your fatigue? • Are there other symptoms that occur when you are fatigued? Making Changes Once you have a good understanding of your fatigue, it is time to make some changes. You may need to make changes to yourself, a particular activity, or the environment where the activity takes place. Making changes to yourself is particularly important and begins with basic wellness behaviors. According to a recently published study, 85.5 percent of MS study participants did not meet nutritional standards, and a whopping 90.3 percent were not meeting recommended dietary and physical activity standards. Good wellness behaviors include: light to moderate exercise, a well-balanced diet, good sleep habits, minimal alcohol consumption, and no smoking. If spasticity is an issue, it is important to practice good management techniques including daily stretching. Try to make yourself the healthiest you can be. Changing how things are done can be a challenge, because it often means changing a familiar routine. Begin by choosing what is important to you and prioritize from there.