Fatigue = :(

Fatigue is probably the most disabling symptom of my MS (everyone's is different), but it is unfortunately also an invisible symptom. Let me tell you about it.

There are several kinds of fatigue in MS.

1. Lassitude. This is a kind of fatigue that is unique to MS. Let me be blunt: people who do not have MS have no idea how this feels.

This is what the MS Society says about lassitude (and my thoughts):
-Generally occurs on a daily basis (check)
-May occur early in the morning, even after a restful night's sleep (this is so frustrating, because you cannot count on being able to do what you plan on any given day)
-Tends to worsen as the day progresses (true, although it can get better with rest)
-Tends to be aggravated by heat and humidity (such as a bath, ahem)
-Comes on easily and suddenly (I call this "hitting a wall")
-Is generally more severe than normal fatigue (YES, "fatigue" does not really convey the severity)
-Is more likely to interfere with daily responsibilities (unfortunately true)

Lassitude is probably the hardest thing about having MS (which I can say now that my burning nerve pain is under control, lol). Lassitude is the voice inside me that screams, "Lie down! Now!"

2. Medication side effects. Although one of my medications commonly causes drowsiness, I do not think it does that to me.

3. Sleep problems. They are very common in MS. I guess I have sleep problems, but I think not severe. I have nothing but bad dreams lately--it is hard to fall asleep quickly when I wake up terrified. I have been careful not to drink water for a few hours before bed, which reduces the nocturnal potty trips.

4. Other medical problems. When I had a UTI, I was a million times worse. I couldn't sleep, I kept crying, and my brain was not functioning properly. Besides being tired and all. I remember calling my best friend, who at first talked to me normally but soon began speaking to me like a child. She was trying to convince me to go to a doctor. I have no idea why I did not want to go, but it made sense to me at the time.

5. Weakness. Weakness and fatigue are different. Muscle weakness can make everything harder to do. If you have to work harder to do everything, you will tire more quickly. Here, here.

6. Cognitive difficulties. Have you ever felt tired after reading a "hard" book or attending a difficult class in college? What if everyday tasks were as cognitively demanding as that? I sometimes have to think hard to figure out where the milk is, how to open my email program, or what all those numbers are on the microwave.

7. Deconditioning. This is the "use it or lose it" principle--when you sit around all the time, you get tired more easily when you do decide to be active. It is hard to handle this one considering all of the other reasons for fatigue. Deconditioning requires activity to decrease fatigue. But with the other reasons/types of fatigue, activity will make fatigue worse. I do not think I am terribly deconditioned at this point, but maybe somewhat.