Lassitude's come home

I have also had multiple sclerosis (MS) for at least the last 24 years. Not many people knew about it. I blamed the falling down episodes on being blind drunk. It's somehow more acceptable to be a drunk than to have a neurological condition. Unfortunately the cancer fatigue and chemotherapy haven't got on with the MS, hence the delay in 'bouncing back' to my old self.

The most common fatigue seen in MS is called lassitude. Lassitude is characterised by an overwhelming sleepiness that may come on abruptly and severely at any time of day. Lassitude is a bothersome form of fatigue because the person may ‘look so good’ and yet not be able to function. A well-timed nap sometimes is most helpful in managing lassitude. The management strategy for this form of fatigue includes rest and the use of antidepressant and stimulant medications.

To those who do not have MS, it may come as a surprise that the most disabling symptom of MS is fatigue. For those who have MS, this is not at all surprising. Part of the reason that fatigue is so common and potentially disabling relates to the fact that there are many different kinds of fatigue in MS, and it is possible to have none or all of the forms at the same time.

Obviously MS does not protect you from normal fatigue that may occur to anyone. However, a person with MS sometimes may have a ‘short-circuiting’ type of fatigue. This occurs when a limb has a weakness. If it is fatigued, the limb exhibits increased weakness. The limb will recover when the arm or leg is rested, but it may be bothersome when activities require its ongoing use.

Repeatedly asking the nerve to perform when it is repeatedly short-circuiting causes fatigue. The judicious use of aerobic exercise may help build endurance, if not strength, and thus may decrease this form of fatigue. However, overexercising with weights increases both fatigue and weakness, so a careful balance must be sought. Management strategies include the appropriate use of exercise and rest, with the understanding that ‘no pain no gain’ is simply wrong and that rest should come before ‘short-circuiting’ fatigue becomes significant.

And if a person does not remain active, muscles atrophy and deconditioning occurs. This is another source of fatigue. Maintaining mobility is essential and the appropriate management strategy for this type of fatigue is exercise and maintenance of mobility.

I'm very grateful for the physiotherapy which is helpful in teaching the concept of energy conservation to moderate the severe fatigue of differing varieties. The physio also helps my efficiency in performing activities of daily living, which include dressing, eating and so forth and along with the swimming, may increase the energy available for other activities.





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