Tired quickly, even without doing too much?Β You’re not alone.Β Fatigue is a well-known symptom of multiple sclerosis.Β So how can you manage a normal daily routine, without the fatigue taking over you?Β The answer is in the article in front of you.
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MS fatigue
About 80% of people living with multiple sclerosis face fatigue already in the first year of the disease, and about 95% face it in advanced stages of the diseaseΒ 1Β .Β The fatigue of multiple sclerosis is different from normal fatigue: it is more severe, more prolonged, and is accompanied by weakness, exhaustion, lack of energy, sleepiness, and worsening of the other symptoms of the disease.Β It can appear on a daily basis, suddenly, without expending appreciable energy, increase as the day progresses and worsen with heat and humidityΒ 2Β .
There are two types of fatigue :
(1) Physical/motor fatigue – can manifest in muscle weakness, unclear speech, and difficulty performing daily activities.
(2) Cognitive/mental fatigue – can manifest itself in slowing down reaction time, memory and concentration difficulties and difficulty performing daily activities.
How does fatigue affect your daily life?
Fatigue may interfere with daily activities such as driving, shopping, preparing food, taking care of children, working and managing a social lifeΒ 2Β .Β For example, if in the past you organized family events, today you may only be present at them.Β In addition, since there is not always enough energy to carry out all the day’s activities, people reduce the amount of participation, especially in those that are not seen as “necessary” such asΒ leisureΒ and social activitiesΒ 3Β .
For recommendations on recreational activities in multiple sclerosisΒ click here
It is important to note that participation in significant activities may improve the quality of life, and bring about positive changes in self-esteem and self-confidenceΒ 3Β .
So how do you deal with fatigue in multiple sclerosis?
There are several strategies that include maintaining routines, developing habits, and lifestyle changes, which can be incorporated into everyday life to better manage fatigueΒ 3Β .Β But since each person’s fatigue is affected by other factors and appears in a slightly different way, the most effective way to deal with fatigue is first of all to knowΒ your specific fatigueΒ .
Know your fatigueΒ : when during the day does it appear?Β During or after what activities?Β How do foods or medications affect it?Β Keeping a daily diary can help collect the information.Β Professionals can be used to analyze the diary and locate the most effective strategies for youΒ 3Β .
Below are a number of strategies that can help you manage fatigueΒ 2,3Β .
Plan your day in advance
A planned and balanced agenda can significantly reduce the degree of fatigue. Think about what is expected of you that week and accordingly schedule activities during the day. Try to schedule important activities or activities that require effort during the hours when you are most alert, when you have more physical and mental strength, and when you do not feel pain or side effects from the medication. Don’t forget to leave time for rest and quiet.
Prioritizing activities
Think about which activities are most important to you to preserve and which are less so. It is possible that some of the activities can be transferred to other people or help them, or simply give up some of them. For example, if it is important to you to continue cooking meals, you can ask others for help with some of the dishes or decide to prepare one main dish instead of three.
Breaking down large tasks into smaller tasks
Sometimes tasks require so much energy that they feel impossible. Breaking down large tasks into smaller steps, and doing each step separately, with a break in between, can help achieve the goal. For example, instead of cooking the whole meal in one day, prepare some of the steps, for example the cutting, the day before.
Energy conservation
Use strategies that require less motor effort, such as learning and practicing energy-conserving standing and walking patterns and using assistive devices. It is recommended to consult a professional (for example, a physical therapist or an occupational therapist) regarding these strategies.
Physical environment planning
Try to make changes in your environment to reduce or avoid wasted energy. For example, if you have arrived at a favorite coffee shop, and an empty table involves standing for a long time, it may be time to get to know new coffee shops nearby.
Changes in the environment also include:
- Structural changes, such as adding a stair ramp to the house or replacing a bathtub with a shower
- Changes in the organization of the environment, such as changing the location of tools in cabinets, so that frequently used tools are more accessible
- Maintaining an orderly and distraction-free environment.
Temperature regulation (cooling the body)
People with sclerosis report that an increase in the degree of body heat worsens the degree of fatigue and weakness significantly. It is recommended to avoid exposure to heat and use cooling means such as air conditioners. These strategies are especially important before or during activities that are expected to raise body temperature, such as exercise.
Paying attention to sleep hygiene
A good night’s sleep can equip you with more energy during the day. Sleep hygiene strategies include ensuring adequate sun exposure during the day to support the wake cycle; Adhering to regular sleeping and waking hours; and avoiding physical activity, large meals, smoking cigarettes or drinking alcohol before bed. It is recommended to develop a relaxing routine before going to sleep, and to keep a quiet, dark bedroom at a pleasant temperature. Also making sure to have a comfortable bed, and using it only for sleeping and not for other activities such as reading or watching TV, can help.
Physical activity
Often people with multiple sclerosis avoid physical activities because of the fatigue. This avoidance puts them at high risk of deconditioning – a state of physical weakening due to inactivity. This situation may lead to weakness and low physical endurance, and therefore the fatigue will be severe when performing physical action as a last resort. Personalized exercise by a professional can help preserve muscle strength, endurance and flexibility, and prevent deconditioning.
Stress management
Stress, anxiety and depression can make fatigue worse. Strategies such as meditation, mindfulness, yoga, and breathing exercises can calm and reduce fatigue.
Diet planningΒ
It is recommended to consult a nutritionist about the best menu for you. Changes in the type of food, amount and timing, can lead to a significant increase in your energy.
In conclusion, although fatigue is a common symptom in MS, and although it can affect your daily life, fatigue can be better managed and quality of life maintained.
The author: Dr. Yifa Arbel (PhD), occupational therapist
Sources:
- Salome et al.Β MS Int, 2019;1:1-7.
- Khan et al.Β Front Neurol, 2014;5:1-15
- Finlayson et al.Β 2012. Multiple Sclerosis Rehabilitation.Β 70-89
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