One More Thing to Celebrate

I'm on the verge of completing something I haven't done in the three years since my MS diagnosis. I've worked 12 days straight before breaking for an Avonex injection and recovery day.

I'm an idiot, right? Probably. But consider why I think my idiocy may be something to celebrate.

My schedule over these last 12 days has been just packed as it used to be...four worship services, five meetings (one out of town), six rehearsals, two funerals, acquisition, installation and setup of a new server for our church computer network, to name the high points...as stupid as that schedule might have been even back then. I've been working like I used to and I HAVE NOT CRASHED!!

One of the most common symptoms encountered by people with MS is fatigue. I believe it's a symptom that is often misunderstood by both a patient and an observer.

Everyone knows what it is to be tired, exhausted, worn out, run down and used up. The "cure" for the problem is rest, of course; sometimes a little rest, sometimes a lot of rest. But, generally speaking, for the healthy person, quality rest proportional to the level of exertion will be sufficiently restorative.

For the person with MS, fatigue can sometimes require resting for a length of time that seems DISPROPORTIONATE to the apparent level of exertion. This reality assaults a sense of fairness common to everyone - persons with MS and healthy people. The person newly diagnosed with MS wonders why a normal amount of rest sometimes just isn’t enough. A healthy person might look at someone encountering MS related fatigue and easily believe, hopefully out of ignorance, that the person is a sluggard and trying to get out of work. One says, “This is not fair! I want to feel stronger and get back to work!” The other says, “This is not fair! Get off your lazy a** and get back to work!”

An article in the Fall, 1983 edition of Inside MS states that people with MS become easy prey to phrases like, "It's psychological", "It's mental", and "You're just overreacting". "I get so tired of hearing people say I know you have MS but you look great", one person commented. "They just don't understand".

The article goes on:

What makes fatigue so special in multiple sclerosis? Dr. Robert M. Herndon, Director of the Center for Brain Research at the University of Rochester, N.Y. and the MS Clinic there says there are four main sources of fatigue in people with MS.

Demyelinated nerve fibers appear to use much more energy conducting nerve impulses than normal fibers and as a result they fatigue with use, causing increased weakness and poor coordination.

Weakened muscles put an extra workload on stronger muscles, causing them to fatigue more rapidly.

Depression and frustration at having a chronic disease such as MS can result in fatigue.

People with MS also experience normal muscle fatigue like anyone else but because of all of the energy sapped by their disease this normal fatigue is more common and occurs more quickly.

Dr. Davis clarifies fatigue in people with MS even further by maintaining that fatigue "can either be based in the muscles or the central nervous system and it doesn't take much to fatigue the central nervous system."

"Not only do people with MS look well, they feel well until they begin a certain activity. They function beautifully for a while and then all at once they have to stop because the nerve impulses just aren't getting through. "It's like a motor - it can be a very powerful motor but if you can't get the electricity to the spark plugs, the machine won't run."

Dr. Davis says some of his own MS patients have described their nerve fiber fatigue as similar to dreams in which the dreamer is being chased but somehow can't make his legs move.

Been there, done that, as the t-shirt says. But not the last 12 days! Hallelujah!