Multiple sclerosis and fatigue management

Multiple sclerosis and fatigue management

RDaSH leading the way with care

Introduction

All people experience fatigue due to weakness and tiredness affecting their muscles after exercise and exertion. The type of fatigue experienced in multiple sclerosis (M.S.) is different as the nervous system is involved as well as the muscles.

? Blurred vision, numbness and tingling in the hands and feet are due to fatigue of the sensory nerves.

? Fatigue in people with M.S. happens much faster than fatigue in people without M.S.

Fatigue inducers

Facts and Figures

? Fatigue is the most common symptom of all clients with multiple sclerosis, affecting up to 85% of individuals.

? It is believed that, due to nerve damage, the impulse transmission (the nerve signal) is more difficult and weakened. This results in feeling weak, tired, shaky, heavy and having poor concentration. This means that much more effort is required to move.

The following are known to cause fatigue in M.S. ? A hot bath ? Infections ? A heavy meal ? Hot, humid weather ? Spicy food ? Over exertion ? Hot drink ? Over heating ? Smoking

? Frequent socialising

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How to identify things that cause fatigue

It is essential to identify activities that cause fatigue and plan around them.

1. Use a diary to record and help identify times when you are tired and the activities that cause fatigue. Do this for a normal week.

2. Record how the fatigue affects you (e.g. making your vision worse, hands more shaky).

3. List all the activities you do and separate them into sections in Table 1 (page 7).

Tips to help combat fatigue

By identifying when you are most tired you can plan your day accordingly. Try to do activities identified as "essential" and activities that you want to do at a time when you are less tired. If you are planning to go out for the evening, try and plan your day with activities that do not make you tired so that you have plenty of energy left for the evening!

The following tips may help combat some of the tiredness you may feel:

In general:

4. Look at the essential tasks and think about how, when and why they are done.

Ask yourself the following questions:

? Are they all really essential?

? Make sure that your furniture is easy to get up from. Contact an Occupational Therapist if you are having difficulties.

? Avoid going up and down the stairs too often. Plan ahead.

? Could someone else carry them out?

? Could they be made easier to carry out?

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In the kitchen:

Laundry:

? Sit down to do jobs wherever possible e.g. washing up, ironing. Contact an Occupational Therapist for advice and equipment provision.

? Arrange kitchen cupboards so that items you use every day are easily reached.

? Use electrical labour saving devices when cooking e.g. steamers, food processors, and electric tin openers.

? Consider the purchase of a washing machine and tumble dryer.

? Buy clothes that do not need ironing or need very little ironing.

Shopping:

? Consider bulk buying frozen food and ready meals.

? Have shopping delivered.

? Consider the use of a microwave.

? Shop using the Internet.

? Consider carousel racks for base cupboards to reduce bending and stretching.

? Slide heavy items along the work top instead of lifting them.

? Consider a split-level cooker with an easy opening oven door at eye level.

? Try using lightweight utensils e.g. melamine instead of heavy china.

Housework:

? Get somebody to take heavy items upstairs for you e.g. the vacuum cleaner.

? Keep a set of cleaning products in the bathroom.

? Do light housework in short bursts only ? if possible get someone else to do heavy housework.

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? If you have heavy or numerous items to transport, use a trolley.

? Use duvets instead of sheets and blankets.

Gardening:

? Ask someone else to do heavy gardening tasks e.g. cutting the grass.

Personal care:

? Avoid hot baths, have a cooler shower or bath.

? Change your garden area from grass and planted borders to textured gravels and pots, which are easier to maintain.

? Use a towelling bathrobe rather than a towel to dry yourself.

? Keep cool by using a fan in hot weather.

? Wear light coloured clothing in the summer as it keeps you cooler.

? Plan your social life so that it is evenly spread out.

ONE final important requirement ? rest

From using your diary you will have identified times when you are more tired. Use these times to rest and reduce the levels of fatigue. It is advisable to do absolutely nothing whilst resting to allow every part of your body to recharge.

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