Detective work, part I

Fatigue. Apathy. They have been my constant companions for almost a decade. The question has been, what is the cause?

A glance at a WebMD slideshow gives some possible causes, and I had eight of the first ten:

  • Not enough sleep (as any reader of this blog knows) ✔
  • Sleep apnea ✔
  • Unhealthy diet (historically, although I’ve gotten much better recently) ✔
  • Anemia (since I was a kid) ✔
  • Depression ✔
  • Hypothyroidism (for almost 30 years) ✔
  • Caffeine overload
  • Hidden UTI (an issue I often have due to MS) ✔
  • Diabetes
  • Dehydration (I know I don’t drink nearly enough water) ✔

The others were heart disease, shift work, food allergies, Chronic Fatigue Syndrome and Fibromyalgia, none of which I have to deal with, thankfully.

And then, of course, there is the elephant in the room: MS. Fatigue is one of the major symptoms of Multiple Sclerosis, affecting 80% of people with MS.

Here’s a tidbit from the National MS Society:

Researchers are beginning to outline the characteristics of this so-called “MS fatigue” that make it different from fatigue experienced by persons without MS.

  • Generally occurs on a daily basis
  • May occur early in the morning, even after a restful night’s sleep
  • Tends to worsen as the day progresses
  • Tends to be aggravated by heat and humidity
  • Comes on easily and suddenly
  • Is generally more severe than normal fatigue
  • Is more likely to interfere with daily responsibilities

MS-related fatigue does not appear to be directly correlated with either depression or the degree of physical impairment.

I’ve been working with my doctors (neurologist, naturopath, and primary care doctor) to figure out which of the many possible causes is actually the source of all this fatigue. Suddenly, a new possibility came into play, something that no one had thought of.

Tune in tomorrow for part II!

tired by fltmech98 / CC BY

Plan #7 – Get better sleep

 

Sleep

Most people set alarms to get up in the morning. I also have to set an alarm to make myself go to bed at night.

It wasn’t always this way. For most of my life, I was renowned for being an excellent sleeper. I could (and did) regularly fall asleep anywhere: at school, in church, on mass transit, in cars (which got to be a real problem once I learned how to drive). My going-to-bed routine involved one step: laying my head down on the pillow. BAM! I was asleep.

Part of this tendency must be genetic. My mom has been known to fall asleep while sitting at the dinner table having a conversation. (Put a glass of wine in her hand and – just by virtue of holding the glass – no drinking necessary – it will happen even faster.) I also come from a family of snorers, and I have the added bonus of interspersing snoring with what is called, in technical jargon, “not breathing.” During the many years it was untreated, all that disrupted sleep definitely added to my drowsiness.

It’s not that I am not still drowsy. Heck, I am tired all the time! The problem now, though, is that I am sleeping at all the wrong times. This MS fatigue is a killer; I’ll barely make it home from work (or church, or the grocery store, or a walk) before I feel the need to collapse and take a nap. Then, when nighttime comes, I can’t sleep.

I blame the double-barreled menace of steroids and smartphones, frankly. I was on that pulse steroid treatment for three years; one day a month I stayed up around the clock, which sent me into a tailspin when I had to return to my regularly scheduled programming. I’d fall asleep by day and sleep so long that I couldn’t sleep at night. I got into habits of reading on my phone while I was lying there awake, and that addiction has been really hard for me to break.

I’ve tried the whole not-napping thing, with varied success. Some days, like today, I try to resist the pull of the nap, until I realize I have just fallen asleep sitting up instead of attending to the paperwork piled in front of me. I’ve also tried to keep my naps short, but I get so groggy and sleep so soundly that I either can’t wake myself up or I can’t seem to function when I do.

Oh, well! It’s a trial-and-error process, I suppose. I need to keep making the attempt to figure out what works for me and take my successes where I can get them. In the meantime, I’ll try not to keep regaling you with my sleepytime woes. I’ll use that time to catch up on some zzz’s instead.

cpap to the rescue

Set a timer for 10 minutes and try to write your whole daily post.  Now go back and give yourself 5 more minutes to write about how you felt working under such a tight deadline.

As part of my Search for Health and my Attempt to Be a Responsible Adult, I have been trying to wear my CPAP machine more consistently. I don’t wear it often enough, because the dry mouth, chapped lips, and claustrophobic fighting-against-the-current feeling are, shall we say, less than pleasant. But I’m trying to put those cares aside in favor of the benefits:  it lets David sleep better because he doesn’t have to listen to me snore, it sends more oxygen to my poor  apnea-starved brain, and it apparently helps prevent heart attacks. Those are generally considered to be good things.

We have discovered an unexpected bonus over the last couple of weeks, though: Fu, our nocturnal cat, hates it. Instead of curling up with one of us to sleep – and later jumping into and around the bed in search of food or companionship or whatever the heck she wants at 3 am – she is keeping her distance from the bed. This is huge. We had tried everything to keep her away, and just stumbled upon this unexpectedly. I am thrilled. David is thrilled. Fu is less than thrilled, but I can live with that.

I’m finding ways around the CPAP badness as well: dry mouth rinse and Vaseline on my lips before putting the mask on have been a big help. Constant mask strap readjustment has helped, too. I’ve been able to fall asleep with some conscious relaxation exercises to get past the claustrophobia. It’s getting better – and if we can keep the cat away at night, that will be better still.

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It was weird to try to write a post in only 10 minutes. I rushed to pick something to write about; I wasn’t ready to get to pick my own topic! But since it was just telling a story, it went quickly. In fact, I wrote the whole post in only 5 minutes and 40 seconds, though I was sure that I was almost completely out of time. I used that extra time to read over what I’d written, briefly; the entire thing could be completely incoherent, for all I know.

The whole thing reminded me of timing how long it took Quinland to empty the dishwasher. She used to hate that job and dragged her feet whenever she was asked to do it. When she discovered that she could do the whole thing in under 3 minutes, it suddenly became much more bearable. Knowing that I can crank out a post in 10 minutes, however mundane it might be, is definitely a freeing concept.