TagFatigue

WHAT REALLY AFFECTS QUALITY OF LIFE IN MS?

Results from the Trajectories of Outcome in Neurological Conditions (TONiC) study in MS have just been published – “Quality of life in multiple sclerosis is dominated by fatigue, disability and self-efficacy”. If you want to read and keep a copy of the paper, until 1 July 2021 you can read or download it for free from this, link without any need to register or pay (thank you to Journal of...

The solution for fatigue: getting tired (both of us!)

Nourbakhsh et al. have the honour of publishing the first article of 2021 that will change my practice. As bright and shiny as all the monoclonal antibodies on our treatment shelf are compared to the dusty and lacklustre drugs used to treat the symptoms of MS. However, the symptomatic treatments determine day-to-day life for many pwMS: fatigue, spasms, neuropathic pain, etc. For fatigue, the most...

Gratitude

Barts-MS rose-tinted-odometer: ★★★★★ A problem in modern medical practice is the assumption that there is a pill for everything. The one eye-opener for me after my recent trauma has been how easy it is for medics to reach for the prescription pad. When I was first discharged from hospital I was on 14 different medications. About half of the medications were prescribed to manage or prevent the...

Wiped-out and you?

Do you relate to this list of facts in relation to MS-fatigue? The most common spontaneously reported symptom for pwMS is fatigue.PwMS use the words “tired,” “exhausted,” “wiped out,” and having “little or no energy” to describe their fatigue. More patients rated fatigue as their “most troubling symptom” compared with other MS-related...

Temperature Sensitivity

Are you temperature sensitive?  In my experience the vast majority of pwMS are affected by changes in temperature; typically it is hot or cold temperature that triggers changes in central nerve conduction velocity that brings on old symptoms. One of my patients reports becoming paralysed if sits outdoors in the sunshine for as little as 30 minutes in the middle of summer. Other report worsening...

Genius

My #ECTRIMS2019 highlight #3 is the elevation of fatigue to be the first secondary outcome measure in a clinical trial. Was this genius or a marketing coup? I would have loved to be a fly on the wall when the steering committee of the OPTIMUM study made the decision to bump fatigue to the top of the secondary outcomes. If you have MS you know that the most troubling symptom the majority of MSers...

Heat

My thoughts are for our readers with MS who are having to live through and cope with the latest heatwave. The BBC has just reported that this is the hottest late August bank holiday on record; “Temperatures had reached 33.2C (91.8F) at Heathrow by 14:16 BST, the Met Office said, beating the previous record of 28.2C set two years ago. On Sunday, the record for the hottest late August Bank...

Fatigue in MS – what we don’t know?

Fatigue in MS is a strange duck, on many levels obvious and frequently described by PwMS (80-90%), but one that lacks sound medical explanation and science doesn’t even know how to test it yet. I was sure that the fatigue in MS, particularly exercise induced fatigue, was somehow related to the conduction block caused by the demyelination in the long tracts (corticospinal tract). It would...

Exercise, exercise, exercise ….

If you live in London it is impossible not to have gotten caught up in London-Marathon fever over the weekend. Eliud Kipchoge won the London marathon in the second fastest recorded time  (two hours two minutes 38 seconds). Interestingly, Kipchoge wears an electric blue band on his wrist, where four simple words are written: “No human is limited”. He has obviously not met someone with...

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