I'm no stranger to fatigue. It is one of the most commonly felt symptoms of multiple sclerosis, after all. It's usually a fairly low-level, background kind of tiredness; a sort of deadness I feel in the core of my muscles and a general, all-over lethargy. Oddly, I find that exercise often helps to shake it off, somehow giving me energy even as I burn it up. My muscles are usually tired after a run, sure, but the sense of wellbeing the exercise gives me seems to cut through any lingering underlying fatigue.
I'm often at my most vulnerable first thing in the morning: I don't have a lot of sensitivity in the soles of my feet, and those first few weary steps out of bed are the ones when I seem to be at the most risk from falling over. I generally get up and totter my way carefully around the bed towards the bathroom to try and avoid an unfortunate stumble and another fall when I can't quite feel the ground with my feet. There are some days, though, when I just wake up tired and can barely summon up the energy to get that far. Sometimes this coincides with the morning after my weekly injection, when one of the side-effects of the drug I take seems to be making me feel like I've been hit by a bus. Some days though, I just feel fatigued and there doesn't appear to be a logical explanation. It's just one of the things that I've had to get used to.
I've been tired all this week, retreating to bed before half-nine on a couple of occasions and literally dragging my feet a bit as I've gone about my daily business. One slightly late night after an evening spent at the pub quiz last night, and I woke up this morning with nothing at all in the tank. The day, it's fair to say, has been something of a struggle.
When I was at my last MS clinic in August, I told my neurologist about this, and he suggested I think about medication. I was reluctant. I'm already on more medication than I would like, so I was reluctant to start taking more unless I really had to. Besides, it somehow feels like giving in. I know it's irrational to some degree, but there's part of me that still thinks that a lot of this is a question of mind over matter: I simply will not allow my MS to become my excuse for not getting things done. Besides, my fatigue isn't really that bad, is it? It's not as though I can't get out of bed, is it? My neurologist told me that I was being ridiculous: I didn't have to take this medication regularly, but perhaps it was sensible to have some handy in case I had a really bad day and needed a bit of a lift. He wrote a letter to my GP asking them to prescribe me something if I ever asked for it. He was happy with that, and I was happy to leave it at that.
Three months later, and this morning I found myself on the phone to my doctor arranging to have a prescription made up for some amantadine. It's an anti-viral medication that was originally designed to combat influenza, but has been found to have the side-effect that it helps combat fatigue and muscle stiffness in people with MS. I haven't picked it up yet, and I'm not at all sure that I'm going to take any..... but I'm going to have a new weapon in my armory for those days -- like today --when I just can't seem to get started.