The Fatigue Factor
I am often reminded of the time I set out for what was to be a short walk. Struggling with an armload of groceries, I was in a hurry to get home. Unfortunately, I came upon construction debris in the road, and was forced to take a detour around the mess.
As fate would have it, the path I chose was deceptively circuitous. As one road led way to another, I discovered that I was going in circles. My legs grew weary and the load heavier as I continued through the winding course. By the time I stumbled home, I was completely and deathly exhausted. In short, I used much more energy navigating through the twisting and zigzagging course than if I'd been able to use the more direct approach.
My experience is illustrative of the process at work in MS. Myelin-damaged roadblocks force the communication mechanisms of the brain to take less effective, and roundabout routes. This inefficient detour can result in a burdensome fatigue for the person with MS, both physically and mentally.
Physical Fatigue
When asked about MS-specific fatigue, many sufferers anecdotally describe it as "bone-tired" or a "wearing a suit of armor" feeling. It differs from normal fatigue in that there is generally no easy correlation between the amount of energy expended and the severity of the weariness. You would expect someone who just scaled Mt. Olympus to feel extremely exhausted. You would not expect that same level of exhaustion from someone who merely cooked a simple dinner. Yet, the problem is not simply an amplification of normal fatigue. There are many more nuances involved in this symptom.
MS fatigue is often variable, sometimes unrelenting, and generally appears regardless of the amount of sleep the patient gets. Some patients find that although they regularly get a full night's sleep, they awaken in the morning unrefreshed. Many require a scheduled nap in the afternoon when the fatigue is at its worst levels. For me, I have found no connection between the total rest I get, and the way I feel at any given moment. There have been times where I have gotten plenty of sleep the night before, but spent the next day in a zombie-like stupor, where even the simplest task requires a superhuman effort. On the other hand, there have been times where I made it through an unusually busy day, yet felt no ill effects for several days.
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