Fatigue control?

just as rain can be anything between that miserable dampness from heavy mist or drizzle through to the drenching tropical downpour or the windborn hurricane stuff so my fatigue takes on many related forms.

My first real experience of fatigue was the mental fatigue resulting from the effort of simply managing where I put one foot in front of the other lest a foot wrong causes a twist or a stumble to suddenly increase chronic back pain. Physically raring to go. But mentally exhausted, used it all up, not alert. Hard to find the energy to talk. In need of sleep to recover, until the next day. Made worse because I didn't understand what was happening and information was scant.

Beneath that the constant drain of "nerve pain" that reduces mental energy. All consuming.

In retrospect the fatigue of migraines. A desire to just curl up in a ball, unable to think of anything beyond the pain. Seemingly incapable of coherent thought. Hard to bundle up the pain and throw it away. Very much a "just leave me alone in my sea of pain" sort of fatigue.

By contrast, the short term fatigue of having rowed a couple of kilometres, or cycled up a hill. Muscles that don't want to move another inch, but recover relatively quickly. A pleasant sort of fatigue in some ways, with an increased sort of mental energy. A feeling of being "pumped" that comes with a bit of achievement..

But the possibly deeper physical fatigue of having walked in the hills all day. All done. Mentally a bit euphoric but ready for a rest. Back to normal the next day after a good sleep..

Then the fatigue of a general feeling of missing mental and physical energy. Of not quite being on the ball. Fatigue that doesn't go away with a sleep. Permanent. Something almost undefinable, as if off to the side but when head is turned its not there, but nevertheless its somewhere. An even, consistent, sort of fatigue. A vague feeling that something is not quite right. The fatigue of low thyroid that disappears with the aid of a little white tablet.

And now the roller coaster of pollywhatsit. That peculiarly deep fatigue that leaves one staring at the wall. A mixture of mental and physical fatigue. A feeling deeper than lethargy that somehow prevents any action at all. Knowing that there are things to be done but mentally incapable of translating that into any movement. Contemplation of a simple movement draws the conclusion that its too hard, and not worth the effort. Deep, unfathomable, overwhelming, relentless, fatigue. Round and round in circles, neither mind nor body willing to make the first move. Beyond help or encouragement, nothing can overcome it.

But it comes and goes. Some days are better than others. Its also cumulative. Overdo things and there's a cost. Like a saw tooth, a long slow climb followed by falling off the precipice to start the whole process all over again. Hard to put a finger on the cause. Its just there. Having to wake up and test the waters to know what the day will hold. A fatigue that one isn't in control of.

And at other times mentally alert but unable to concentrate or problem solve. Not tired, just not working. A different, pred induced, fatigue. Consistent and persistent for days and weeks. Brain fog. A feeling of not being able to mentally punch a way out of a paper bag.

Hard to separate, but add in a state of mind that swings from acceptance, through hope and back to denial, with pred highs and depression lurking. All designed to confuse and confound.

I guess this has been festering in my mind for a long while. At first I read "fatigue" in these pages as just another word. But then it seemed different, difficult to define, meanings were attached to it. People seemed to know what it meant, why didn't I - I seem to have that problem with lots of words. 

And eventually it dawned on me. Just like when people tell me its raining I have no way of knowing if its the slow steady damp soaking rain or the short sharp downpour and flash flood. Is the fatigue mild or deep, is it consistent or up and down, does it last forever or relieved with sleep, is it physical or mental or both and do the proportions change, what are the things that change it, and so on through characteristics I haven't yet recognised. And there's nowhere to read about it.

I have the same difficulty with pain. From the dull persistent ache, through something a bit more localised, to the sharp screaming pain, with associated colours to help describe. Ask my children and all they knew was "it hurts". But that's for another day.

I can tell the difference between muscles stiff from polly and muscles stiff from exercise.

But somewhere in the above is a light and tunnel sort of thing. If my all consuming polly fatigue is up and down like rolling hills rather than a flat featureless plain then somewhere there must be something I can do to command the high ground rather than languish in the valleys. And commanding the high ground is how battles are won.

The language we use, I use "roller coaster" a lot, "yo-yoing" appeared further up this page, "highs and lows",  "spirals", probably a few I've missed, provides a source of hope. If it changes it can be controlled, or at least managed, if only we can figure out how. And I don't want to build a freeway that cuts through the hills and bridges the valleys, I want a road along the ridge tops.

Which in a very rambling sort of way gets us all the way round to all the little tricks we have around pacing, and breaking big tasks into little tasks, and doing something that is achievable, and resting before we collapse. And managing the pred so we are just at the Goldilocks dose between pain and side effect. We can change our diet, and observe the effect on our fatigue. And we can do whatever exercise we are capable of without overdoing it. It all adds up (which is much better than subtracting down).

So, yes Ron, sorry there isn't a magic bullet that can vanquish our fatigue at a stroke, but there are a myriad little things we can do to manage it and reduce the effect it has on our lives.

And just like the rain, it eventually stops. At least that's my version. 

On a more mundane note. I was pollyed while polishing our truck (the one we lived and traveled in). It was bright when I finished. I don't know if that counts as bright.

There is a research project ongoing at Aberdeen University looking at the specific fatigue of PMR