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How to Deal With MS Fatigue

By U.S. News & World Report

If you suffer with fatigue from multiple sclerosis, you know it’s not just a matter of feeling a little tired every now and again. With this sort of extreme exhaustion, you regularly feel so wiped out you have to stop in your tracks and rest right away. You’re not alone. Fatigue is one of the most common symptoms of multiple sclerosis, and studies estimate between 75 to 90 percent of patients experience at least some of its debilitating consequences. Although you can’t completely prevent the onset of this kind of profound tiredness, there are lifestyle strategies that can help almost all MS fatigue sufferers.

Multiple sclerosis is an autoimmune disease that destroys the protective coating (myelin) around nerves in the brain and spinal cord responsible for sending signals to other areas of the body. This miscommunication can create far-ranging symptoms, from depression, sleeplessness and brain fog to muscle spasticity, tremors, visual blurriness and fatigue.

[See: 5 Rare Diseases You’ve Never Heard of (Until Now).]

“MS is a highly individualized condition. In a similar way, fatigue is not the same for all patients,” says Dr. Jaime Imitola, neurologist with the Ohio State University Wexner Medical Center. “Some MS patients can be hit with overwhelming lethargy shortly after waking in the morning, while others function well until one or two in the afternoon before their battery runs out,” he says.

No matter what time of day fatigue hits, it’s a wallop that knocks out all your energy. What’s packing the punch? It looks like one of the biggest factors is sleep disturbance. A 2012 study published in Acta Med Iran looked at the relationship between sleep problems and MS fatigue in Iranian patients and concluded that sleep difficulties had more impact on feeling totally wiped out than either depression or the severity of other MS symptoms. More recently, research published in 2015 in the journal Frontiers in Neurology found in a study of 107 individuals with MS, 61 percent reported sleep difficulty and fatigue. The researchers came to the conclusion that sleep disturbances are likely the primary factor triggering MS fatigue.

But a good night’s sleep isn’t necessarily a cure for MS fatigue, either. “Although sleep is a contributing factor, so is stress, depression, side effects from medications, as well as other influences. Damage to specific regions in the brain of MS patients is probably the primary culprit,” says Dr. Howard Weiner, co-director for the Ann Romney Center for Neurologic Diseases and director of the multiple sclerosis program at Brigham and Women’s Hospital in Boston. An MRI study reported in the June 2014 journal Radiology supports Dr. Weiner’s view. The research concluded that abnormalities in strategic brain areas were responsible for fatigue in MS patients.

Just having MS, in many instances, is cause enough to feel fatigued. “MS can be a tremendously exhausting disease. Certain symptoms such as tremors and weakness can use a lot of energy,” Imitola points out. “It’s also important to note that fatigue is a common symptom in most autoimmune diseases; MS is one of them.”

[See: 10 Seemingly Innocent Symptoms You Shouldn’t Ignore.]

So what can MS patients do to lessen their overwhelming exhaustion?

— Stay cool. “Whether it’s a hot day or you’re running a fever, heat makes fatigue worse mainly because the damaged myelin-covered nerves malfunction when exposed to temperatures above normal,” Weiner says. Following general strategies to stay chill, such as taking a cool shower before going out or staying in an air-conditioned environment, can help lessen the chances of fatigue hitting.

— Try aspirin. A 2014 study sponsored by the Mayo Clinic, in cooperation with the National Multiple Sclerosis Society, found that two regular aspirins (325 mg each) taken twice a day reduced MS-related fatigue. Before trying this yourself, be sure to discuss it with your doctor. Some people are sensitive to aspirin, and it can be dangerous if taken with certain other medications such as blood thinners.

— Exercise. “It doesn’t have to be strenuous to be effective,” Weiner says. In fact, several studies have shown that yoga can help MS patients. One of the first studies in 2004 on yoga’s impact on extreme tiredness was published in the journal Neurology. The research took place over six months among 69 MS volunteers. Subjects were divided into three groups: One-third practiced yoga, one-third performed regular aerobic exercise and one third did neither. The result? Taking a weekly yoga class, along with home practice, significantly lessened the fatigue that accompanied MS.

— Consider caffeine. “Stimulants, including black tea as well as coffee, can help,” Imitola says. “But don’t drink caffeinated beverages near bedtime because it could interfere with a good night’s sleep.”

— Schedule wisely. Another tip from Imitola: “Do all your important chores that require the most mental and physical energy when you know from experience you’ll be less likely to be struck with fatigue.”

— Take a nap. You can’t fight MS fatigue when it comes on. “Even a short nap, one as little as 10 minutes, can help perk you up,” Weiner says.

— Manage medications. “There are disease-modifying medications that can help with contributing symptoms (such as sleep disturbances or depression), as well as specific drugs that work with fatigue,” Imitola says. But the pendulum swings both ways. “Some medications have side effects that add to feelings of fatigue. That’s why it’s a good idea to go over all the drugs you’re taking with your doctor,” he says.

[See: 10 Lessons From Empowered Patients.]

There’s another reason to stay in touch with your physician. “Since fatigue is highly individualized and differs from patient-to-patient, it’s important to have a discussion with your doctor to try and discover the key factor that’s triggering your excessive exhaustion and work together to develop a personalized plan,” Weiner says.

More from U.S. News

5 Rare Diseases You’ve Never Heard Of (Until Now)

10 Lessons From Empowered Patients

10 Seemingly Innocent Symptoms You Shouldn’t Ignore

How to Deal With MS Fatigue originally appeared on usnews.com

Don’t Settle for Student Loans to Pay for Online Education

By WTOP Staff
Online college programs are becoming a more popular choice for prospective students, with one study finding that more than 6 million students enrolled in at least one online course in fall 2015. The popularity of these courses can be attributed in part to their flexibility with working adults' schedules, students' ability to progress more quickly through online programs and, oftentimes, cheaper tuition. [See 10 low-cost online bachelor's programs for out-of-state students.]Online degrees can be beneficial to many college students, but some studies have shown online learners complete their programs at lower rates than students at traditional brick-and-mortar campuses. Individuals with student loans but no degree comprise two-thirds of defaulted borrowers. Though these numbers are not encouraging, just like for traditional programs, there are ways to reduce how much you'll need to borrow for an online program to ensure you won't become one of these statistics. Don't just settle on borrowing student loans to cover the whole cost of your program and living expenses. Instead, start thinking about how to cut costs and cover your balance in different ways, such as the following. -- Grants and scholarships: Even though you are taking an online course, you can still apply and receive grants and scholarships. But your first step should be to complete the Free Application for Federal Student Aid, commonly referred to as the FAFSA, which will allow you to receive a Pell Grant if your expected family contribution is low enough. The EFC criteria and award amounts are adjusted annually, but the 2017-2018 academic year awards range from $606 to $5,920, which could significantly lower the amount you borrow annually. Your next step is to apply for scholarships. You can start by checking online scholarship search engines, such as the Salt Scholarship Search, College Board's BigFuture and Peterson's. But don't forget to take advantage of local organizations and your school's financial aid office. Both may offer scholarships that you can't find with a national scholarship search. [Review these 10 sites to kick off your scholarship search.]For instance, organizations like the Elks Club, Knights of Columbus or the Rotary Club typically offer scholarships annually to local students. Just because you're going to school online doesn't mean you're ineligible. Visit your local library for scholarship listings, and ask around town. You might be surprised how many local organizations offer scholarships. While these scholarships typically aren't large, every little bit counts. Each dollar you receive in a scholarship is a dollar you don't have to borrow and pay interest on. -- Work-study: Another option for online students may be work-study awards. Not all students enrolled in online programs are eligible, but students at some schools -- including, for example, SUNY Empire State College and Liberty University -- are. Work-study awards are not given upfront like scholarships and grants. In most cases, they are an offer to earn up to the awarded amount if you secure an eligible work-study job. While there is a misconception that all work-study jobs must be on campus, students can work for off-campus, nonprofit or public employers as long as the work is in the public's interest. You may be able to work for a for-profit employer if the job is relevant to your course of study. No matter who the outside employer is, it will need to have an established agreement with your college for you to receive work-study funds. Remember, to be eligible for federal financial aid, you must be enrolled and pursuing a degree or certificate. If you're not working toward a credential, Pell Grants and work-study won't be option, but you may still be able to take advantage of private scholarships -- just be sure to read the eligibility criteria carefully. [Explore what to know about financial aid in online programs.]-- Pay as you go: One of the great benefits to enrolling online is the flexible schedule, which can allow you to complete your college coursework around your responsibilities. But prospective students often overlook using their part- or full-time job earnings as an option for paying for college. Almost 80 percent of college students in 2015 worked at least part time while attending classes, according to the National Center for Education Statistics. By budgeting and thinking strategically about your college costs, you can likely reduce your dependence on student loans by paying a portion out of pocket. Many -- but not all -- online programs are less expensive than traditional programs and often have shorter payment periods. Six, eight or 10 weeks are common course durations. Because of the frequency of payments in an online setting, you may be well-placed to pay as you go and possibly avoid borrowing altogether. Attending college online and avoiding student loans may be challenging, but if you are willing to put in the effort, you can limit the amount you need to borrow. More from U.S. News Q&A: Understanding Student Loan Discharge Eligibility Student Loan Refinancing Isn't Right for All Borrowers
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