I am always tired, have been for as long as I can remember, it's just something I have come to live with. However, I have always been able to manage to get through my work day through the consumption of large amounts of caffeine and energy drinks. For the last month or so the fatigure has worsened. I find myself locking my office door to take naps, unable to concentrate on anything for more than a couple minutes. I am constantly forgetting what I am doing or talking about. I am also increasingly finding myself looking up how to do parts of my job that I have done for years. I asked my neurologist if she would give me some time off from work before this negatively affects me at a job that I do absolutely love. She said no, it's depression not MS, although she did just put me on 3 days of IV solumedrol for numbness in legs, feet, and right hand. I do deal with depression but it has never affected my job, work is where I go to get away from everything. If I get caught taking naps on the clock, or they realize how far behing I really am on my tasks, my job is going to be adversely affected. Why is it so hard to just get some time off to get through this spell?
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Q: How do I convince my doctor to give me time off for fatigue?
Hi TiredOfBeingTired,
Welcome to Health Central. You've done the first thing by starting a conversation with your neurologist. If they don't know what's going on, then they can't help us.
Some important things to keep in mind. When you describe a symptom or difficulty with your physician, it is important to express not only how severe the problem is, but also how the problem is affecting your ability to function in daily life.
If you job performance is threatened by your symptoms -- for example, if you need time for a nap at work -- then your neurologist may help you consider whether or not to ask for accommodations by invoking the Americans with Disabilities Act (ADA). Under the ADA, most employees are guaranteed workplace adjustment, as long as the accommodation don't present an "undue hardship" for the employer. Be aware, however, that ADA protections apply only when the employee discloses disability-related problems on the job and the employee must be ready to suggest the possible solutions.
Your neurologist may also suggest trying one of the drugs commonly used to combat MS-related fatigue. If disturbed sleep is that culprit in daytime drowsiness, perhaps addressing that problem is appropriate. Or read Dr.Kantor's post regarding off-label use of drugs and other approaches to tackling MS fatigue
And certainly, if your fatigue and daytime sleepiness are caused by depression, then it would be appropriate to address this issue head-on. I struggle with depression at times and take advantage of anti-depressants which have helped me to function in a semi-normal manner.
So, as you can see, there are many ways to address the problem without asking for complete time off. Perhaps working with your neurologist, you can find an approach which works for you.
Let us know how this working out for you. Others will be able to learn from your experience.
Thanks,
Lisa
Hi TiredOfBeingTired:
Lisa has made most of the points I was thinking of with the exception of your consumption of caffeine products. They will do your body more harm than good - digestive, intestinal, nerves, fatigue crash.
Some people have adverse reactions to caffeine after being diagnosed with MS in that it makes them sleepy. I am one of those people.
It may be a good idea to talk to your neuro or family doc to have Provigil prescribed for you for during the daytime. It is a fatigue fighting drug and has very few side effects. Some MSers take Ritalin, but I believe that to be too drastic of a drug. Start slow with Provigil. Read up on it before you ask for it at WEBMD.
I don't know if you are in the USA or not, but the ADA laws here cover you for frequent breaks at work (within reason) or else a shortened work schedule. If you haven't already told your employer about your MS, it is understandable, but you cannot get ADA's at work unless you come clean with them about your disease.
If shortened work schedule or frequent breaks is not possible, perhaps an aide to help out during the day would be good.
At any rate, please please cut out the caffeine and energy drinks -- they are false highs and set you up for deep crashes.
Let us know how you are doing.
Take care,
Anne
I myself suffer sort fatigue that even reach out turn bedside lamp feel like effort required be less climb a mountain ,I have found B12 helped little.
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