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Sometimes, you just know it’s going to be one of those days.  You have a million things planned that you need to get done, but you wake up that morning, and right away you know your RA has a different agenda.  No matter how much you might will yourself to fight it back, ignore it or deny it, the fatal fatigue has already slipped in to begin what I call ‘the slow leak.’ 

You go through the motions telling yourself you’ll feel better as the day goes on. You get ready. Maybe you even make it to work, but like a tire that has been punctured, what little energy you had steadily seeps out until suddenly, you are so profoundly tired that you can’t even hold yourself up in your chair any longer.  And that’s it – your day is over. Off to bed you go.

Sound familiar?

Or maybe this:  You’re feeling pretty good.  You are out participating in your life the way you should be – out with friends, running errands, having a normal day – when out of nowhere, some internal switch is flicked off by your pesky immune system and every ounce of energy you had vanishes, leaving you vanquished and utterly exhausted with a force that surprises even you.

Or how about this: You don’t feel great, but you’ve felt worse, so you try to get on with things. Mentally, your mind is active and alert, aware of all that needs to be done, but your body feels like it is moving through a thick fog of inertia that you just can’t shake. You try to get extra sleep. You eat especially well. You exercise, hoping to burn off the fog fatigue surrounding you, but to no avail.  You’re stuck in it until it decides to lift, which could take days or even weeks. Too bad if you had other plans.

There is no denying that the pain RA causes is awful, but for many of us, the most damning, highly inopportune aspect of having RA is that while the pain is bad, the fatigue is often worse.

It comes and goes of its own accord.  Sometimes it hovers menacingly, threatening to descend at any moment and rain on your parade (or your business meeting, a dinner out with friends, that big party you’ve been planning for weeks and really looking forward to). 

For me, even though most of my other symptoms are under control, I still find myself struggling to deal with fatigue. There seems to be no way to beat it, either. 

Take last week, for instance.  I started Monday feeling fine. I had the week all planned out in terms of when I was going to fit in my exercise, drinks with friends, etc. Monday went as planned, but that night, I found myself wide-awake at 4am in the morning – never a good sign.  I skipped working out the next morning and mustered through Tuesday as best I could, meeting up with an old friend after work to catch up.  It was not a late night by any stretch of the imagination.  I got to bed at a reasonable hour, but once again found myself tired and awake at 4am, desperate to fall back asleep.