The numbness and tingling are spreading. The muscles are more spastic, stiffer and tighter. Legs are weaker; coordination and balance are worse. Walking endurance is reduced and the fatigue is escalating. Why?
Multiple Sclerosis is an unpredictable disorder, and symptoms vary immensely in type, frequency, and intensity. Figuring out what is going on and what to do about it is fearful, frustrating and confusing.
And there's always the chicken-and-the-egg question of trying to figure out what is causing what. Is the MS itself acting up, or is it reacting to something else? Is the depression (fatigue, etc.) causing a bad day or flare-up, or is the bad day / flare-up causing the depression (or fatigue, etc.)?
It's very easy to blame what the symptoms are doing and how we are feeling on the MS itself. However, more often than not, the MS is actually reacting to something else.
So how do you know, and what can you do about it?
MS is highly sensitive to an endless list of things, and existing symptoms often intensify due to things such as:
- weather changes and types of weather (heat, humidity, storms)
- sickness (colds, allergies, infections …)
- lack of food, water, rest, sleep …
- medication
- stress (temporary physical / emotional / mental, not chronic)
- monthly menses
For example, a fever can immobilize a person with MS. When the body is cooled down and the fever is gone, the symptoms will subside. Spending two hours on the phone trying to resolve an insurance problem can escalate fatigue enormously; taking a nap afterward or venting in some way will ease that stress and help calm down those symptoms.
Or, maybe those intensified symptoms are the result of what I refer to as a
"pay day." For example, if I wake up one day feeling great, I might push myself too hard to do extra things. Then I "pay" for it the next day and can do only half of my normal daily activities.
In situations like these, the worsening of symptoms can last from several hours to a full day to perhaps several days, depending on what the cause is. You have to think carefully about things like this relative to recent or that day's events: What happened or didn't happen? What changed or didn't change?
When you figure out what the culprit is, it can then be remedied and the symptoms will calm down. Things go back to their normal state, whatever "normal" is to you. No residual damage.
So when the MS itself would directly cause intensified symptoms or new symptoms that do NOT go away after a few days? Now we may be talking about an attack, relapse, or flare-up … ie when we come out of remission. It can just happen on its own, but often will be triggered by any major event, such as:
- falls, accidents, sicknesses, infections
- chronic physical, mental or emotional fatigue / stress
- a major life occurrence (death, divorce, new baby, abuse …)
In these situations, or in the case when symptoms don't calm down after a week, when the cold / infection is over, and bed rest does not improve anything, it's time to call your neurologist to discuss the situation. The MS may be relapsing and steroids (like Solu-medrol) may be needed to shorten the duration and severity of the relapse.
It is a good idea to keep a journal, taking notes of what happens with symptoms, medication changes, health (eg menses, colds …), etc. Over time, being tuned in with your body will help you figure out if it is the chicken or the egg. Then appropriate action can be taken to calm down those activated symptoms – and calm down the fear that accompanies them.
