How can I get over fatigue?

March 12, 2012 8:42 PM

How do I work through fatigue spells/flare ups?

I have something auto-immune going on. I posted this last year and weaned my son fairly shortly after that, reduced my hours at the weekend job, and things got a little bit better.

I was having problems with my hands being really cold and painful in the wintertime on the occasion that I forgot to wear gloves. My neighbor who is a doctor said that this was not good. So I went to my doctor again and demanded more testing and I tested positive for something auto-immune-related. (Antinuclear antibody test was positive and Anti-SS-B was positive.) It will be 3 months before I can get into see a specialist, and my PCP told me "It is probably Sjorgren's syndrome, but who knows with these things." (And from the last question, my mom has lupus.)

So, whatever, waiting to see a specialist was okay, until the fatigue that I described last year came back. It wasn't as intense as before, but I am once again, EXHAUSTED at all times. It is hard for me to get out of bed in the morning. I have trouble being productive. I have to hoax myself to do stuff "Okay self, get up, take a shower, brush your teeth..."

So while I wait to see a doctor, what can I do to get through these periods of fatigue? I still need to be present for my kid. I still need to go to work.

Having this start of a diagnosis has made me feel better about asking for help. (Like putting kid to bed exhausts me.) And I've tried to explain the Spoon Theory to my husband. I'm doing as much work as I can during productive times.

But I need to not be tired. I need to be there for my kid. Also I have a fairly demanding job and others depend on me. I am a super productive Type-A person normally.

Any ideas on things to do? Eat certain things? Take an aspirin? I have NO IDEA. And I don't have any medical professional to guide me.

posted by anonymous to health & fitness (13 answers total)

I am in your almost exact situation. Likely auto-immune (positive ANA and Complement C4, likely Lupus) and waiting to see a specialist. Oh, the waiting.

My husband and I got home last night from a 3-day romp in Baltimore, and when I woke up this morning, I was so utterly exhausted and in pain (joint pain) that I could barely get out of bed, let alone ride my bike to work. Sometimes ibprofen helps, other times it doesn't. Tylenol is worthless for my inflammation.

Unexpected days off are so unfun for me and ny coworkers. It really helps to know that I have at least one coworker who is extremely empathetic and understanding of my situation. Also, today it occurred to me that I should probably get some kind of documentation from my doctor for school and work. Any way you can make people (discreetly or otherwise) aware of whatever is going on is best. Even your kid needs to understand that her mommy gets really tired sometimes and can't always take her to the park or the mall. My husband knows that I'm tired and sore all the time and puts up with the complaints like a champ.

I'm looking forward to hear more experienced advice here, but having advocates (collegues, friends, family, and my doctors) have been vital in keeping me sane, not to mention guilt-free, when I have flare-ups.
posted by two lights above the sea at 9:21 PM on March 12, 2012

Also, don't over-do it! :)
posted by two lights above the sea at 9:22 PM on March 12, 2012 [1 favorite]

I feel like I'm tired all the time, and I'm a huge fan of Odwalla's Blueberry B Superfood. The B12 helps me out a lot. It takes a while to work its way in, but the boost you get is very... even? And you get to avoid that "I-am-a-corpse" feeling that comes from drinking too much coffee!

Vitamin D has helped me as well. Are you drinking enough water? It's no cure, but it'll help!
posted by Chutzler at 9:23 PM on March 12, 2012

Totally seconding vitamin D. I have (what is probably) lupus, and vitamin D has helped a lot.

Also, it helps to force myself to move, even when I really don't feel like it, so I don't get sore from staying in one position for too long.

600-800mg of ibprofen is helpful too, taken 4-6x per day (only for a few days in a row - that can fuck with your stomach lining if you're not careful). And the better I eat and sleep, the better I feel. That's pretty obvious but whatever - both are tough when you feel like shit.

But really, there's not much they can do, even with a diagnosis.

Having a good friend to talk to, who won't judge you and will believe and entertain you is a total gift. I hope you have a few who can do that for you.

Feel free to memail me if you want to talk or hear my experience with lupus. On preview: it sucks.
posted by guster4lovers at 10:13 PM on March 12, 2012

I sometimes have this from fibromyalgia (had it for 40 years now). I can only say that you really need to pace yourself. You may need whole days of sleep to make up for a few days of activity.

I use Vit B supplements for more energy, along with my prescribed meds. I agree on the water,too.

As painful as it seems, mild exercise- even a walk around the block, can get some endorphins going and try some stretching exercises. The cold hands sound like Reynaud's syndrome-often linked to autoimmune disorders.

I know for me the symptoms do come and go...
posted by Isadorady at 11:34 PM on March 12, 2012 [1 favorite]

Ugh, I don't wish Prednisone on anyone, but I can't help but say....it does help immensely with this. Of course the medication route will be for you and your specialist to decide upon later down that road. I'm simply mentioning this because the "at least this won't last forever" mindset helps me mentally with this stuff.

Seconding Vitamin D and mild exercise. Forcing yourself to get up and exercise first thing in the morning will be the hardest thing you do all day, for certain - but there's a good chance you will feel better the rest of the day. In order to get yourself going, promise your body to just do ONE tiny baby step - say, a slow walk around the block. That's it. Then you can stop and go inside to rest. What usually happens is that once I get my body to agree and do just a simple, 5-minute walk, my energy begins to snowball. By the end of my 5 minute walk I feel like I can go for a second walk around the block, and so on. I usually end up out there for a nice 20-30 minutes, which really gets me inclined to tackle more tasks throughout the day than I would have otherwise. But do be fair with your body and don't push it; if you walk around the block once but don't feel like a second go-around afterward, then don't go. Just consider giving it another try the next day.
posted by Squee at 2:58 AM on March 13, 2012

I have arthritis in my spine which causes joint pain, muscle spasms, interrupted sleep (4 to 5 hours most nights), and nerve pain. I am generally fatigued.

What's worked for me on the fatigue front is:
Vitamin D and B
Not over doing it ( I break this law all the time, I hate not being able to do somewhat basic stuff in my mid twenties)
I walk. Walking gets the blood flowing, and can reinvigorate oneself
Naps, I fucking love an hour nap. I try to schedule days in which I can sneak one in. Even if its just a lunch break.

Yet the one thing that keeps me going and motivated are my goals. I am not going to let this pain in my ass (literally) condition set me back. I've got things to do, and I know down the line, things will most likely only get worse. On that note, its important to remember ones limitations as Id rather not spend the next day barely able to get out of bed.
posted by handbanana at 6:31 AM on March 13, 2012

Oh I should add, coffee or tea. Nothing beats caffeine. If sensitive to caffeine don't over do it. The body will acclimate somewhat, and it is a good pick me upper.

Make sure you stay hydrated with water throughout the day.
posted by handbanana at 6:33 AM on March 13, 2012

I have fibromyalgia and on top of the sleeping pill and Savella, I've found that a good B12 vitamin does wonders to keep the flare ups at bay. Ibruprophen helps a little once one gets rolling as does a hot bath. But if I'm at work and I start to feel the beginning of a flare up the only thing I can reliably do is to walk around and stretch. And then bust out the heating pad. I swear, warmth is one of the few things that makes life livable.

Like a lot of other folks with fibro, I've discovered the less physically active I am, the worse it gets. Which seems counterintuitive. But the key is doing small amounts of activity. Like two sun salutations in yoga, a long walk around the block, some stretches, those types of things are small enough that they keep me from getting too bad, but they don't overtax my system.

When I am feeling okay, I try not to pack too much in, because it will backfire and then I start the whole vicious cycle again. But most of all, I've just learned over the last 5 years to be tired. Most everyday I wake up with sore shoulders and hurting ankles and most every night I go to bed with the same pain. You build up a tolerance to it. You discover that, eventually, after enough days and nights of soreness that you don't notice it as much. Honestly, the only time I notice how much I hurt is when it stops hurting.
posted by teleri025 at 7:18 AM on March 13, 2012

I have Sjorgren's Syndrome. Before I knew what I had and before I was on medication (Plaquenil), I basically didn't have energy to even go for walks any more let alone get out of bed sometimes. I was super unproductive at work, because I was so tired it was hard to think. I tried to take it easy and I took a lot of naps.

Ask your husband to help out as much as he can. See if you can sneak off and get a nap in during the work day (I lived close enough to work at the time that I went home at lunch and would nap), sometimes even 10 or 15 minutes made a difference. And take it easy on yourself, even when you're feeling productive, don't push yourself, because you'll just end up more tired. You're sick, treat yourself that way. It's hard to do, I was bad at it and made myself more sick.

Try taking fish oil and B vitamins, those are supposed to help. Once you see a rheumatologist though, Plaquenil has been a miracle drug for me, I feel like an entirely different person. Good luck!
posted by backwords at 8:39 AM on March 13, 2012

I say this just as a gentle and general warning, because I have myalgic encephalomyelitis/chronic fatigue syndrome and not an autoimmune illness: While it's very difficult to reduce your energy-expending obligations, especially for those of us with hard-driving personalities, it's generally easier than increasing energy markedly. In the early years of my illness, I kept thinking I was making appropriate activity reductions, but unfortunately I was still pushing too hard and because I did, I kept getting worse. Over the course of four years I went from mildly affected to bedridden. I've been bedridden now for four years, and there's little hope I'll ever make significant recovery. Here's the blog entry I wrote for the newly diagnosed with fatiguing illness.
posted by jocelmeow at 12:54 PM on March 13, 2012

There are very few subjects where I can claim any expertise, but living with the "fatigue" of autoimmune diseases is one of them, after >15 years on disability with scleroderma, Sjogren's etc.

Unfortunately, if your fatigue is coming from Sjogren's or another autoimmune disease, saying "I need to not be tired" gets you about as far as a cancer patient saying "I need to not have cancer." This fatigue is not under your control. It is not there because of anything you did, or didn't do, or because of how you've lived your life. There probably isn't anything you can do to make it not be there, no matter how much you need to be rid of it. You can manage it somewhat, you can learn to live well with it and around it, but it's not going to stop being there. There is no magic food, or supplement, or visualization, or diet or exercise regime that will make it vanish. Depending, though, on exactly what your diagnosis turns out to be, there may be medical treatments that could help a lot, so hopelessness is not called for.

In the meantime:

Listen to your body, especially when it tells you to rest. Don't listen to your schedule, or to the well-meaning people around you (or the voices in your head) who will tell you that you need to keep pushing yourself when you feel drained. Those approaches can work well for healthy people, but with these diseases, pushing through fatigue will only make you sicker. When it comes to exercise, everyone's limit is different -- do what you can, but stop while you feel you could still do more. Work hard to tune out the ubiquitous "Just Do It" and "Push the Envelope" messages. With these illnesses, those mandates just don't apply.

Start ruthlessly re-evaluating your priorities. For everything that you do, ask yourself if you really need to do it. If you do need to do it, ask yourself if there's an easier way to get it done. Move more slowly, take fewer steps, take breaks before you get totally wiped out.

Practice saying "no," to invitations, new projects, and lots of things you really would like to do. Don't let your energy be scattered -- focus it only on the things that are most important to you.

Practice asking other people for help -- people's generosity amazes me every day.

Recognize that rest is an important, productive and admirable activity. You may look like you're doing nothing, but your body is hard at work restoring itself. Don't feel guilty when you stay in bed a little longer -- give yourself credit for being smart enough and strong enough to do it, with all those fun, important things calling your name.

Watch out for the Good Days! It seems that every time I have a Good Day, I have such a backlog of things that I need and want to do, that I do too much, and end up paying for it with a major crash. Try not to do much extra on a Good Day -- just let yourself enjoy feeling better. (Will I ever learn this?)

I agree, caffeine is a miracle. But not too much, because it can make Raynaud's syndrome much worse.

Vitamin D and B vitamins help lots of people, and they're low-risk, so they're probably worth taking in reasonable doses.

Eat whatever decent diet seems to make you feel best. I think it's a good idea to avoid extremes, and be guided by your body's intuition, at least until your doctor(s) can tell you specifically what you're dealing with. Foods that seem most energizing to me include nuts, fruit (especially berries, bananas and dried fruits) and yogurt. Meat makes me feel sluggish, but some people thrive on it. Pay close attention to how different foods make you feel, and eat accordingly.

Be patient and persistent -- it can take a long time and a long list of doctors to get these things properly diagnosed. Be sure to get copies of all your medical records. Keep notes about any symptoms, cause the brain just loves to forget this stuff. Take pictures of any rashes or any other visible conditions -- the doctors will need every clue they can get.

memail me if you ever have any specific questions, or you just want to vent. Good luck!
posted by Corvid at 8:11 PM on March 13, 2012 [6 favorites]

Listen to Corvid. She says a great many things I know from hard experience...things I was too tired to type out and so I linked to my blog entry instead! :)
posted by jocelmeow at 9:12 AM on March 14, 2012