Fatigue can be one of the most debilitating and confusing things to experience, treat and manage when it comes to chronic illness. While I live with Rheumatoid Arthritis, Osteoarthritis and Fibromyalgia, chronic pain isn't the only debilitating symptom I live with on a daily basis and have to carefully manage. All three forms of my chronic illness and depression that comes with them result in an overwhelming amount of constant fatigue that I must carefully prioritize.
I did a thing yesterday, can't do a thing today! Maybe even tomorrow too!
What is Fatigue?
It is a common symptom caused by autoimmune diseases, chronic illnesses, chronic pain, and depression associated with them. Fatigue is a whole body invisible force that weighs you down. It is extreme tiredness that makes it hard to do the simplest of mundane tasks. It can be sudden or it can be gradual.
Dishes become your worst nightmare. Everything piles up. You just can't move like there is an invisible wall inside you.
For some people with chronic illnesses they struggle the most with fatigue over pain. Pain you can localize, ice it or heat it, stretch it, take a pill, know to not over use that joint or smoke a joint. Fatigue is all over. You have to learn to live with fatigue and manipulate it best for you to live a fulfilling life. Also doctors tend to focus more on your pain than your fatigue which can be frustrating to some patients who are really struggling with the fatigue.
What causes fatigue?
Fatigue is especially triggered by autoimmune diseases when inflammation is high. That is also when pain is often increased which can result in less activity which then increase pain which leads to disturbed sleep (painsomnia). Lack of sleep can trigger cognitive dysfunction, stiffness, inactivity and emotional challenges. For some there is no escaping fatigue. My fatigue has me sitting down in a daze often, especially the early hours of the morning. It's important to get up moving a little every 20 minutes or so, if you can.
Physical activities can trigger fatigue such as line ups or standing in one place too long because we often stand with our posture off. House work, overusing joints effected by arthritis and extending them too much can even cause fatigue. Simple things like moving from point a to point b like taking the bus can cause fatigue which sometimes makes the next step of the day too much for us.
Emotions like stress, anxiety, frustration, anger, loss can trigger fatigue. When diagnosed with arthritis you often feel sense of loss of your old self. Depression makes arthritis worse by long bouts of inactivity and sleeping. Mood definitely effects arthritis. It's important to keep the emotions associated with chronic illness at bay.
How do I manage my fatigue?
The best way to understand fatigue is to watch patterns in your daily activities and routine. This is when a note planner comes in hand. Think about what your weeks bigger activities are and schedule in a rest after, whether it's for the rest of the day or even a few days after. I often plan a rest day after I go to the doctors, I also try to bundle my appointments on the same day so I can manage the rest of my life a bit easier, if not I try to plan a day of rest in between. Doctor appointments are extremely tiring! I typically like a rest period each day before my son gets home from school everyday. The energy of chronic illness and a 5 year old do not match. With me being a single mom my time off is him at school during the day or on the weekends when he is with his Dad. It sounds luxurious but I spend most of that dealing with my health.
Occupational Therapist can help you manage your fatigue with tips, tricks, gadgets and posture. A lot of my recommendations here come from what I have learned from them.
Rest and sleep are different, sleep is for your brain while rest is for you body. It is important to not oversleep with arthritis or nap too long or often so you don't throw off your body clock. If your cognitive dysfunction is high that's because you probably need sleep or didn't sleep enough the night before. I usually have a hard time sleeping at night. I practice it every night but I am still just not very good at it. Obviously we all have those days that are body is telling us we need rest and sleep, that's ok, if your body needs it, then sleep just make sure to stretch well after.
Medium-firm mattress with a cushioning overlay because aligns your skeleton when sleeping. Too soft of a mattress will cave in and cause more pain as your skeleton comes out of alignment. Pillows are great for propping up joints if needed. Placing your pillow just underneath your shoulders to prevent a kinked neck.
A physiotherapist trained in inflammatory arthritis can help you with your posture and exercises so strengthen your body.
Exercise will help your fatigue. Even if you can not do it all at once, breaking it up into 10 minutes here and there exercise will help improve your fatigue. Exercise is my best medicine for pain, mood and fatigue. However avoid exercise 2-3 hours before you go to bed. Eat at appropriate times, not eating will cause more fatigue and making sure you eat the right foods will generally improve your overall health and then some of your fatigue.
Avoid eating or drinking too late, this is not good for your heart health. Avoid alcohol as it will cause a fitful sleep, I gave it up completely, definitely couldn't sleep with it in my system and generally makes me feel a lot worse. Avoid caffeine at certain times of the day, everyone varies, mine is usually latest 4 pm unless I am trying to go out later in the evening. Having prepared foods can be wonderful for your fatigue, set aside a day to pre-make some meals and purchasing already cut vegetables is an excellent tip for eating healthy and managing some fatigue.
You environment may be causing you fatigue if it has poor ventilation, getting outdoors and fresh air can significantly help some of my fatigue during the day time. Your environment such as items in reach or out of reach has to do with collecting fatigue throughout the day, try to keep the usual necessary things in arms reach. Make sure your posture is correct and sit to do your work, it can save your energy tremendously!