Fatigue

PaulW

Does anyone have any advice for dealing with Fatigue?

I have kept a diary lately to try and nail down when it happens, but nothing evidential has shown itself.

My history is psriosis ( both plaque and gutae ) since aged 16 with joints, head, face, chest, forearms, shins affected. Since january this year the pain within my joints has increased and i'm now on Methotrexate injections after a failed Luthflunomide course. I've been diagnosed with PsA and OA. Since 16 i was in the Army for 6 years and when i left became a carpenter, then took on all trades and have been a builder ever since. I still work every day and understand the pain i'm in, but the mental fog is knocking me sideways.

I now stutter, trip when walking, slow to understand questions and have a shocking memory ( short term ). I recently got the all clear from a head MRI so i putting this all down to fatigue.

I've read lots to do with what it is, but nothing to help in managing it.

Any advice or tips would be appreciated from those who manage fatigue themselves.

Thank you

[Deleted User]

Hi Paul and welcome to the forums.

Sorry to hear you are having so much trouble with fatigue as a result of psoriatic arthritis and osteoarthritis. Part of having PsA can often mean bouts of extreme washed-out fatigue that’s quite different in quality and intensity to just "being tired" and which doesn’t always improve after resting or a long sleep.

It is worth keeping a regular diary of these episodes to report to your doctor and also to help you plan and manage what you plan to do when it does strike.

Our website has some very good suggestions on managing fatigue and is well worth a read:

Managing fatigue

Explaining to other people can also be a tricky issue. Try searching the internet for "Spoon Theory" - it is a good metaphor to illustrate for others to help them understand.

If you need to speak to someone then do call our Helpline on
0800 5200 520 free Monday–Friday, 9am–8pm.

Do join in on the forums and let us know how you are getting on.

All best wishes
Brynmor

PaulW

Thank you Brynmor

I find it difficult to manage the output as so far i haven't found anything specific that sets it off. It can happen at any day of the week, regardless of work and at any time. It kicked in at 8pm last night and on Sunday i woke up with it lasting most of the day.

Work does suffer when it happens and even though the pain from the other issues i can understand and deal with, this is something i can't quite grasp or understand as it is so random.

I'm 45 and have another 20 years at least of workign life ahead of me, i can't afford to be losing customers due to being in this state 2 to 3 times a week.

There is the personal issue with my wife who is amazing, but quite rightly worried sick as her partner is not who he once was a few times a week.

Quite frankyl i'm a little worried about where this is going and was looking for some feedback from others who deal with it and if they know of their triggers for it happening.

Thank you

stickywicket

Hi Paul. Welcome from me too but I don't think I can add much to the very good link that Mod Brynmr has given. The end section is particularly helpful, I think.

I have RA and OA. I associate the fatigue with an RA flare though I can also get a day of it the day after my meth(otrexate) day or the day after that.

But you write "I now stutter, trip when walking, slow to understand questions and have a shocking memory ( short term ). I recently got the all clear from a head MRI so i putting this all down to fatigue." and I don't really find I get any of that. What does your rheumatologist say? Does (s)he feel this is related to the arthritis or not?

dreamdaisy

I have PsA, OA and fibromyalgia. The fatigue caused by the auto-immune junk only occurs when the disease flares (which it can do despite the meds I take). That kind lasts for weeks, sometimes months, and renders me on occasion bed-bound, sleeping for hours at a time and never feeling an improvement.

The OA fatigue is a different beast, being self-induced and easy to shift by taking things quiet for a couple of days. My sleep quality is poor as I am woken regularly by pain break-through but the only solution to that is more drugs which for me is not an option: I've had them in hospital and felt worse, things are grim enough. Even when I sleep well I do not wake bursting with energy, usually I'm just bursting.

Fatigue is part-and-parcel of the disease but at least with the OA I can exercise control over how I feel. I think my signature sums it up. DD

PaulW

stickywicket wrote:

What does your rheumatologist say? Does (s)he feel this is related to the arthritis or not?

They were the one who pointed out that the symptoms are possibly linked to fatigue.

I have a few options available on moving forward with it.



Anymore information linked to people’s history with it and links between scenarios and it happening is welcome

Thank you

[Deleted User]

Hi

Sometimes the symptoms you are describing with the fatigue, tripping over etc can also be from the fibromyalgia.

Also the forgetfulness, there is something called fibrofog which is also a symptom of fibromyalgia.

Hope this helps.

PaulW

moderator wrote:

Hi

Sometimes the symptoms you are describing with the fatigue, tripping over etc can also be from the fibromyalgia.

Also the forgetfulness, there is something called fibrofog which is also a symptom of fibromyalgia.

Hope this helps.

Thank you for bringing this to my attention.

From the information I can see, it has a similar output to PsA?

dreamdaisy

Yup, tired when I replied so forgot fibrofog: might have been fibrofog behind that,
thereagain might not. :roll: TBH after many years I neither know nor care, it happens, it passes, it's annoying. I hope you can find some answers but as every physiology is unique it is far from easy. DD

Ansam

dreamdaisy wrote:

Yup, tired when I replied so forgot fibrofog: might have been fibrofog behind that,
thereagain might not. :roll: TBH after many years I neither know nor care, it happens, it passes, it's annoying. I hope you can find some answers but as every physiology is unique it is far from easy. DD

I have PsA and the most debilitating effect of this to me, currently, is fatigue. If I'm having a flare, it's like full on flue, but, even when not I just feel totally drawn out or extremely lethargic. I find that if I can combat the lethargy (though this can be a real struggle), and get off my backside and do something (anything), I feel tired and achy. But the mental 'hurrah' of achievement is great and makes it worthwhile. If I have been very active though, the aftermath(and it's accompanying aches) can make breaking through the lethargy more difficult. I think, that as my 'exercise' is infrequent, it's not just the joint pain that exacerbates this, but also the pain from muscles that are not used to exertion. I find it hard to keep to regular exercise plans.

frogmorton

When I get fatigued I just have to sleep. Nothing brings it on I can overdo things all I like it's only when the arthritis is flaring that it happens. Then it tends to last for the duration of the flare - could be weeks.

Like Stickywicket I am interested in the tripping and falls and whether your rheumatologist thinks it's arthritis related. It's good that the MRI came back clear though

I totally agree with keeping records of what - if anything sets it off.

Toni

PaulW

One thing i don't seem to have is the tiredness like others have stated, ie having to sleep.

My work is labour intensive and i'm at it every day, so wanting to sleep isn't a physical side of the fatigue for me.

Muscle pains & aching ( PsA ) is normal everyday but the foggy head comes and goes. I had a pretty good 8 days in a row for the head being clear and then had 2 1/2 days full on IQ reduction mode.



Also ,other than tripping, knee's giving way when i walk ( maybe a fraction of a second ) which causes my legs to buckle is another physical issue.

dreamdaisy

It may be inconvenient to say the least but if tripping is becoming more common then it may be time to think about using a stick, concentrating more on how you are moving and doing specific leg muscle strengthening exercises. We tend to not walk properly when knees etc. hurt in an effort to reduce pain but we inevitably end up causing more by putting other joints under strain. DD

frogmorton

I think fibro is not so much to do with the bones so not quite the same as the PsA https://www.versusarthritis.org/about-arthritis/conditions/fibromyalgia/

I have totally heard of 'fibro-fog' Paul it's an idea to get checked out?? Reading that info it does sound a little like you describe...

I can imagine using walking aids at work as a builder would be very tricky. Some people use knee braces and the like, but I believe we need to be extra careful not to overuse them and make our muscles weaker.

Toni x

JCJC777

may be MS

BettyMac

It might be worth asking the rheumatologist if there is any other type of biologic treatment which could help.

The suggestion about keeping a diary is a good one. If you can print it off and use a highlighter pen to show the worst bits, it gives the doctor a good picture of how the disease is affecting you.

JCJC777

hi Paul wondered what fatigue management tools you use now? - it sounded like you were really searching. best wishes

Baloo

@PaulW For mental health I gained a lot of confidence from naming different mental affects of my fatigue which I know are always going to happen. For me, am I becoming Optimistic, Indecisive or Anxious. From previous experience I can handle indecisive or anxious, I mostly know how to do that, to stop the fatigue being worse.