nani
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| Sun Oct 16, 2005 9:13 pm what else can help with fatigue |
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What else helps?
You've tried basic lifestyle changes (Table 2) and maybe medication. They helped, but not much. What next?
It's time to call on professionals with expertise in adaptive equipment, energy-saving adaptations, and general exercise and aerobic fitness (see Glossary). Occupational and physical therapists are trained in these areas. They'll start with some of the same issues addressed by your doctor, such as your history of fatigue, how hot weather affects you, how you move, and what you've already tried to improve your energy. Occupational and physical therapists will evaluate:
· Your general physical condition—strengths, weaknesses, and areas that can be improved.
· Your environment—where you live, work, and spend time regularly, including any devices you use to help you function.
· Your aerobic fitness—how well your heart and lungs work during physically demanding activities.
· Any mobility devices you use to help you move around: canes, crutches, walker, wheelchair (manual or powered), scooter, ankle/foot orthotic.
How to Make the
Most of a Nap
A nap is any quiet rest period—not necessarily sleep—during daylight hours when you'd normally be awake. An occupational therapist can help you determine whether your nap schedule is helpful for your situation. Naps are helpful only if they don't interfere with your nighttime sleep.
Where: a sofa, recliner, a bed (on top of, not under, the bed covers). You can even nap with your head down on a desk.
How often: one to three times per day (daylight hours), when you'd normally be active.
How long: 10–30 minutes, as often as three times per day;
1–2 hours, not more than once per day.
Helpful hints:
· Turn TV and music off or go to a quiet environment.
· Loosen tight clothes (don't put on sleepwear).
· Dim the lights; if you can't do that, face a corner or use an eye mask.
· Close curtains or blinds.
· Use light covers or sweater or jacket to avoid getting chilled or overheated.
They can also help you fill out an Activity Diary. By showing which activities take the most out of you, this document will help identify specific fatigue problems.
The results of all these assessments will be used to tailor fatigue-fighting strategies for you. Suggestions will be in one or more of the following areas:
Energy effectiveness strategies (EES)
Together, you and the expert (usually an occupational therapist) will come up with a plan to help you meet your goals. You'll meet several times to develop and refine strategies. With training, you'll be able to use these strategies effectively by yourself.
Aerobic exercise
You'll get an exercise program that may include at-home exercise, group exercise, or both, depending on what works best for you. Along with your exercise program, you'll learn more about ways to keep cool and adjust other activities. As you progress, the expert (usually a physical therapist) will guide you in adjusting your exercise level to reach your peak fitness.
IMPORTANT: Over-exercising can cancel out the benefits and worsen fatigue. Follow the exercise program you and your therapist develop. If it stops working, it's time to call your therapist for a review of the program.
Equipment changes
Changes in equipment or the use of assistive technology can make a big difference in the energy you expend doing basic tasks at home or at work. The expert (an occupational or physical therapist) may suggest that you modify devices you already use or try new ones. Trial periods with different equipment will show you which changes help. Occupational and physical therapists know how to use equipment properly. They can also help you with reimbursement issues.
Environmental changes
The expert (occupational or physical therapist) may visit your home and workplace and explore your usual mode of travel, whether you drive or take public transportation. The therapist will discuss possible modifications or changes with you, to find out what's practical. You'll need to try each change to see what works. In fact, people often test several changes before finding one that makes a difference.
What will my insurance cover?
Medical insurance plans vary greatly. Read your policy. If you have questions about what medical services, equipment, and medications are covered, talk with someone in the human resources department at work or call your insurance company.
Some policies only cover visits to professionals in their official "network" for all medical matters, including mental-health issues like depression and anxiety. (You can get a list of providers in the network from your insurance company.) Some limit the number of visits they will cover. Even Medicaid policies differ by state. That's why it's a good idea to find out about your insurance benefits before you begin seeing any health-care professional. Remember: You always have the option of seeing any health-care professional you choose and paying the full costs yourself.
How does the Americans with Disabilities
Act relate to fatigue at work?
The Americans with Disabilities Act (ADA) became a U.S. law in 1990. Thanks to the ADA, it's illegal to discriminate against people with disabilities including MS. The ADA covers several areas, including jobs, for most places of business that have at least 15 employees.
A key aspect of the ADA is the idea of reasonable accommodations (see Glossary). These are changes to a job or worksite that make it possible for a qualified person with a disability to apply for a job, do a job, and have equal employment benefits. Examples of reasonable accommodations include:
· Making the workplace easily accessible.
· Providing or modifying equipment and devices.
· Restructuring jobs.
· Changing work schedules.
· Reassigning staff to a vacant position.
· Providing readers or interpreters.
· Adjusting exams, training materials, and policies.
This law has many details and exceptions. If you have questions about how the ADA applies to your job or other areas such as access and public services, call PVA at 800-424-8200 (Web site: www.pva.org), United Spinal Association at 800-807-0192 (Web site: www.unitedspinal.org), or the National Multiple Sclerosis Society at 800-FIGHT-MS (800-344-4867; Web site: www.nationalmssociety.org).
What if treatment stops working?
Human bodies change as they age. MS, too, changes over time. Changes may come suddenly or with warning. Pay attention to changes in your body. If you notice increasing problems with fatigue (or anything else), check with your doctor. Options you haven't tried yet may make a difference. And remember that medical progress is being made every day. By the time you need it, a new treatment may be available. |
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