Fatigue is the lack of mental or physical energy. Fatigue can be a direct result of a disease process (primary fatigue). It can also be an indirect consequence of an underlying condition (secondary fatigue). Unlike multiple sclerosis (MS), neuromyelitis optica (NMO) doesn’t cause fatigue, but living with the disease can lead to fatigue. Moreover, other factors that can cause fatigue in people with NMO include
- Chronic pain
- Medications
- Bowel and bladder issues
- Sleep disorders
- Mood disorders
- Depression
- Infections
- Changes in walking
The origin of fatigue may be associated with spinal cord lesions causing pain in NMO patients.
What is NMO?
Neuromyelitis optica (NMO) or Devic disease is a rare, autoimmune disease of the central nervous system (brain and spinal cord). NMO primarily affects the myelin sheath that covers and insulates the central nervous system. Therefore, the disease targets the spinal cord, optic nerves and brainstem. The damage to the optic nerves causes swelling and inflammation, resulting in pain and vision damage. However, damage to the spinal cord causes weakness or paralysis in the legs or arms, loss of sensation and problems with bladder and bowel functions. Moreover, damage to the brainstem can lead to prolonged hiccups, nausea, vomiting, vertigo or respiratory failure.
NMO is a relapsing-remitting disease. During a relapse, new damage to optic nerves and/or the spinal cord can cause additional disability.
Unlike multiple sclerosis (MS), NMO isn’t a progressive disease. Hence, preventing relapse is crucial to prevent further disabilities.
There are two types of NMO
- Relapsing form: This is the most common type of NMO and mainly affects more women than men. It has periodic flare-ups with some respite in between.
- Monophasic form: This involves a single attack that lasts a month or two. Both men and women are equally affected by this form.
How to tackle fatigue in NMO patients
It is important to identify the underlying reason for the fatigue. For example, if the person is not sleeping due to pain or bladder dysfunction, it should be identified and corrected. Also, try these methods to tackle fatigue
- Pacing is key. Prioritize the tasks that need to be done in a day and tackle the most important ones first.
- Inform the boss, co-workers and family when feeling fatigued. It helps to set expectations and allows them to understand the situation and come forward to help.
- Take breaks throughout the day when needed.
- Ask for help with chores, such as cooking, cleaning and laundry.
- Incorporate exercise routines into your day to build stamina and reduce fatigue.
- Reorganize your home and office to reduce the amount of wasted energy.
- Rest enough if nothing is working.
- Opt for physical therapy if you’re exerting too much energy doing everyday things, such as walking.
How to live with NMO
Living becomes difficult with NMO because the disability worsens over time. Some other complications of NMO include
- Visual impairment or blindness
- Paralysis or weakness of one or more limbs
- Stiffness or muscle spasms
- Loss of bowel or bladder control
- Depression
Some people may require ventilators for breathing purposes. People with NMO should seek support from friends, family and support groups to deal with the trauma. A person with major disabilities may also require help from neurologists who specialize in NMO, occupational therapists, physical therapists and social services professionals.
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