Sitting down to write this, it’s hard for me to concentrate. I’d planned to write about some new MS mobile apps, but I can’t get my brain to focus on the task.
I’ve been bragging about how I’ve been feeling sharper and better able to concentrate over the past several months, but not today. Distractions are more distracting than usual.
For two days, my legs have felt weaker than usual when I get out of bed in the morning, even though I’ve had a pretty good sleep each night. I’ve been feeling tired, too. Writing this I feel like dozing off. We know that fatigue and MS go together like beer and a burger. I’m always a little tired, but I’d been feeling less tired lately. Until now.
What’s an MS flare?
An MS flare, also called a relapse or an exacerbation, has a specific definition. The MS symptoms, old or new, must last at least a day. There must be no other reason for the attack, such as an infection or stress, and the new attack must be separated from a previous one by at least 30 days. The flare can be mild or seriously debilitating.
My last flare was long ago — I think it occurred during the second Gulf War. I was treated with the IV steroid Solu-Medrol, and the treatments were given early in the morning so that I could spend the rest of the day at work. I guess I had about a half-dozen exacerbations over the first 15 years of my MS, but I’ve had none since about 1995. That was when I started treatment with a disease-modifying therapy, Avonex.
Since then I’ve been treated with Tysabri, Aubagio, and Lemtrada. I think each has helped slow the progression of my MS, and I’ve written about some of them in several “MS Wire” blogs.
Maybe it’s a pseudo-relapse
I’m hoping my symptoms are just a pseudo-relapse. In a pseudo-relapse, no new neurological inflammation occurs, but old symptoms are re-triggered temporarily. This could be caused by things like stress or heat, and I’ve had plenty of both recently. Or, maybe I’m just suffering from a lack of exercise, forced by COVID-19 restrictions.
I’d really hate it if after all these years I regressed into a genuine exacerbation. But life can be like that with an unpredictable illness like MS. If that’s the case, I’ll deal with it.
Meanwhile, I’m going to do what I’ve wanted to do since I began writing this column this morning: take a nap.
NEXT MORNING UPDATE: I woke up feeling strong and alert. Chalk this one up as a pseudo-relapse.
(A version of this post first appeared as my column on the MS News Today website).
(Featured image by Peggy und Marco Lachmann-Anke from Pixabay)
