damaged, shouldn’t there be less brain, using up less energy? Not exactly Take any individual action like, say, looking to the left. The command that the brain sends to initiate the movement requires a tiny bit of energy. Over time, your brain has figured out the most efficient way to do this – sending a signal from point A to point B. However, injuries in the brain (say, from a sclerotic lesion of Multiple Sclerosis) can interrupt this pathway. Thus in order to look to the left, the signal now needs to be re-routed - from point A to point Q to point R to point B. This new route works, but its less efficient, thus it requires a slightly higher energy input. This increased cost is minuscule – nowhere near enough to cause any noticeable difference for you. Until you multiply it by the billions of operations that your brain is processing every second. When added up throughout the day, this inefficiency leads to a massive energy cost, just to perform the normal operations that we usually take for granted.
“For a person living with MS, the mental energy required to maintain function can be astronomical.” In medical school, we rotated through different specialties every 6 or 8 weeks or so. On the last Friday of each rotation, there was a massively stressful exam required to pass to the next rotation. After this exam - for two blessed days until the next rotation started - we had absolutely nothing to study for. Needless to say, the plans for the post-exam festivities were always very ambitious. We’d be going out Friday night and staggering home sometime Sunday afternoon, with Grey’s Anatom-esque scenes of debauchery in-between… Except, after every exam, it was always the same story for all of us – on the couch with barely enough stamina to order takeout and watch half a movie before falling asleep with the TV on. Why? Because mental activity is way more fatiguing than physical activity For a person living with MS, the mental energy required to maintain function can be astronomical. This can be true even in the absence of outward symptoms. Ironically, some of the things that help improve fatigue can be incredibly hard to do in the setting of fatigue. Exercise is a great example of this. One of the only surefire ways to improve overall energy is routine exercise. But, when someone is exhausted, exercise becomes incredibly difficult. Usually, this translates into not doing it. And then the fatigue gets worse... Fatigue is a snowball rolling downhill - it makes itself worse as it goes, and at a certain point can become almost unstoppable Of course, it can be stopped (or at least controlled) - but usually not by any single intervention. Improving sleep habits, adjusting diet, and encouraging exercise are the bedrocks of fatigue management. Sometimes medications can help. But perhaps the single most important intervention in the fight against fatigue is creating and sticking to an energy budget. Everything your brain does has some cost, and the best way to stay on budget is to cut out unnecessary spending. Some costs are unavoidable - like meeting a deadline at work, or trying to remember how to divide fractions when helping your kid with virtual homework whilst acting like you know what you're doing. But lots of these costs can be avoided, yet we overpay for them throughout the day. The biggest unnecessary expense for just about all of us? Stress.
.
www.IamAwareNow.com …
34 AWARENOW / THE THANKS EDITION .
In patients with multiple sclerosis, the net energy cost is higher. This doesn’t make intuitive sense. If parts of the brain are