I know, it's hard to believe I don't have a medical license. 8-D

Get thee to a new neuro now, Woman! HURRY!

...and on your way out the door, tell the doctor that the only unsubstantiated symptom you have is cognitive in nature, and it has to do to having him as your MS Neuro for way too long. Adios!

Karousel
What was the prescription he gave you? I need to ask for some!

My neuro told me once that if the fatigue I experience is increased as the day progresses, it's probably from MS. If it begins in the morning, it might be depression. Yours sounds like it's MS related.
Make sure you have your thyroid numbers checked; my fatigue is usually a warning that my thyroid isn't working right and my medication needs to be adjusted.
If that's okay, then definitely you should at least get a second opinion from a different neuro.
Keep us up to date about what's going on...

It's Provigil. I take it on days I really need the energy but I hate the crashing feeling I get from it late in the day.

Iron, b12, testosterone, bloodpressure, breathing, exercise, cholesterol, rbc?
Edit - 1000mcg's of b12 in the morning is my cup(s) of coffee.
Edit2 - Thyroid mentioned has alot to do with testosterone I believe. My brother's hypo (low) thyroid, low testosterone

Thanks sooo much everyone.

I don't know what to think. Yes, fatigue catches me in the afternoon/early evening but I had gadolinium contrast and it didn't show active inflammation.

BUT it feels like my head is stuffed with cotton wool, I feel a quite dizzy, disoriented, and uncoordinated, I have obvious problems with gait and I get swamped if I have to think too much or follow any kind of complex or sequential instruction or directions.

As a teacher, and trying to keep on top of a constantly changing environment it is totally doing my head in and all I can do is lay down and close my eyes when I get home.

I am so over it - I have had MS fatigue many times in the last ten years, and I know what this feels like.

This is the same neuro that neglected to tell me I had an unruptured brain aneurysm for six months. Trouble is, he is my only choice geographically.

Thanks again for your support and humour - you all make me smile and realise that yes, there are much worse things.

I need to lay down, get over it, and soldier on

Cheers

Lyn

Lynn, have you considered looking into a prescription for a mild stimulant? I've just started on a VERY low dose (5 mg.) of Adderal - my neuropsychologist recommended it after my latest neuro-psych tests were evaluated.

So far, I can tell a distinct difference in my ability to concentrate and process new information quickly, (such as driving in an unfamiliar area of town and needing to visualize alternate routes from a map in my head - that was impossible just a few weeks ago). It also seems to alleviate some of my fatigue.

He feels that any of the ADHD/ADD drugs help MS patients with cognitive issues and many of them see an improvement with fatigue, also, but only if taking them daily. Due to side effects with my heart condition, I only take mine when I have to leave the house or work on anything requiring focus and concentration, so the fatigue help is spotty for me.

If you think you might benefit from this type of therapy, you can research Adderal, Ritalin and Provigil - I'm sure there are other drugs of this type, but those are the ones he uses. Provigil is very expensive, but I'll probably want to switch to it when a generic becomes available since it has fewer heart-related side effects.

Good luck. I can't imagine having to function in a classroom setting when the "fog" descends. I admire you for soldiering through; I don't think I could do it. Kudos!

I should be more vigilant - looks like I should go take my pill now! Karousel, I see you've already suggested the mild stimulant option. If you see this thread again, please provide a little more info about the "crashing feeling" on Provigil. I'm handling Adderal quite well, and it's in the amphetamine family. No crash and burn at the end of the day, just a need to take it early enough to let it clear my system before bedtime.

I was seriously planning on switching to Provigil once it's generic in the U.S. - can you provide more info on its downside?

Lynn - Just my suggestion & opinion - Call your PCP and, like Debbie mentions, get your thyroid checked as well as check in to other things that may be causing the fatigue. Also, fatigue and lesion location & load do not correlate. You can have 1 lesion and have severe fatigue. Remember, our bodies and brains have to work much harder than others in order to accomplish our everyday tasks. This is where the fatigue comes in. There are times where just taking a shower in the morning can exhaust me to the point of having to lay down. It doesn't mean I am in a flare or have new lesions or anything like that. For me, it means that my muscles are in spasms and got tired. (Which, not all muscle spasms and/or spasticity cause pain. They can be constantly pulling and yanking, even a little bit, not cause pain, but cause fatigue and the muscle is running a "marathon.")

Also, you are a teacher and have to be on all the time. I, too, admire you greatly for doing this and can't imagine being a teacher and dealing with MS symptoms. I could not do it. Little ones are so "busy" all the time. That alone could cause fatigue. Fatigue can happen when we are in sensory overload. When too much is going on all around us and we can't absorb it all, it can cause us to feel drained and fatigued. Have you had a neuropsych test? It may be something to consider.

I have to say that any neurologist (MS specialist or not) that says MS doesn't cause pain has never experienced the hug. (Ok, so that is my most painful symptom). They have never felt like they just ran 5 miles in water or on the sand. They have never been woken up in a full body spasm. They have never felt like an ice pick was being jabbed in their eye. They have never felt the electrical zap go through their ribs or face or legs. MS does cause pain!!! We can all attest to that.

Again, talk with your PCP about all of this, including the pain you are experiencing (which, btw, pain alone can be exhausting). He/she may be more helpful to you than your neurologist at this point. My PCP, before he retired, was great about that. He started me on Neurontin to help with all the nerve pain. For me, it has been a blessing.

Hang in there and let us know how you are doing.