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.

For me it feels like a heavy weight has been put on my physically. I get the same feeling if I drink way too much coffee. Suddenly I'm out of energy and wiped out and almost have a hangover feeling. In writing it sounds like the MS fatigue but it's a much heavier feeling for me. It's hard to explain exactly how I feel so I hope I'm making at least a little sense!

MS debilitating fatigue attacks are not hard to explain to us who have had them, K.

I'm not talking just the ordinary fatigue from operating in a weak body. I'm talking about when you can't hold your head up.