RICK SOMMERS: Yeah. I think fatigue, in MS that is the one thing people will often say you'd never know, because unless you're walking with an apparatus you look great, you seem like you're functioning, you seem like you're getting along, but I, more often than not, deal with fatigue on a daily basis and have had to find ways to manage it.
DAVID R. MARKS, MD: Why does this occur?
DR. JEFFREY GREENSTEIN: We don't really know exactly why fatigue occurs in MS. Some people think it may be because of the inflammation that exists in the brain, but it quite equally could be because nerve damage has occurred and pathways in the brain which keep us alert and keep us activated. So there are two actual aspects to fatigue. One is more of a mental fatigue that occurs, and the other is a physical fatigue where people's muscles may give out on them, and that's particularly common. For example, some people walk very far and start limping because their leg will give out. So there are two components to fatigue that we have to bear in mind.
DAVID R. MARKS, MD: Now, Rick, you're here nodding your head, both for the mental and the physical. Give us some examples of how it interferes with your life.
RICK SOMMERS: Well, basically, just on the job I am tired. If I am out late at night, my friends will see me yawning at the table, and it's not because the conversation isn't entertaining. It's because I may have been up early, and it's hard for me to keep up. I'm not going to lie. Life in New York City is especially fatiguing, because everything is a production. And then when you add on top of it the stresses and strains of everyday life, and then a chronic disease, it's enough to wear you out. I find, as I said, you really need to pace yourself and you have to redefine what your limits are.
