Relapse or overworked?

[rendean]

Ok, I'll admit I haven't read ALL the Health Pages yet and the answer to this question is probably in there, somewhere but  I would like some advice from those of you who have experienced something similar.

About a month ago I started with a new symptom, the unrelenting leg/bone pain. Feels like you've been kicked in the shins and includes the entire leg. Both legs actually, some days one more than the other.  Upped the Lyrica to 100mg, didn't work. Switched to nortriptlyin 75 mg which helped initially but now isn't doing much now.

The question. I had a LONG day at work on Wednesday-10.5 hours plus a one hour commute each way. Needless to say I was down for the count the next day(Thurs.) and slept most of the day when I wasn't groaning in pain. Yesterday I went to my scheduled PT.The pain had abated somewhat and the therapist did "simple" exercises such walking a heel to toe walking with distraction. Everything I had gained in balance and proprioception was gone. The therapist
had to "catch" me with the belt numerous times. The pain is better today.  So, is the leg pain, etc., part of a relapse since it is a new symptom? Is the loss of skills due to fatigue or worsening symptoms from a relapse?

I've learned my lessons regarding the long work days which used to be quite frequent.  The last time I worked 10+ hours was only 2 months ago and I suffered no ill effects.

Any thoughts?

Thanks,
Ren

[rendean]

Update:

Just came from the neuro and I "officially" have RRMS and I am "officially" in a relapse since the leg pain is new symptom he calls it an exacerbation.


Ren

[Quixotic1]

I pretty much agree with what has been said.  Ess was right on with what I thought when I read your posting.

The onset of leg pain was clearly a new relapse.  This can happen even if the previous relapse had lingering symptoms that had stabilized or plateaued.  

The return of weakness and loss of gain from exercising due to severe fatigue is something we all of experienced.  For the most part in myself, I consider this a part of "paying the piper" and not as a new relapse.  I'm in such a phase right now.  My sister and I are on the mandated shopping mission to pick out ALL of the things that will go in the finished basement, flooring, wall colors, tile, faucets, sinks, lights, countertops, cabinets and on and on.  Ann and I were on extended shopping trips every day last week and after two days I started coming unglued.  My fatigue is still ongoing and I don't think of it as a new relapse, but more like suffering the effects of "injuring" myself.  It may take a week or so to recover.

However, a relapse can certainly begin with a new level of fatigue that does not remit for a long while.  Also, I think that it need not have other symptoms, but that gets into the area where each neuro might have a different view of it - the part of the definition of  relapses that has fuzzy borders.

Terry - I think you are describing a true relapse.  Often we can't know until the symptoms suddenly lift and we see that it had a beginning and an end.  The relapse is clear only in hindsight.

Ren - Tell your co-workers that, "I'm not as think, as you drunk I am!"

Actually, I believe that the use of a cane can protect you a little from the appearance of being enebriated.  Instead of staggering here and there, you stagger around using the cane to steady yourself.  Impression to outsiders is, "Oh, she is medically unsteady, " instead of "Wow, wonder what she is on."

Quix

[rendean]

Thanks. Your situation sounds similar to mine. I'm glad you're beginning to return to your old normal.  Very good news that the balance returned as well. I think that's what bothers me the most other than the leg pain. The balance issue is quite obvious at work and I can't apppear to be intoxicated, which is what I look like.

Ren

[saveone]

Beginning about the middle of January I began having this overwhelming fatigue, the kind that invades every pore and cell of your body.  It started right after I had a couple of good days and I decided I could clean house....I got a real lecture from my PT for that.

Any how, all of the gain I had experienced at PT began to disappear.  I couldn't do my exercises, my balance was gone again and so and so on.

It is now the middle of April and I am beginning to come back to myself.  It seems it went away as quick as it came....my balance and endurance have returned with it...at least to my normal.

terry

[rendean]

Thank you for your input, it is very much appreciated! I have an appointment tomorrow afternoon  with the neuro to discuss the new dx and treatment plan. Included now, will be the symptom and fatigue, etc.

To sho: Thanks for the leg fatigue info. Hadn't thought about it being the legs themselves versus the balance.

Once again, thank you  and enjoy the rest of the weekend. It's beautiful here with bright sunshine and a delightful 70 degrees. Geez, I sound like a weather girl.....

Ren

[essdipity]

Some good points have been raised here. Technically a significant new symptom like your leg pain does constitute a relapse. The remission you had been in may have been only partial, but still you can have another relapse. This one I think will be accurately characterized only when some time has elapsed and you can assess your other symptoms and see how you feel. You do need to contact your neuro.

Plain ol' MS fatigue can occur in conjunction with new symptoms or totally on its own. I'm even wondering if exhaustion way beyond what seems normal is a relapse in itself. I'm talking about exhaustion that lasts more than a day or two. Comments, anyone?

ess

[shoshin]

Well, I don't know the answer to your question and I agree with everyone that you should talk to your neuro.

I just wanted to say that when my legs are fatigued, I have a lot more trouble with my balance exercises and it doesn't seem to be that my balance has gotten worse so much as that my legs wobble a lot and I can't control them as well. So hopefully, if this is just from overdoing things, the setback with your PT exercises will pass. Anyway, I hope that's all it is, but like somebody else said, you'll probably only be able to tell over time.

sho

[michelleric]

I am sorry you are still having trouble after that long day on Wed. You need to take it easier, (I don't listen to my own advice you know). However, you really do need to cut back those long days to a shorter ones. I will paying the price tomorrow for today too, just a bit frustrating. I feel it is like "giving in" or something like that, but we have to take care of ourselves.

Gosh, I better re-read this for me! :)

Hope you have a easier night and can sleep OK...

Hugs to you,
Michelle

[rendean]

Thanks for responses. I have a scheduled appt. with the neuro so he can officially diagnose the MS. He had told me 2 weeks ago when we spoke that if the lip biopsy was negative then we would treat this as MS. The phone call to me, at that time,  was in response to the new unrelenting leg pain and a new RX for the nortriptylin. It will be interesting to see whether he considers it a symptom or whatever.

Hope you both have a great weekend!
Ren

[Sarahsmom46]

You are at a point now where you need to probaly call the doctor or nurse if he/she has one and ask if this a relapse or not as this is all still pretty new for you.  

I got some very good advice from a doctor at an urgent care center, if you can believe that, who knew a lot about MS.  She told me that if I have MS, then I will have to learn by body symptoms to know what symptoms are being caused by the MS versus what is being caused by something else (i.e. a virus, over work, etc).  You'll learn this over time.

For now, listent to your body to know when something isn't part of your new "normal".  If in doubt, call the doctor.

I'm sure others will be by soon to offer their experiences.  

Julie

[sllowe]

For us rookies, it's so hard to distinguish the relapse vs. the symptom.

From my experience, it sounds like a symtom.  Not just a symptom, as they are just as wretched as relapses.

Jost it down Ren, and annotate the severity, how long it lasts, and when it backs off.  When and if it subsides, you'll have it to look back on when it returns.

I only have a hug for you sweety, and wishes that it subsides long enough for you to have a break.
(((hugs)))
shell