- Pushing patients beyond fatigue wears them out -
Dr. Joel Steinberg
GBS-CIDP Foundation International, USAPublished in "Reaching out" Summer 2005
"......... Dr. Steinberg has suffered from GBS and is therefore personally familiar with the phenomena of fatigue.
Unfortunately there is little information in current medical litterature, but it is important that physiotherapists and occupational therapists are made aware that pushing a patient beyond their fatigue will wear them out.
The same applies to walking. Many patients find they can walk short distances and then their legs start to feel like rubber.
For most, eventually, fatigue tends to diminish and they can remain active for longer. Most patients eventually resume a normal lifestyle.Patients should remember, when they visit their neurologist, that the standard testing for muscle strength does not look for fatigue or exhaustion, so they should reveal exactly how far they are able to walk or how often they can perform some repetitive activities.
It is important, as the patients recover, that they accept the activity they can endure is fixed and should learn to conserve their energy. It can be compared to a credit card: once the credit has run out you just have to stop.
The other important challenge for recovering patients is that of abnormal sensations, which can include diminished sensations, numbness, tingling or pain. The pain can be oppressive and unfortunately, some doctors are not good at recognising it.
More sophisticated treatments dealing with pain and abnormal sensations are becoming available. Other items which some patients may find helpful are moist heat-pads and cold applications. As with fatigue, these sensations do eventually tend to dissipate.
In his experience, Dr. Steinberg was able to detect early warning signs of fatigue when he walked from tingling in his toes. Practical warning signals such as these should be used by those who have fatigue-induced abnormal sensations."
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