Tuesday, January 8, 2008

Risks of MS Fatigue in the Professional Musician and Suggestions for Coping

  1. Be a professional musician who chooses to teach private lessons.
  2. Teach private lessons to young pianists and french hornists of various ages and skill levels.
  3. Have a little (debilitating) MS fatigue which fortunately responds well to Provigil, albeit at the higher doses costing about $18/day.
  4. Taper Provigil use over the holidays, simply going day by day, stop when you drop, and go when you can.
  5. Return from the holiday break, forget how much brain power and energy is actually required to teach one-on-one music lessons, and go it alone without the help of pharmaceuticals.
  6. Fiercely fight the pull to disengage, blink repeatedly to attempt to regain visual focus, and try really hard not to let the student catch you with your eyes closed at any moment.
  7. Be sure to smile as usual and sound peppy (children respond to your energy), be encouraging and try really hard to remember how and what they just did, and avoid saying uuhhhm as it makes you sound distracted.
  8. Never calculate how many hours remain in your workday, since even before MS a 4-hour teaching day is equivalent to working an 8-hour day in an office, but without the breaks.
  9. Question why it is you ever thought that teaching from 2:30pm to 9:00pm, without a pre-teaching nap and without drugs, was a good idea.
  10. Remember (after 2 torturous days) to take some Provigil and easily determine if it really does help or not.

    I'll see you tomorrow. MS fatigue or not, and hopefully coherent.


  1. i am new to the names of all the drugs for MS symptoms. what is provigal and how does it work? does it help?

  2. by the way...i just posted something which i would love to hear your opinion about.

  3. Whoa ... Umm, but I have NO TALENT! I guess I should be a Rap Artist then.

  4. Hello Lisa, thank you for visiting me and for the encouraging message. Much appreciated.

    I tried a drug called Amantadine - it is for Parkinsons Disease - that has had some success with MS fatigue. (Same as Provigil? - no idea). It turned me into a total insomniac. I admire your persistence. I was a teacher but could not switch over to private lessons as I felt my unreliabilty would have been a huge obstacle. Well done! MS AND RA. Life is not fair (but was never promised to be).

  5. So the jury is in....
    Provigil does indeed help!!

    MerelyMe, there are a few drugs more commonly used to address MS fatigue.

    1. Amantadine - an antiviral medication (influenza I think) is also used in Parkinson's disease. It works through some 'unknown mechanism' and is sometimes effective in relieving MS fatigue. I have a friend who takes this and is works for her.

    2. Provigil (modafinil) - a 'wakefulness' treatment for narcolepsy is a nervous system stimulant. This is similar to Ritalin which I think has also been used to treat fatigue. Provigil has the potential to be abused and I've read that for some it loses it's effectiveness over time.

    3. Prozac and Zoloft - antidepressants which function to increase serotonin levels. I've taken Zoloft and it has not helped with fatigue (that I know of.)

    There may be others but this is what I can remember right now. It's important to note that there may be some level of experimentation necessary to find a med which helps any one individual. This is one to talk over with your doctor.

  6. wow..prozac and zoloft may help? i would really be interested in hearing about your zoloft experience. this is one drug i was thinking of trying for my depression but...i just am not sure. seems to have so many side effects and would be hard to come off of should i not like it.

  7. Prozac and zoloft may be used to address ms fatigue, but they also are blamed for fatigue. Zoloft has done nothing for my fatigue, but it has for my depression.

    When starting therapy and when increasing dose levels, I have experienced some minor intestinal effects which lasted about a week. Nothing too bad.