Heat intolerance and Multiple Sclerosis

I have not quite worked out the effects of heat on my body quite yet. As I once again learned today on a quite lovely day.

So let’s just exercise.

And let’s do it during the hottest part of the day.

Sounds like a plan.

Brilliant.

I get I have symptoms of pseudo-relapses with heat, stress, lack of sleep and illness. However, the last MRI had no lesions. And no new relapses. So I wait. And try to figure these things out. Basically, just working on this fatigue and these pseudo-flares at the moment.

Pseudo-flare

• Heat
• Stress (emotional, physical)
• Infections
• Vaccines
• Hormonal changes
• Other medical conditions (thyroid disease, diabetes, or anemia)

Heat intolerance is also called Uhthoff’s phenomenon (or Uhthoff’s sign) or a trigger for temporary worsening of symptoms (glitch, short circuit). Which is something I do experience every once in a while. Often enough that I notice it.

Basically damage that is already existing and getting disrupted. And will simmer down once you cool down your core temperature.

What I do not experience is a relapse which would be a new symptom that lasts longer than 24 hours.

Multiplesclerosis.net

However, I have experienced a lot of fatigue and I want to manage that with exercise so I have decided to set up an exercise routine for that. Starting really slow and working my way up. The fatigue itself has been problematic. More so given the utter and complete insomnia issue I have had. So the fatigue during the day is intense.

I decided to go on a short walk. Just 25 minutes. But it was hot out. 25C out to be exact. Peak time of day. I didn’t take the advice of bringing water with me because I thought, hey, well, this is a nice short stroll. I have walked this before. No problems.

But the heat gets to me. And on the return walk my leg began to lag. Then drag a bit. And then I was tripping on it a bit. And then, well, that drop foot at the end of the walk was kicking in. The stairs though were not too problematic.

I don’t actually get this. Not even a little bit. It is a guessing game. Sometimes that leg is fine and other times it’s like, nope, not handling this heat business today at all. Or not dealing with this long walking deal today, thanks. Other times, its good to go. Which is why exercise and strengthening my legs overall seems like a pretty substantially big deal to me.

I drank a bottle of water when I got inside. I do know to do that after exercise. But then I had a moderately hot shower and that didn’t help at all. Again, not recommended. So again, feeling absolutely brilliant when the leg was not doing great to begin with.

Then the day after, the leg was still a little off. So not great. But that was not from the heat. Apparently, from I looked up that was just a MS hangover and fatigue. Basically, I overstressed my nervous system. To a system that was already fatigued and stressed.

That hangover effect can cause:

• Overall weakeness
• Fatigue
• Cognitive difficulties
• Feeling really wiped out and exhausted, done in. That generally lasts around a day and sometimes longer, depending on that trigger.

And then, lack of sleep can prolong symptoms into the next day.

Careful of a tricky relapse:

I am watching carefully for a relapse and this particular trigger, especially when symptoms persist can mast a relapse.

1. Heat specifically, and stress and inflammation combined can trigger a new area of inflammation up and a new symptom to appear.
2. You need to watch for a) the appearance of a new symptoms or b) significant worsening of an existing symptom for longer than 24 hours without heat or illness involved.
3. Cool down, hydrate, rest for 24 hours
4. Monitor for those 24 hours after all the neural fatigue has simmered down
5. Identify symptom if it is new one that became apparent with the dysregulation of heat exposure and remained flared.

Things to remember and try:

• Exercise at colder times of the day (So a stroll in the morning will be workable for me)
• Exercise in airconditioned environments (we do have an air conditioner)
• Pre-cool your body before exercise or going out into a hot environment
• Drink water directly after exercise. Also stay fully hydrated. Drink fluids before you feel thirty.
• Go for warm to cool showers
• Wear loose, cool clothing. Lighter colors. Breathable fabrics. (Also not what I did). Wear a sunglasses and a hat. (Also forgot these.)
• Use cooling cloths and other cooling options
• There are ways to mist yourself
• There are cooling vests
• There are portable fans
• Limit caffeine and alcohol that can cause dehydration (oh, yeah, I do not limit caffeine in any shape or form)
• Review medication so that if one is effecting your temperature regulation you can adjust that.

Heat intolerance and muscle weakness