Daily Remission - Is it Common?

[tony123]

Hi, my wife was preliminarily diagnosed with MS based on lesions in her brain and spine. Only the spine lesions are active. They are still running additional tests to rule out RA, Lupus, Lyme Disease, etc...

She currently has issues walking with one foot dragging some and fatigue. The strange thing is that every evening from 6pm to 8pm she can walk fine with no problems and her fatigue suddenly goes away. Is this "light switch" type behavior common for people with MS during exasperbation?

[Thinkimjob]

Hello. My foot-dragging is definitely worse when I've walked too far, or it's too cold or too hot.
It used to go away completely, just for a little while, but I've had MS for 15 years, and I've only been staggery for three.

If your wife is having an exacerbation, there's a good chance it will improve when the flare is over.

[MSer102]

Hi Tony! I think you mean "exacerbation" not exasperation. Exacerbations are sure exasperating though!

The other word that doesn't mean what you think it means is "remission". Remission refers to the time - sometimes extensive - in MS when a person isn't experiencing an active episode of inflammation - the "relapse" or "exacerbation". Remission does not mean just not feeling a symptom and it isn't something that happens in episodes every day. It's the wrong use of the word to say that your wife is having a "daily remission" even if she is currently having a flare (exacerbation). Remission is the period of weeks to months or years AFTER her relapse has finished.

Symptoms can and do come and go during the day whether someone is in a relapse or not. Some of it has to do with normal body temperature and chemical cycles that go on during the day, every day. In MS nerve signals don't travel efficiently when body temperature is higher and travel better (but not necessarily well) when body temperature is lower.

It might happen that your wife's body temperature is a bit lower in the evening and other chemical cycles are favorable then so that her nerve signals are traveling better so she doesn't drag her foot and doesn't feel as fatigued. But there's no magic to it. These cycles go on in every body every day. They affect some people more noticeably than other people. Some people will say they have big differences and some people will say they don't. My daily ups and downs aren't anywhere near that dramatic.

Your wife's responses to the regular cycles might be more dramatic than other people's so it might seem like a "light switch" has been flipped. If she has a lot of demyelination she might be more sensitive to daily temperature and chemical differences than other people who don't have so much demyelination. It might be interesting for her to experiment with cooling her body temperature at other times of the day and see what happens to her fatigue and other issues.

[aitch10]

I have that. Almost exactly. Not sure how common it is, but I do way better after dinner than at any other point during the day.

[jessiesmom]

Exacerbation/Relapse/Flare

I would just like to thank MSer102 for an excellent response to the original post. It was a wonderful articulate explanation of several MS terms and issues.

[tracibk]

I have that! Around 4,no matter what I have done that day, I have no energy. I feel better around 7.

[Seasha]

I would just like to thank MSer102 for an excellent response to the original post. It was a wonderful articulate explanation of several MS terms and issues.

I second this and thank you, MSer102!

[bree2013]

I second this and thank you, MSer102!

I third this - Thank you MSer102! I always enjoy reading your posts as you do a very good job explaining things in layman's terms.

Tony, perhaps your wife can try what MSer102 suggested with cooling her body temp and seeing if her symptoms do change.

Bree

[jjs]

I have that too, though not quite every day ... but often when I am not oing well I will feel markedly better in the later evening time. Maybe from about 8 to 10 or so. It always struck me as strange because it defies logic - one would think they would feel more tired and dragged down after a whole day is behind them but instead have a short burst of energy.

I want to also say thank you for the detailed response above; this was a question I had myself but never asked. Good info here ... I should read the posts more often!

[Hawkeye]

I'm twelve years into my MS 'journey,' and guess I have something like a switch in my daily life. The best I feel and the clearest I am mentally kicks in about 10:30 every night and lasts 'til about 1:00 AM. It is my most alert and awake time of the day, which does not fit in very well with my wife's normal daily clock!

I am tired, dizzy, and foggy in my thinking all day, with the seeming low point about about 3 pm. Then about 10:00 PM, as my wife begins to 'fold' after a busy day, my flywheel begins cranking up.

I don't get it, it makes no sense, but that is life day after day.

I've lived my entire life as a night owl, and wonder if this ingrained circadian rhythm plays into the explanation, somehow.

This is one s-t-r-a-n-g-e disease!!!!

[MSer102]

I've lived my entire life as a night owl, and wonder if this ingrained circadian rhythm plays into the explanation, somehow.

As a lifelong night owl myself I absolutely believe it does.