Moms Health Club’s theme for this year is “The Good Health And Wealth Of Ghana Starts With Me” this is a follow up to the theme for 2010 which was “Your Health, Your Responsibility – Take Control”. My goal is not to make readers experts in healthcare but to raise awareness and emphasize the point that we are all in a position to improve our health.
One will hardly complete a day’s work at the clinic without talking to a patient who complains of fatigue. The whole world appears to be in the “fast lane” and it is almost fashionable to complain of fatigue. Colette Bouchez refers to this whole fatigue syndrome as “a global energy crisis that has nothing to do with oil” and I totally agree with her. We all do experience fatigue once a while but when we know the likely cause(s) then we are in a position to make the right choices to correct this. Many of us may confuse fatigue with weakness and this may throw our diagnosis in a totally different direction. Always remember that the information we give our healthcare professional goes a long way to determine the conclusion he/she will draw.
Weakness is “a lack of physical or muscle strength and a feeling that extra effort is needed to perform daily activities that require you to move your arms, legs or other muscles”
FATIGUE on the other hand is “a feeling of tiredness, exhaustion or lack of energy”
According to the folks at Mayo Clinic, all our complaints of fatigue can be grouped into three (3) main categories:
1. Lifestyle Factors e.g. lack of adequate sleep, cigarette smoking etc
2. Psychological Factors e.g., stress, depression, grief etc
3. Medical Conditions e.g. thyroid disease, liver and kidney disorders
Dear reader do not attempt to make any ridiculous diagnoses just because you experienced fatigue for a few days. Only a trained healthcare professional can combine the information you provide, her examination findings and relevant investigations to make a diagnosis.
1. Lifestyle Factors
a. Lack of adequate sleep: you may be able to rob yourself of sleep for a while but consistently sleeping for four or five hours a day will eventually bring on fatigue. Some of us may think we get adequate sleep but we may be suffering from sleep apnoea and hence interrupt our sleep several times without knowing. Fatigue and dozing during the day becomes our trademark. Look out especially if everyone complains about your snoring. If you are overweight it may be a brilliant idea to start off with some weight loss
b. Not enough fuel: Food is fuel for our body and if we starve it or deprive it of certain components of a balanced diet, then it will come as no surprise if we feel tired often.
c. Caffeine overload / Excess alcohol consumption : Caffeine like alcohol may have some good points but never be deceived a glass or cup too many will surely bring fatigue in its tracks and some even more heart troubling news that will cause you to lose more sleep and worsen your fatigue could also be in the pipeline
d. Shift Work Sleep disorder: The challenges of modern life means some of us need to work when our biological clocks and other physical factors make sleep so welcoming. Working for long periods on the night shift for instance makes it difficult to sleep during the day sometimes through no fault of ours and other instances they are purely self made.
e. Dehydration: This could be self inflicted by not taking adequate fluids (e.g. water). I actually read a few times that we should only drink water when we are thirsty. NEVER try that!!!! Your body always needs water. I mentioned it a few weeks ago that it is rare for most people to overload themselves with water. If you need to restrict your intake of water, then your doctor will advise you on that. In some cases dehydration may be as a result of severe burns, an illness, trauma(with bleeding) etc
2. Psychological Problems
a. Stress: Whether physical or emotional can often lead to fatigue and the yawning and stretching go unabated. Please do not start pointing to all yawners as being tired. Who knows it may be from good old hunger – the body’s own prompting to refuel it. Normally the fatigue from stress will persist till cause is removed
b. Depression/Anxiety: These bed-fellows are notorious for causing a lot of woe and quite often they attack together. Yes one may be predominant but always look out for the other. They torment you so much that you feel fatigued all the time. A favourite path they plough is to mess up your sleep and also stress you out psychologically.
c. Grief: Mourning the loss of someone dear or crying over “spilt milk” has its own mode of payment and you my brilliant reader guessed right. Fatigue is the price we pay
3. Medical Conditions:
a. Anaemia: Whatever the cause may be, it affects the effective transfer of oxygen to the cells and fatigue is one of the symptoms. Some anaemia may be purely self-inflicted. We may skip meals (fuel for the body) in a dangerous attempt to lose weight and may end up developing anaemia.
b. Thyroid Disease: Both hypo and hyperthyroidism may present with fatigue
c. Diabetes: Sometimes Type II Diabetes may only present as fatigue. Time to check your blood sugar if you haven’t since we launched this crusade.
d. Heart Disease: Many of these including heart attacks may present with just fatigue. This feeling subsides when we manage the condition appropriately.
e. Infections: Impossible to run away from these. They are numerous and we will only mention a handful. “Hidden” urinary tract infection, malaria, typhoid and even viral infections such as the common cold.
f. Food Allergies: Sometimes instead of the often common tell-tale signs of an allergy, fatigue is the only way our body may react to certain foods it would rather do without.
Of all the causes of fatigue my favourite is “The Working Mom’s Syndrome”. I am not sure if that has been coined yet but all ladies who have to juggle work (remember stay at home moms also have a lot on their plates) and taking care of under ten year olds will swear they are destined for the Intensive Care Unit. Make no assumptions my dear reader, this diagnosis is purely one of exclusion. Essentially your doctor should have considered all the various causes of fatigue before settling on this.
When fatigue persists for over six (6) months then we are wading into the area of Chronic Fatigue Syndrome and our management may require medical/psychological means.
So when you next feel extremely tired,
• Go through your check list
• Talk to your healthcare professional
• Start mild exercising three (3) days a week after seeking clearance from your doctor and surely all other things will be added unto you.

Dr Kojo Cobba Essel
Moms Health Club

References:
• Mayoclinic.com
• Webmd.com