Hello Renee
I'm glad you're here.
Fatigue is a very common side effect of MPNs. I often wonder if my fatigue is just caused by my age (73) or my MPN (ET). But I think it's more likely the ET. It's not like usual tiredness. Sometimes I just CAN'T, and that's never been a problem before.
You might want to take a look at the link below, which is one of the many resources on this site.
Good luck!
https://www.mympnteam.com/resources/managing-fa...

Managing Fatigue With MPNs | myMPNteam

https://www.mympnteam.com/resources/managing-fatigue-with-mpns

Solidarity 🌷

Exhaustion is a symptom of MPNs, and so is body pain. While stress might accentuate them, when one has an MPN, it is far more likely they are there due to the MPN. There are some good articles on this website on how to handle fatigue, especially related to energy saving. There are actually pacing programs on physiotherapy websites that can help with energy saving.

Below there is some research on MPN symptoms:
"Prominent symptoms include fatigue (92.7%), early satiety (61.9%), abdominal pain (45.9%), abdominal discomfort (53.2%), inactivity (60.5%), headache (48.3%), concentration problems (61.7%), dizziness (55.2%), numbness (61.3%), insomnia (65.4%), sad mood (62.7%), sexuality problems (57.9%), cough (46.4%), night sweats (56.4%), itching (52.6%), bone pain (48.5%), fever (20.2%), weight loss (34.2%), and impaired quality of life (84.2%)"
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC46...

"Fatigue in MPN is common, debilitating and distressing. It affects all aspects of health, wellbeing and life. Health professionals could affect patients' lives substantially by acknowledging and understanding fatigue in MPN, including contributing factors and potential opportunities for management. More systematic data describing the causes and management of MPN fatigue is needed."
https://onlinelibrary.wiley.com/doi/epdf/10.100...

Regarding pain, this article is a good read:
https://www.mympnteam.com/resources/pain-and-mp...

"Chronic pain (abdominal, bone) is a prevalent and undermanaged feature of MPN disorders. Chronic non-MPN pain is further complicated by the development of the disorder. Many MPN patients lack understanding on its prevalence and furthermore feel ill-equipped to manage it. Patients have, however, found symptomatic benefit from various pharmacological and non-pharmacological treatment modalities that require further exploration. Results from this study suggest MPN patients should be assessed regularly for pain and offered early referral to specialized services for evaluation, source identification and treatment."
https://ashpublications.org/blood/article/132/S...

I hope you get all the support that you need to reduce your symptoms.

Pain and MPNs: Causes and Management | myMPNteam

https://www.mympnteam.com/resources/pain-and-mpns-causes-and-management

Impact of Inflammation on Myeloproliferative Neoplasm Symptom Development

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4619953/

Fatigue is the most common MPN constitutional symptom; however, fatigue an come from other causes, including stress and the medications used to treat MPNs. Sometimes timing is the only cue as to which is which.

Regarding the body pain, that is another potential MPN symptom. This can occur for a number of reasons. One of the reasons is the overproduction of inflammatory cytokines that is function of deregulation of the JAK-STAT pathway. Chronic systemic inflammation can be a significant problem with MPNs. While NSAIDs like ibuprofen can help, NSAIDs potentiate the blood thinning effect of aspirin. Caution is needed when adding a NSAID to your treatment plan.

There are a number of strategies to manage MPN Fatigue. You already have one reference to strategies. Since this sounds like a change in symptoms, it is important to review with your MPN care team. Hopefully your MPN care team includes a MPN Specialist rather than a regular hematologist. Many doctors, including hematologists, have little experience with MPNs. MPN expert consultation is essential for optimal MPN care. Just in case you need it, here is a list. https://mpnforum.com/tsr-the-list/

Wishing you all the best.

TSR — The List

https://mpnforum.com/tsr-the-list/

Stress can really take a toll on your body, and it is so difficult to pinpoint causes, in my 23 years experience.

I had a shower of pulmonary embolisms before my diagnosis in 2001, presenting only as slight shortness of breath, also a small brain stem hemorrhage, which presented as a vision change and loss of balance.

I would ask your Doctor what you should be concerned about…take in written questions and write down the answers…and, of course, listen to your instincts and call your Dr. or get into a prompt care if you are concerned.

All the best, and please keep us posted here.

Have you had blood work recently to determine your status? It sounds like you have a very demanding job and it may be to much combined with a MPN diagnosis. Can you divest if any of your responsibilities or are they part of your job? Fatigue and body aches seem to be frequent symptoms for MPN. If you’re concerned it is always a good plan to touch base with your specialist. 12 days can seem like a lifetime when you’re hurting. Hugs to you.