Monday, November 12, 2012

Cognitive Dysfunction

Cognitive Dysfunction - affectionately known as brain fog - or fibro fog, for those with Fibromyalgia.

What does it mean??  Essentially that your brain is betraying you.  It is frustrating and challenging to deal with as you live your life on a day-to-day basis.  People who live with autoimmune diseases such as FMS, MS, Lupus know well what it is to attempt to function during a brain fog attack.  You feel as though you are slipping - losing your faculties ... feeling as though you are a person of advanced age - when in fact you are maybe 25!  Forgetting why you entered a room.  Asking a question - then asking it again five minutes later, with zero recollection of having asked it the first time - or what the response to the question was.

Doesn't sound too terrible - right?  Well ... were that all it involved - perhaps one could live with ease under the 'fog'.  However that is just the tip of the proverbial iceberg.

Symptoms of cognitive dysfunction can vary from mild to severe and differ from person to person - and from day to day.  Some of the symptoms include but not limited to:

Word Use and Recall: Difficulty recalling known words.  Use of incorrect words, inability to recall names.

Short Term Memory Problems:  Forgetfulness, Inability to recall what has been read or heard.

Directional Disorientation: Not recognizing familiar surroundings, easily becoming lost, having trouble recalling where things are.

Multitasking Difficulties: Inability to pay attention to more than one thing. Forgetfulness of original task when distracted.

Confusion and Trouble Concentrating: Trouble processing information, easily distracted.

Mathematical/Numerical Difficulties: Difficulty preforming simple math, remembering sequences, transposing numbers, trouble remembering numbers.

Many people who suffer from Cognitive Dysfunction often say that the effects of the 'fog' is often worse than the physical symptoms and/or pain they experience from their illness.   I can say from personal experience that this, for me, is true. Being in pain - even physical agony is one thing.  Feeling that you are losing control of your faculties is something altogether different!  Imagine speaking and suddenly - in mid-sentence, you completely forget what you were saying. Imagine this happening all of the time.  Imagine getting 90's in math in school ... now imagine on one day you can do a running mathematical total in your head .... and the very next day, having to use a calculator for simple mathematical problems.  Having to repeat a phone number over and over as you write it down as not to transpose the numbers.  When at one time you were a virtual phone book for hundreds of numbers! Imagine that Monday is different from Tuesday - and Wednesday is different again. And sometimes 1 o'clock can be different from 2 o'clock.

Causes of Brain Fog is not known.  However, it is theorized that the following may be contributing factors:

- Lack of Restorative Sleep.   (This is not the same as not getting enough sleep.)
- Abnormal Cranial Blood Flow Or Volume.
- Brain Abnormalities.
- Premature Brain Aging.
- Mental Distraction Due To Pain.

In Fibromyalgia (FMS) Brain Fog / Fibro Fog is generally worse when the pain is worse. When you are in a flare. In FMS and ME, it can be worsened when exacerbated or under sensory overload.

According to Marshall Pathogenesis, cognitive dysfunction is caused by microbes. More severe forms of cognitive dysfunction are seen in diseases such as Alzheimer's, Chronic Fatigue Syndrome, Multiple Sclerosis, Fibromyalgia - to name but a few.

Studies suggest that women with autoimmune illnesses such a FMS, MS, CFS will experience cognitive dysfunction more frequently and more severely than their male counterparts.

Unfortunately there are no cures for CDS - and treatments only work for some people.  Essentially putting a band-aid on a broken leg.  For me, it is worsened when I am in a FMS Flare.  And has become more frequent once I became diagnosed with early-onset MS a few years ago.

Essentially it comes down to reducing flares - as flares seem to amp up the fog .... a vicious cycle really.  Stress or over exertion will trigger a flare - a flare will trigger the Fog - the fog triggers more stress.

The bottom line is understanding and learning to cope.  What doesn't kill us makes us stronger!  Stress is one of the certainties in life.  Attempting to reduce stress will reduce the frequency of the flares which in turn will reduce the severity of the CDS.   Ultimately having people who understand and support you is key.  Because when you are in the middle of the fog - and feeling lost - it is nice to know there is a hand to grab - a hand to lead ... without judgement.

Remember, you are not your illness!  And an illness is just that.  An ILLNESS. And bares no reflection on the person you are, any more than a wheelchair defines someone who is losing the ability or function of their legs. So, much like the person who uses a wheelchair - or a cane as a tool to cope with loss of leg function.  Find tools to help if you are afflicted with CDS .... notes, recordings, meditation....  there are no right or wrong answers ... if you find something that works - use it!!