Managing Cognitive Difficulties

By: Meagan Freeman

When we think of spring, we think of renewal, spring-cleaning, organization and clarity. We think of new growth, birth, refreshment and a new beginning. This can be especially difficult for patients struggling with memory loss and multiple sclerosis. How do we achieve organization when we have a difficult time recalling why we walked into a room?

How many times have you misplaced your keys? Lost your phone? Forgotten someone’s name?

Cognitive difficulties brought on by MS are an incredibly tough thing to accept, especially in the very young. We aren’t supposed to experience memory loss like this in our 40s, 30s and even 20s. When that familiar face says “hello,” on the street one day, you know you recognize this person…but you think: “what was that name again?” Embarrassing to say the least.

Like any MS symptom, these changes are caused by lesions and brain atrophy over time. Medications used to treat MS symptoms may also be responsible for causing cognitive issues. Pain medications, anxiety medications, and muscle relaxants may cause patients to become sleepy, fatigued, and even confused. We should all be cautious when using these types of medications, especially when driving or doing other dangerous activities.

What can be done about these issues?

Occupational therapists, speech and language pathologists, and neuropsychiatrists can perform a specific battery of tests to determine the severity of the cognitive impairments. Then, computer-assisted tools such as memory aids, and other forms of cognitive rehab can be used to improve memory and learning. The other key point is that lesion load, or the number of lesions seen on MRI, can correlate with cognitive problems. Therefore, it is natural to assume that staying on a disease-modifying drug is important in keeping the lesion load low.

In my own life, I have experienced a great deal of cognitive decline over the last few years, and I am only 40! I began to notice that I was forgetting the reason I entered a room, where I put important things in my home, where I set my keys, and even names. I was horrified when I noticed these changes! Some of these things can be blamed on normal aging, stress (6 kids!), and perhaps lack of sleep/rest. However, I am quite sure that MS has a lot to do with it. All we can do as patients is educate ourselves, educate our families, and be aware. Communication with our providers is important as well, and we need to be sure that we are receiving every available treatment. Don’t ever assume that nothing can be done for you. Training your brain by reading, writing, and continuing to learn are excellent ways to keep the mind working! “Use it, or lose it,” as they say!

Use your spring-cleaning time to organize your life. Keep things in specific places that you will remember clearly. Label things, and use a pill sorter to remind you to take your medications, if needed. Write everything down, and set reminders in your phone. If we prepare for those moments of memory loss, we will find them less worrisome. Happy Spring!

*Meagan Freeman was diagnosed with RRMS in 2009, at the age of 34, in the midst of her graduate education. She is a Family Nurse Practitioner in Northern California, and is raising her 6 children (ranging from 6–17 years of age) with her husband, Wayne. She has been involved in healthcare since the age of 19, working as an Emergency Medical Technician, an Emergency Room RN, and now a Nurse Practitioner. Writing has always been her passion, and she is now able to spend more time blogging and raising MS awareness. She guest blogs for Race to Erase MS, Modern Day MS, and now MSAA. Please visit her at: http://www.motherhoodandmultiplesclerosis.com.

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About MSAA

As a national nonprofit organization, the Multiple Sclerosis Association of America is a leading resource for the entire MS community, improving lives today through vital services and support. MSAA provides free programs and services, such as: a toll-free Helpline; award-winning publications including a magazine, The Motivator; website featuring educational videos and research updates; S.E.A.R.C.H.™ program to assist the MS community with learning about different treatment choices; a mobile phone app, My MS Manager™; a resource database, My MS Resource Locator; equipment distribution ranging from grab bars to wheelchairs; cooling accessories for heat-sensitive individuals; educational events and activities; MRI funding and insurance advocacy; and more. For additional information, please visit http://www.mymsaa.org or call (800) 532-7667.

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