Today I wanted to take the time to describe a symptom that almost all Multiple Sclerosis Patients seems to have experienced at least once in their lifetime if not all the time, cognitive fog or “cog-fog” for short as we call it. This is an extremely frustrating symptom especially because most people just don't know how to describe it or express how difficult it makes getting through the day. I'll try to convert this symptom and the frustration associated wit it into simple words so that maybe you can relate, share this with someone you have been trying to explain this to, or identify an issue you sort of knew was there but really never knew what it was!
So What is Cognitive Fog?
Well a more technical term for the symptom would be “cognitive dysfunction” which is describing your inability to properly allow your brains cognition to run smoothly. Cognition is the process of thinking, planning, problem solving, focusing, recognizing people or objects, even language!
So cognitive dysfunction, or cog-fog, can effect you in many different ways, it's a very general term and may not even cover some of what you yourself are experiencing! Here are some of the more common issues people with MS have with cog-fog:
Now again, this is a very broad symptom and can effect so many different areas of your brain it would be impossible to list all the possible effects because you can take each of those impairments listed above and brake them down into smaller more detailed impairments that can also be further broken down and/or branched out into other symptoms because each individual experiences each impairment a bit differently. Some people might have a hard time with names and be fine at remembering terms while others have the opposite problem. Some people might spend a minute staring at a toothbrush while their brain tries to identify the object and others may have never experienced that in their life but instead spend their time staring at a simple word that they simply can not remember the definition of.
- Short term memory impairment
- Speech impairment (finding the right word
- Problems recognizing objects
- Difficulty learning
- Just feeling slow in general
What Kind of Cog-fog Does Matt Experience?
Since there are so many weird things I have heard of people experiencing and it would be nearly impossible for me to list them all (not just because of logistics but because I myself have memory issues) I will take the time to try to explain a bit of what I experience because more than likely, if you have MS, you have experienced something similar. In the comments below you can share your personal cognitive functions and I will create a Part 2 to this article going over some of the stuff I left out!
My memory is horrible but in a very odd way. I have not studied this function of the brain in depth but I do know that memory is not believed to be stored in any one particular part of the brain in full, some bits of memory are spread out in weird places. So maybe this is why certain aspects of my memory are poor and others are great? It's not just as simple as short term and long term although my short term memory is much more effected than anything else.
Let's look at some examples to better explain what I mean. Short term; I may leave my room to complete a task elsewhere and ten feet down the hallway I will forget where I am going and why I am going where ever it is I am going. If you give me a list of verbal directions I will most likely forget each step immediately. In fact, if you tell me anything at all and I am not making a conscious effort to remember what it is you are telling me I will probably forget it. I can be on the phone and talking about a single subject with a friend for half an hour, then the cat jumps up on my desk and knocks something over. I express my frustration and now I don't remember what we were talking about for the last half an hour.
It's not that the information is not being stored, it's that my brain is having trouble creating the right synapse to access that information because all it takes is one tiny thing to remind me where I was heading with my train of thought and then it all rushes back in. Without that reminder my brain can not find it's way back down the right path of information to find that one single fact that it is looking for which is why I believe my long term memory is so much better. Those paths have been traveled so many times that my brain literally (for lack of better terms) has memorized them, etched them in stone, made them muscle memory. I may hear a song for the first time in years and I will be able to remember the lyrics without the slightest impairment. I can remember my way around town or my old school that I have not visited in over 8 years. It is burned into my brain.
Speech and Communication
This one is one of the most frustrating to me personally because I have always prided myself in speaking properly with a natural flow and I have always taken even greater pride in how I write as I view writing as very personal and artistic (not that I express that form of writing here on this blog haha).
It started with my inability to find the right words. I knew what I wanted to say but it's like part of my vocabulary had disappeared. I even knew the definitions of the words I wanted to use but I just couldn’t remember the words themselves! This makes holding a conversation very difficult, I mean, how could it not be when you can't think of a word as simple as “because” or “identified”. Take a look at the “word clouds” below and maybe this will help you visualize the frustration.
Let's say that the sentence I want to say is “When I was at the store, the cashier told me that my credit card balance had exceeded the allowed limit”.
So above you can see the vocabulary used to spell this sentence out. With cog-fog it's a little like trying to speak this sentence with part of your vocabulary missing. So now try to express that same sentence using only the words in this second cloud below and other words to try to substitute for the missing ones.
Tough and frustrating isn't it? And even if you did solve this issue with ease remember, you had to stop and think about it which makes you pause in the middle of a conversation plus, most the time half the words you are trying to find as a substitute for your missing vocabulary are missing from your vocabulary as well so not only can you not remember the word you are looking for but you can't remember the next best word to describe that word! ARG!
Now as a writer I experience a lot of weird things here and there that most people may not ever notice but because I encounter them so often they have become a huge issue for me. When you speak you can hear your mistakes s you make them but when you write you are only thinking about what you want to say and have no way to confirm if you said it properly until you look back and read what you wrote. My days of writing a final draft essay from start to finish without the use of a rough draft are far gone.
Right now one of my biggest issues when it comes to written communication is that I leave out all the suffixes to words even when I am consciously thinking about trying to not make that mistake. So if I thought I wrote “flooded” I would read back my sentence and notice that I wrote “flood”. All the “ed's”, “er's”, “s'”, everything, they are all missing so when I am done writing an article I have to go back and add them all in at the end.
My second issue is that I replace similar words with each other. A common example is when I want to write something like “An elephant is in the room” I will replace “an” with “and” so it reads “And elephant is in the room”. “Or” with “to”, “miss” with “mix”, even “cat” with “car”. So when I am going back over my writings adding suffixes to empty words I also have to replace all the mistaken words like “conscious” with “cautious” you know? I also make many weird grammar mistakes that I never used to make as far as using the wrong words goes but I can't think of any examples at the moment but trust me, I have said some weird things and those of you who are my friend on Facebook probably notice this all the time as I spend less time proofreading while in the middle of a chat.
Recognizing Objects and Routines
This is not a constant issue for me but this happens every once in a while and leaves me standing there thinking “wow, really?”. So sometimes for a split moment in time my brain will not recognize basic, everyday, objects or I will mix them up. For example, countless times I have entered the bathroom with the intention of brushing my teeth but rather then grabbing my toothbrush I will grab a shaving razor and begin applying toothpaste before realizing “wait a minute, this is not right...”
Not sure what to categorize this with but it feels like a recognition issue so this is where I am listing it. There are also times where I will just forget the simple order of life. I will put the milk in the pantry rather then the refrigerator and the cereal box in the refrigerator instead of the pantry. I have even taken the trash from the kitchen to my bedroom before once again realizing “this is not right, it goes outside!”.
And More To Come As Always!
So that is a bit of what I have to deal with on a regular basis but since I have memory issues I guarantee you I left something out! Consider this the tip of the iceberg! So does the term “cognitive fog” make sense now? Dealing with all these tiny issues in real time slows you down and makes you feel slow up in the head. It feels as though you are walking through a room full of fog, your slow and disoriented and things just feel off somehow. Sometimes you can laugh about it and sometimes that one little thing happens that just sets you off the edge and makes you want to collapse into tears because you can no longer control who you are inside your body, the one place you thought you were safe from Multiple Sclerosis, your mind.
If your experiencing cognitive issues the best thing you can do is try to stimulate your brain so that it continues to create new pathways. Play games that are based on puzzles, do word searches, crossword puzzles, read, write, download challenging games on your phone or iPod, anything that makes you think. Your brain is a muscle and needs to be exercised just the same! Sure there are medicatio0ns that can help with certain aspects but just like there are pills to help you gain weight you should try to do some of the work manually on your own, just works better that way.
I would very much like to write a “Part 2” to this article because I know I am leaving a lot out and I know that you all will have lots to share. Please share your experiences with cog-fog below in the comments whether it is a symptom, a funny story, or a frustrating story. I am also interested in hearing about any medications you might be taking to help with these issues or any medications you have heard of that sound like they may help. If you don't want me to mention your name when I quote you in my next article just post as “anonymous” or simply state that you would like me to leave your name out.
I look forward to your responses! I hope that all is well out there!