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I mentioned in an earlier post that the last time I met with my neurologist I discussed with him my concern about my memory. I felt it was getting worse and I found myself feeling overwhelmed an increasing amount of time when I was trying to bring back information or switch from one topic to another with different people. My neurologist felt it was appropriate for me to have a test of my cognition and then discuss the results with the neuropsychologist in their practice.
The testing was very interesting and it was obvious it was covering the areas that people with MS could have problems with and eliminating other conditions that could affect memory. I then had a very good meeting with the Neuropsychologist who went over my test results with me and gave me a lot of very good information and some practical ideas that I could put into practice to help myself with my cognitive problems.
He emphasized that it was not my memory that was the problem it was retrieval of the information. And this was because the original learning and imbedding of the information in my brain was most likely faulty. He explained that unfortunately it takes people with MS longer to process information due to loss of myelin covering the nerves. Therefore it takes longer to imbed it . For example if you are reading or learning something and then you immediately go on to something else you basically may not have given your brain (which has become slow due to damaged myelin sheath) time to imbed that material. So when you try to retrieve it(remember) you can have a problem with it as you either haven't stored it well or not at all.
So I take that to mean my pushing through reading a book, magazine or news article to a point where I?m not even able to process the new information well is pointless. Not only does it not do any good for the current information but I will not have remembered what I had read earlier because my brain was most likely unable to finish processing that before I pushed myself to move on.
I?m going to start thinking of how I?m going to change this.
He also talked about how the brain is always processing information even when you?re not aware of it. For example: I mentioned how glare bothers me and I was embarrassed to admit that I had lost 3 pair of anti-glare glasses. He responded by using that as an example of how my brain would be working hard to try to cut back on the glare so I could function better and that in itself can be exhausting. And yes I was less tired and sharper when I was wearing the anti glare glasses over my prescription sunglasses. He also reminded me that inside there is also glare like fluorescent lights, computer screens etc.
The glare situation also brought up the fact that no matter what you?re doing the brain is active. Just sitting doing nothing it?s taking in all the sensory input. But then when you start to concentrate on a task at hand your brain doesn't turn off all the stimuli like noise or glare etc. you have to focus over it. People with MS can find this difficult I know that I do. My husband can listen to television or music while he's reading or working I can't. I can only do one thing at a time except occasionally when I'm good but it's becoming less so.
It was then explained to me that the ability to do multitasking usually starts to decrease slowly when a person is their 30's. But for people with MS the loss of the ability to do multitasking is much quicker.
For example when I go out to an event with a lot of noise from people talking like a cocktail party or even a busy restaurant when the noise level goes up and I'm trying to remember (retrieve) what I want to say to be part of the conversation it just seems everyone is talking too fast for me. And if there's glare or bright lights it's impossible. That's when I know I must pull back or I'll be overwhelmed.
But that can also happen to me at home when people are giving me fast directions for the computer or everyone jumps in to help me with different ideas. Then I don't remember what they told me an hour or the day before. I feel stupid and they are annoyed. They tend to think that I just wasn't paying attention to what they were saying.
But the visit with the Neuropsychologist confirmed to me that it wasn't that I wasn't paying attention but that my brain did not have enough time to find the right pathways. As he explained to me poorly myelinated nerves carry their signals very slowly. And on top of that it may require the message to go around " pot holes "of demylinated nerves to search for those that can carry the messages to the right places to implant them.
Another example of cognitive progressive trouble for me over the years is visiting a museum. This is something which I have always loved to do. But over the years it has been more and more of an effort to be able to go from painting to painting without being so terribly exhausted I can't even think. So for me it's now small museums or limited viewing with breaks in moderate ones.
We've recently went to an exhibit at the Clark Museum of Picasso and Degas art works. It was a wonderful exhibit but it was very crowded so you couldn't really go through very fast . However it was relatively quiet and there was no glare from the lighting. So as I waited in the lines I could rest my eyes and let my brain process the images and information at it's own pace. I did not view the exhibit as intensely as I was once would have . Also I was too tired to visit the other exhibits in the museum. However it was a good visit and a good learning experience of doing things slowly giving one time to process material.
For more information there are many sources on the Internet that also explain the difficulty with MS and the speed of cognitive processing. One example is: http://thjuland.tripod.com/processing-speed.html
The National MS Society also has a lot of material on cognitive difficulties and ways to help remedy them. Check them out at :http://www.nationalmssociety.org/search-results/index.aspx?q=cognition&x=23&y=8&start=0&num=20
I am hoping that the new drug Ampyra will have the same positive effect on my cognition as it does on my walking. I'll report back on this in a future blog. Meanwhile if your able to have a thorough neuropsychological test do it. It's true "Knowledge is Power".
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