I’ve spoken about PAIN, I’ve spoken about FATIGUE, now its time to speak about ‘COG FOG‘
“Cog Fog” is a term generally used to describe the confusion, disorientation, general grogginess, and other issues resulting from cognitive dysfunction which commonly occurs with MS.
ability to use and understand language
recognition of people and places
ability to learn and remember new things
ability to plan and execute plans
ability to judge distances
Have you ever found yourself in a situation that requires you to use a massive amount of brain power.
Counting… do you save your spare change in a money-box?
Remember those days when we had to count our own coins, before the days of taking it to a machine that counts it for you but only gives you a percentage of what you actually put in!
You want to treat yourself to something really nice but you have to count all those coins yourself before you know if you have enough money!
How about a flat pack piece of furniture that requires assembling, how are you at putting those together? I used to be brilliant!
What ever you find challenges your brain, keep that in mind.
Now imagine you are trying to do that task but you have some very bored children around you that are constantly trying to get your attention, you can’t take your mind off the job in hand but they are so distracting!
Ok, now imagine you’re in a really noisey environment! Lets say a pub & England are playing in the world cup, plus the job your trying to do and the board children that won’t stop nagging.
Someone shouts your name but you can’t stop! You know that as soon as you take your attention away from your task, you’ll forget where you got to & will have to start again!
They keep shouting you, the crowd in the pub are so noisy you can’t hear yourself think. The children are nagging, you start to lose your focus! It won’t stop though! You can’t stop, kids nagging, someone shouting you. You rub your eyes, your heads going fuzzy! England score! What were you doing? Did your head explode!
Now times this by 10 & your half way there to feeling what its like to have MS ‘COG FOG‘ or what I occasionally call a ‘BRAIN FART’
Don’t forget that whilst all the above is happening, you also have that pain I spoke about & the fatigue!
Both of those can make the ‘COG FOG’ worse. So the more pain I am in & the worse my fatigue is then the my ‘COG FOG’ is heightened!
I might forget where I am,
I might forget the way I am going even though I’m in a corridor with only one way out! (Yes that has actually happened)
I might forget your name,
I will probably forget what I am talking about & in so many occasions I actually just stop talking!
You’ll see me just stop talking mid sentence & look at you blankly as though I’m waiting for you to say some something!
This is Cog-Fog!
Cognition and cognitive symptoms
About half of all people with multiple sclerosis have some degree of problem at some time with aspects of thinking – memory, attention span or concentration. Cognition is the term that covers all aspects of thinking and these symptoms are referred to as cognitive problems.
For most people the symptoms are relatively mild and like other symptoms can fluctuate from day-to-day, worsen during relapse and improve during remission.
As with physical symptoms, not all people with MS will experience all of these problems. Cognitive problems can be made worse by some medications, including those used to treat pain and depression.
Many people may not recognise cognitive symptoms as an aspect of their MS and they can arise early in the course of the condition although the greater the disease duration and severity the more likely problems are to occur.
Whilst frightening, cognitive changes are generally mild and management strategies can provide effective methods of lessening if not eliminating the functional effects.
Many people with MS report that their memory is not as good as previously. Memory difficulties are primarily related to the recall of recent events or information and forgetting to carry out planned actions in the future. Both these situations lend themselves well to using systems to record information and to act as reminders or prompts, eg diaries, notice boards or mobile phones.
This problem is described as experiencing difficulties with being able to follow a series of complex, instructions, especially if the information is given rapidly.
This may arise as the result of an individual being so agitated and anxious about a task, that they are unable to mentally structure their thoughts to instigate a series of separate actions. Consciously breaking down a task into simpler steps or stages can allow progress.
Also called ‘tip of the tongue’ phenomenon, this is a recall problem rather than the loss of memory for that word.
This tends to occur when a lot of information is being delivered to a person at once and only some is relevant, for example where several people are talking at once.
Management of cognitive symptom
Management of cognitive symptoms often involves finding strategies to minimise the effects of symptoms, and sometimes a retraining approach whereby progressively more challenging exercises are given to strengthen impaired function. Management often involves psychologists, speech and language therapists and occupational therapists.
Compensatory strategies that might be used include:
- establishing a fixed routine, eg always keeping things in the same place
- using a large page-to-a-day diary and developing the habit of consulting it
- prioritising tasks to do only one thing at a time and removing distractions (background noise, TV, etc.)
- using technology as a memory prompt eg dictaphones or mobile phones
- avoiding jobs which need concentration when fatigued or anxious