Brain Fog and MS

Mark Twain once said, “If you tell the truth, you don’t have to remember anything.” 

 I'm sorry, but that is not how things work in my world, dear Mr. Twain. To put it another way, you are aware that specific knowledge resides somewhere in your brain. It simply takes a few diversions in order to function, make decisions, and extract information, so the information frequently comes to you later than you had anticipated. 

So, if you have MS, you more than likely either experienced it, or forgot you once had it. 


Yes, I am referring to "brain fog," and just like you, I frequently experience hazy thinking that borders on being a problem. It can result in amusing circumstances, hazardous circumstances, and circumstances you want to explain to individuals whose thinking is unaffected by MS-related cog fog, but you can’t find the way to do so. 

According to research, more than half of MS patients will develop changes in cognition. These include losing your train of thought, having trouble concentrating, confusion, difficulty making decisions, understanding and processing information, and suddenly forgetting the name of a friend you've known for years. The list is seemingly endless because, of course, you can't even remember what you forgot.  

People who don't have cognitive problems will admit that forget stuff too. This is where I start to get a little irritated because A) I am aware that everyone forgets stuff and B) People are quick to tell others to "stop being so dramatic or moaning."

The difference between them and us lies in terms of severity. I went to Beaumont for a neurological examination a couple of years after my diagnosis. As I waited, someone sat down next to me, so I nodded as a way of saying hello. When she asked me how I was doing, I said, "I'm OK, marching on as always." 

Trying to overcome my initial awkwardness when meeting new people, I found myself feeling more and more in the grip of shame and idiocy while thinking, “Who are you and where do I know you from?” 

Since I am currently writing this piece and can't recall the person's name, I will just refer to her as Sophia (ancient Greek for "wisdom," which is a perfect moniker for this work). 

“I'm Sophia, she said. I shuffled in my seat and kept quiet until Sophia stated, "I'm an MS nurse." The confusion on my face must have alerted her, and Sophia remarked, "I was your MS nurse when you were first diagnosed." I responded, "Oh yes, of course," like a tomato-red fool who suddenly lost her bearings. 

Evidently not, as it turned out. 

I came to your house numerous times to teach you how to self-inject and to chat a little about your MS, she said. I suddenly realised who Sophia was right then and if you describe impairments as beginning at their absolute worst, to say that was the low point of my day would be an understatement. 

This was a brain fog extravaganza. That afternoon, I worried as I went home because if this is what MS is capable of, I will continue to worry about the future of my memories. And not long after that, when a friend asked me to be a witness at his wedding, I would stumble in a similar but more terrifying way.  

My mother's face changed colour and shape when I expressed my pride at being someone's witness for the first time. “You don't recall being your brother's witness at his wedding 10 years ago?she asked. "Nope, was it any good?" I replied, in an effort to calm her disbelief. Photos proved that indeed, I had been, and that MS-related cognitive deficits are no laughing matter. 

When a neuropsychologist tested my seemingly wilting grey cells, he said that not all was lost, as my issue is related to cues being needed to be able to search and bring up information. I have since developed prospective memory impairment as well, an inability in remembering to carry out a planned action at a certain time in the future, but that is fodder for a future post. 

Cog fog is not just about memories, as it also refers to thinking. It includes explaining how you're feeling, taking longer to find the proper words, being disoriented, and more. 

As you can tell, there are numerous ways your inflamed, shrinking, brain tries to screw up your otherwise brilliantly formed brain. All of us have heard of transplants, but there is currently no replacement therapy for your brain, thus it is up to you to take the best possible care of it. 

One of the ways I deal with my daily cog fog issues is by not overthinking them. I do this by using quips like the one I just used, “not overthinking” a cog issue, or by using the moniker Sophia, which is Greek for “wisdom”. 

Intellectual stimulation, such as solving crossword puzzles, studying psychology, reading non-fiction books, and watching documentaries on TV, is a more practical way to try to address my cognitive impairments. Eating good meals (particularly fish) and leaving the house to walk my dog are two other modifiable strategies that could enhance brain function. As long as it improves your life, you can make the list as long or short as you wish. 

Do everything you can to make the most of that beautiful brain!  


Useful resources:

Brain Fog is one of the topics that will be discussed at MS Ireland’s upcoming National Conference. Learn more here. 

Read about MS and how it can impact memory and thinking here.