Tuesday, August 11, 2009

Coping with chemo brain

Last week, Jane Brody of the New York Times explored new scientific findings about chemo brain, the foggy thinking and forgetfulness that afflicts many cancer patients after treatment. Today,  she offered advice for patients in "Taking Steps to Cope With Chemo Brain."

"Nearly every chemotherapy patient experiences short-term problems with memory and concentration. But about 15 percent suffer prolonged effects of what is known medically as chemotherapy-induced cognitive impairment," she wrote last week. "The symptoms are remarkably consistent: a mental fogginess that may include problems with memory, word retrieval, concentration, processing numbers, following instructions, multitasking and setting priorities."

In today's story, her suggestions about coping including making lists and doing one thing at a time instead of multi-tasking as in the past.

Sometimes I experience that fogginess myself. The kids tell me, "You just asked the same question" or "You told us that three times." In general I'm pretty high-functioning, as they say, but I have lapses. Sometimes I just shrug and say, "Chemo brain, sorry." Or, sometimes I say, "I know I've asked you five times in a row. If I hadn't asked you 10 times over the past two weeks or so, maybe I wouldn't repeat myself!"

The question is: Can you attribute these things  to chemo brain, or are they a sign of aging, or just a quirky personality trait, or perhaps the kind  thing  that happen to most people on and off? (Once before cancer, after writing a story about early Alzheimer's, I diagnosed myself with it, but let's not go there.

The kids' list of slightly dopey Momisms predates cancer, leading of course to the question of why they make fun of me, but let's just assume it's because they find me so endearing. One of their favorites came out of my mouth when I was giving one of many lectures about never let a drunk person drive you home, always call me, I will not lecture, etc. etc. It came out, "Never get in a car with anyone who drives!"

The other day, I asked Joe to move a soda can off a wood table, "before the moisture vaporizes."

"Did you mean condense?" he asked. The word had escaped me. "Whatever, you get the idea," I said. (As in, "Give me a break. Just move the bleepin' can!"

Before cancer, I got lost while driving, even sometimes, I'm sorry to admit, when dropping one of them at a friend's house where I had been many times. Today I space out sometimes too. So what else is new?

In any case, if you think you suffer from chemo brain, you might want to check out Brody's suggestions. One of my favorites is making lists. I keep a pad near my bed and write down the names of people to call and things to do.

It's actually something I've done for a while, again, even before cancer. Occasionally I wake up at night, turn on the light and write something down. Sometimes in the morning, I can't understand exactly what I wrote. And of course just because you write something down, doesn't mean you'll do it. But it takes the pressure off your mind from worrying that you're forgetting something. At least you see the list in front of you and the you can go from there.


Susan C said...

A good friend of mine, Idelle Davidson, co-wrote the book Your Brain After Chemo that Jane Brody references in both articles.

I finished it on vacation, and, even though I'm "high functioning," I got a lot out of it. She addresses all the other factors that can exacerbate or resemble or coexist chemo brain - declining estrogen, age, stress.

I have definitely cut back on multi-tasking. I become too distracted and make too many mistakes.

Lauren said...

I've been on chemo for a few months (I was diagnosed with Hodgkin's in May and have been blogging about it since then) and I'm already feeling a little bit of the chemo brain... I keep asking my mom and brothers the same things over and over again, or putting my keys down and immediately forgetting where they are!

good luck with the chemo brain!


Trish said...

that moment, like your "moisture evaporates" moment, are tough. You know you know the word, you just cannot access it. I was talking to a client the other day and just totally blanked on the word telescope. I got stuck on microscope---close, but two VERY different things.I think I sputtered out something like "you know, the planet viewer".

Am sure all the things Susan mentions don't help, but it sure can be confounding when you are trying to have a conversation.

I do have the t-shirt---"I have CHEMO BRAIN---what's YOUR excuse?" and wear it on days when I struggle a bit. It was a great hit in the infusion room!

Ann said...

I'm right there with you in the word retrieval department. I can coherently form the thought and put together the sentence, but when the time comes to utter it, poof! There are days when a 30 second utterance becomes a 10 minute description of what I really want to say. It's disheartening and a little scary at times, but I refuse to let it stop me. I'll tell you the same thing a good friend told me, you're plenty smart enough. :)

Marilyn said...

I'm the SPOUSE of the person who's had chemo and have to claim "chemo brain" a lot these days. We laugh about it, but it's true. All that's involved in the whirlwind of diagnosis and treatment and the ups-and-downs of facing check-ups and wondering whether to make plans for a month from now, etc. has an effect on more than just the patient.

S. F. Heron said...

I'm still suffering from chemo brain 8 months after finishing chemo.

My husband has become extremely adept at finishing my sentences. He's got great ability to define what a "hoogie, whatjig, or doohickey" is - I used these words so much my children are using them now.

It's such a real part of treatment and recovery.

My oncologist told me I need to cut the impulses and do things slowly. Don't rush, try to think things out first. This helps control the mental stumbling, almost like doing a puzzle. It has helped immensely with my writing. Where before I'd bang out an article, now I outline what I'm writing about to mentally organize my thoughts.

The only problem is that mom's need to think on their feet constantly with kids :)

Nelle said...

I remember when my son was so frustrated having been in the gifted program and then found so many simple words blocked and confused at times. Noone had even mentioned this possibility. I will have to get him the book referenced. I had radiation not chemo to my head, but I experience some similar things. I have been driving and literally had to pull of the road not sure where I was. After a few minutes I realized and was on my way. I use variations of words at times which I now refer to as "Nellisms". I laugh with them when they laugh but it is embarassing when I do this at work. I once said InterNUT instead of internet and found a huge drawing of a nut with a modem attached from a coworker. I now display this on my fridge. Laughter is the best medicine.
Second best is sharing stories and information with people who "get you." Understood. :)

PJ said...

I wish I could think of some of my wittier chemo-brainisms but they've slipped my mind.

pam said...

Dearest Ronni,
i've never had chemo as an excuse for my absentmindedness for many years now...Where are my reading glasses? (i've become my English aunt of years ago!), where are the keys? why did i just open the fridge door? i like to think it's just being preoccupied, the proverbial professor, but i don';t think so!
i've also started writing down the incredibly stupid things i say, -- at least you have kids who adore you, i embarass myself in front of a classroom! but do comment on it...i can remember lines of poetry...and never forget all the dogs of long-ago, names and images...and not just mine, Simon, Winnie, MistyLee, even Sam...!

but appointments? whereabouts of keys? did i take my pills?, etc.

here';s a classic from about fifteen years ago -- so age is no excuse, at least back then...
i asked my psychiatrist friend Bruce, whom you met, what the word was for when you can't remember a word!?!!
no kidding, by the way, it's aphasia, ancient greek always helps elucidate!

Dennis Pyritz, RN said...

Great Post! I am going to republish it tomorrow, Wednesday 2 September, as one of two posts by leukemia survivors as this week's featured Guest Posts at www.beingcancer.net. I will include two links to your site as well as a link to the original post. You may see a rise in traffic as this is a popular feature.
Take care, Dennis