Brain Power

I think one of the most overlooked aspects of MS is the cognitive challenges. Everyone wants to talk about mobility limitations, physical symptoms, medication, you name it, but somehow our brain power often gets left behind despite MS being a disease that is essentially targeting exactly that: your brain. Looking back I think cognitive issues were one of my first symptoms or red flags. I was always your stereotypical bookworm/grade-obsessed, straight-A student through high school and mostly throughout college. I could remember my entire academic to-do list of studying and assignments along with all of my extracurricular and social activities without ever cracking open a planner or organizer. I studied well, but didn't need to study much because I was fortunate enough to have a great memory for things in the academic realm. I could remember the names of people I had met only briefly or years prior; I could remember exactly what I wore on any given day of the week and could describe to you in detail conversations or memories from relatively meaningless experiences that most wouldn't find memorable. I learned well and remembered easily; using my brain was a breeze. 

Now obviously grad school ain't easy, but I really started noticing a difference in my memory during my second year. I found myself completely reliant on my planner and phone reminders as I couldn't seem to keep my assignments straight. Studying suddenly became all the more important and challenging as I couldn't seem to get information to stick quite like I used to. I knew at this point I didn't have age to blame at only 23, but I wasn't having any other symptoms at this point so I blamed stress or just being overworked. The decline was anything from subtle to me, but I didn't tell many people about it because I didn't know if it was really anything to be concerned about. I guess I should have probably known better though considering how sharply my "brain power" decreased. While grad school is obviously going to be more challenging and rigorous than undergrad or high school, I wasn't excelling at the level I once had. Projects and papers were still a breeze because those were about time management and effort; tests on the other hand became a struggle for the first time in my life. It was beyond frustrating. (It did, however, give me a new appreciation for the challenges faced by people who aren't your standard, public school-style learners. For those of you with nontraditional learning styles or learning disabilities, hats off to you for pushing through a system that isn't built for your brains because I now have a slight understanding how hard that must be.)

For a disease that goes after your brain, I feel like the non-medical MS community doesn't talk about our brains nearly enough. MS can come in and swipe your memory, impede your ability to think on your feet, damage your critical thinking skills, and just generally put you into a seemingly never-ending "cog fog." As with all things multiple sclerosis, these symptoms are different for everyone. Some people don't experience or notice them hardly at all, while others feel like their whole lives have changed due to cognitive symptoms. No matter where you fall on the spectrum, when the symptoms do arise they are endlessly frustrating. One of my biggest annoyances is with word finding; I spent an entire day once completely distracted by the need to figure out what the word I was looking for was. It felt like I couldn't move on until I experienced the satisfaction of finding the needed word in my brain. (It was "degenerates" - don't ask why that's what I needed, but after recruiting my husband to help me get there, we found it!) I also have lost the ability to remember peoples' names like I once could. My mom tells a story that when I was in kindergarten, within my first two days I could tell her the first and last name of everyone in my class. My fashion-loving days started early too, as I could also report to her precisely what everyone had worn each day. Now if I met you, I very likely would have forgotten your name within five minutes and prayed that I heard someone call out to you by name so that I could be reminded of it. Then I'd go home and your name would likely disappear into the MS black hole of my brain once again. The MS cog fog, no matter how exactly it may besiege you, feels a lot like that memory-erasing tool they use in Men in Black; you have a thought that's right on the tip of your tongue and then - FLASH - it's gone. 

As frustrating as it is to experience (and get others to understand) the cognitive symptoms of MS, it's so incredibly important to remember that when it comes to your brain, it's use it or lose it. I shied away from cognitive exercises and challenges for a long time after my diagnosis because I was afraid to fail at them or be stressed out by not being any good at them. Turns out, taking on those challenges can have the complete opposite effect. In my recent work training I had to take on numerous tasks that were incredibly intense as far as critical thinking and thinking on your feet; while it was a little intimidating to know I was up against my first really major cognitive challenges since my diagnosis, it was even more validating to complete them and most of the time do just fine. Turns out even though MS may cause you to have to work a little harder, that hard work piece is one that it can't take from you. Research has shown and is continuing to show that making your brain work helps preserve its abilities. Specifically with MS, doctors are praising cognitive games and activities more and more as resources to help you combat the cognitive challenges of this disease. Not only can challenging your brain and using it prevent further decay of your cognitive skills, but it can actually help to improve and restore them! If that's not great news I don't know what is. 

Fortunately my job forces me to use my brain pretty intensely most of the time - some days far more than I'd like to quite frankly. But for those of you who don't feel that way about your jobs, or who just want a more fun way to work those brain cells (can't say that I blame you) there are so many options out there; between the internet and phone apps you can quite literally get a brain workout any time any place. My personal favorite is Lumosity. This app gives you a daily workout of a handful of cognitive games that all work different parts of your brain. They're quick to play but definitely get you thinking; they even track your progress to give you updates on how you're doing, what types of activities you're best at or should focus more on, and the app gives you the option of doing extra add-on activities each day if you so choose. It's also completely free to use the basic option; I opt in to the premium subscription ($11.99 a month) simply because it provides more activities and better progress tracking which I find useful. Other apps I keep on my phone for waking up my brain from time to time include crossword puzzle apps, Wordscramble, Sudoku, and Two Dots. (Warning: Two Dots is incredibly addicting and should you recruit your spouse to also play, it may get incredibly competitive and  you both may get to level 1660. Not that I know from experience or anything...) The point is, there is a lengthy list of ways to work that brain of yours; tools are in your phone, online, or if you like to do things old school, they're even available in hardcopy activity books. As important as it is to focus on things like getting exercises, fitting in enough sleep, eating well, and staying on top of your medications, it is just as important, if not more important, to work that brain of yours. If I've learned anything the last few months it's that the more you let yourself be challenged, the more your brain will be up for challenges moving forward. So instead of just being frustrated with your brain and all its lesions like this...

...put that brain to work and make it earn its keep! While it's really hard to find physical workouts that are genuinely fun, it's pretty easy to find fun ways to work out your brain. So give it a shot - download Lumosity, pull out your old Sudoku book, go to grandma's house and do a puzzle, just do something to get those brain cells fired up. For those of you who have found cognitive games or exercise you find helpful or enjoy, I'd love to hear about them in the comments! 

Let's be honest, this was too cute of a gif not to use

None of us want to need tattoos to remember things Leonard Shelby-style, so do the work! (If you don't understand that reference you need to track down Memento for your next movie night.)