One of the first and most bothersome features of cognition, is that no one, aside from yourself, knows exactly how you think; how your thought process works. They can show in what area of the brain thought takes place; they can pretty much list the chemicals that assist in the process, however they do not know your brain in particular. What I am trying, (and failing miserably at), to explain is that we know personally how hard we have to work on any and every aspect of our thought process. For instance: if I asked you what 1+1 was, you would instanly say 2. Now if I asked you what pi was, or what it is out to 100 digits, well even I myself cannot do either, but if I had to it would take a lot of work and thought. Meaning the time for me to answer some questions are easy, while others take a bit of time; NORMALLY. Now when MS get's in the way, (and this can be a permanent condition, or something due to fatigue) 1+1 can take a second or two. Still, most people would not notice the change and so would find it hard to believe you when you say you're having trouble with cognition. So what do you do when that happens? The very first thing you need not to do, is get angry or frustraited. When you do, you lose control of the situation. No, what you need to do first, even before reporting the problem, is calmly evaluate yourself. Sit quietly and see if you are more tired than usual. Then take a look at what is going on right then and ask if your stress level is up. Another thing to check is how hard are you pushing your brain to get back to what you see as normal? Based on these answers, you can almost see the solution. Slow down your thought process to the point where you are thinking in a more deliberate manner, meaning you are considering your answers. Also, break up a thought into smaller parts. Cognition is messing me up right now, so I am 'chipping away' at what I want to say. I also had to ask my wife to hold her questions and usual fussing until I am done typping. This reduced the amount of distractions, and made it easier to concentrait on what I had to say. Anyway, I hope you get the how to process. You also store what you are doing thought wise, away as information you will share with your doctor the next time you see them.

Now then, I am going to stop here and post as I have several other things that need my attention here, and guys we all know what happens when you put your wife on hold for too long.

MSDave

Hi Dave, good to have you here, and thanks for the info.

I don't have a severe cognition problem (yet) but I do have some serious memory issues, which for more than a year I complained to doctors about. They'd give me a brief standard test , like remembering a short list of things, which they would then ask me to recall 10 minutes later. Only thing was that kind of thing wasn't my problem. My problem was remembering the name of a coworker I'd worked with for 3 years, while I was face to face talking to them!

I think that's sort of the thing you're talking about here. No one really understands how your mind works or what your strengths are, so if there is a change, it isn't always obvious to others. (Am I close?)

The name and word memory is bad enough, cause I get corrected all the time when I use the wrong word--like call the chair a table. I know I just need to klearn to laugh about it, but it's hard to laugh when MS is doing weird things to your brain!

I think of all the little stuff I have to deal with from one day to the next, the stuff happening in my brain is absolutely the scariest!

Cognition, am I supposed to have some of that?

Dan, I think one of the things you are really having problems with is your critical thinking. That was the main thing that made me quit nursing. I have problems enough trying to figure out the sequence of how to put something in a mixing bowl much less the sequence of CPR!

Fatigue is much easier to deal with than my cognitive deficits.

Dave how long have you been DXed? That too can play apart of what we call cogfog here at NT, the stress can interfere with the neurons firing with cog issues, and if this is your first year of surprise you got MS bs, the first one to two years tend to be the toughest, adjusting and adapting, can get a bit perplexing at times.

I hope its just a stress related cogofg, but as times goes on I still see my own cogfog issues, names and what i said puff its gone in two days, things from child hood are still there and my numbers i am still good with . 3.14 should be the Pi number if my brain remembers from math class eons ago. Try to take it slow one day at a time and don't forget you have NT to help you ease and guide you in any way we all can,

wasnt it Pi times the radius told you the circumference of a circle

again welcome to NT Dave

"I don't have a severe cognition problem (yet) but I do have some serious memory issues, which for more than a year I complained to doctors about. They'd give me a brief standard test , like remembering a short list of things, which they would then ask me to recall 10 minutes later. Only thing was that kind of thing wasn't my problem. My problem was remembering the name of a coworker I'd worked with for 3 years, while I was face to face talking to them!"

A few things here... I know that test myself and didn't used to do too well with it, however I figured out a way to beat it for me; still.... that test only evaluates short term memory. Secondly, yours is the great example of the communication problem between doctor and patient. The doc has their own targeted adgenda and most of what you say is ignored or blown off if it does'nt support the doctors postition. In these cases, like you did, you just need to keep hammering until they see what you're telling them, and understand that it IS a big deal.

"I think that's sort of the thing you're talking about here. No one really understands how your mind works or what your strengths are, so if there is a change, it isn't always obvious to others. (Am I close?)"

Spot on! You are right, 'they' do not know you like you do. Again, this is where getting right to YOUR point, and staying there until 'they' understand, is so important. Spending time in thought about what you want to say, before your appointment can help greatly here. Remember that most doctors like an appointment to go no more than 30 minutes, minus any labs or special testing, so try to fit what you want to say, inside of that time frame.

"The name and word memory is bad enough, cause I get corrected all the time when I use the wrong word--like call the chair a table. I know I just need to learn to laugh about it, but it's hard to laugh when MS is doing weird things to your brain!"

Yeah, I wish I could say that it will pass, but everyone on this board would know I was lying. Still, there are things you can do to help yourself. Try to automate as much of your day as possible, meaning as much as possible do things that you need to do daily, at the same time and way each day. They get to be a habit and you can then do them without thinking about them. Try keeping a notebook with you and figure out a type of short hand that will work for you, and allow you to take notes when and where needed.

"I think of all the little stuff I have to deal with from one day to the next, the stuff happening in my brain is absolutely the scariest!"

Thie one both frustraits and scares me bigtime. There was a time in the Army, where I would be talking on 6 different radios, AND talking to my troops in person, AND figuring out our next move in combat mode, all at one time! I did that as easy as breathing too. Now I'm lucky if I can handle on conversation for longer than 20 minutes.

MSDave

"how long have you been DXed?"
I was diagnosed 2 January 96. Happy New Year!!!

"That too can play apart of what we call cogfog here at NT,"
I call it being a "plaque head" and usually tell people when I can't remember something, "a plaque is between me and the answer."

"the stress can interfere with the neurons firing with cog issues,"
EXACTLY! To combat this, I say make a joke out of the situation, relax a little and when you're not expecting it, it will come to you.

"and if this is your first year of surprise you got MS bs, the first one to two years tend to be the toughest, adjusting and adapting, can get a bit perplexing at times."
Again, not my first year, but your point is well worth repeating a few times.

"I hope its just a stress related cogofg, but as times goes on I still see my own cogfog issues, names and what i said puff its gone in two days, things from child hood are still there and my numbers i am still good with . 3.14 should be the Pi number if my brain remembers from math class eons ago. Try to take it slow one day at a time and don't forget you have NT to help you ease and guide you in any way we all can,"
Oh, I see now... I was simply using an experience I have already gone through as an example to help me make my point. I often times will do this when I am bringing information to the table. Using myself as the example, I do not hurt anyones feelings, insult anyone, or invade their privacy. I am sorry if I mislead you or anyone here. I'll have to watch that in the future. I just couldn't figure how to post an idea without doing it like that, and just held my breath and dove in.

"wasnt it Pi times the radius told you the circumference of a circle"
Yes, I think you are right.

"again welcome to NT Dave"

(doing my best Elvis impression.) "Thank you, thank you very much.

MSDave

Actually, I think it is pi x radius squared.

I can remember that, but can't remember what my boss called me on the intercom five minutes ago to ask me.

Actually, I have noticed my cognitive stuff fluctuates. I have had bad periods during a relapse and better times in between. I do notice that there is slowing that doesn't ever get better. I think I will always be slower and less able to multi-task now.

I'm about to do a new neuropsych eval to see if there was a lot of slipping in the last 3 years since I had the last one. I am forever using the wrong words and getting very confused these days.

I've had Ms for Ions, but haven't noticed any cogfog, of note. I'm retired though, and pretty much of a hermit, these days, so I don't have to tax my brain, too much, anymore..

I try to keep my brain active, by doing crossword puzzels and other brain games, online....Word Whomp an others at POGO.. I'm a retired Accountant and I can still play the numbers game, well. I've noticed some short term memory issues but, did I mention, that I'm OTD..

Thanks Dave, for your informative and helpful post..

It's funny. The two areas where I have the greatest difficulty as to cognition is mechanical manipulation, and math, where I have always been weak. I have always had a tendency to transpose digits in phone numbers, etc. As for mechanical manipulation I mean like trying to put things together, like kids toys, slide tab A into slot B and the like. I can do it, but it takes me a really long time. Luckily, this stuff is pretty easy for me to live without, although the mechanical stuff scares me sometimes. I worry that I'm going to forget really simple stuff like how to put ribbon in a typewriter or staples in a stapler one day. Thank goodness for the instructions for the truly stupid that come with them.

The other area where I have difficulty is in words. I had always had a facility for words, until now. I was the walking thesaurus and dictionary. Now I have trouble doing cross word puzzles because I can barely remember a simple word, let alone a substitute or definition, and my ability to spell, which used to be virtually flawless, has taken a turn for the worse. I can still punctuate, however. But as a lifelong secretary, this is all hard on the old ego.

Unfortunately, taking notes (which I do), writing memos (which I do) and setting reminders (of which I have numerous) does little to alleviate the issue of how to spell "adequate" or define "septic." I keep a dictionary and thesaurus handy and refer to them, and find myself depending on spellcheck like never before.

It will be cognition problems that drive me to retirement. I can only hope that like all my other sx these will continue to be relatively mild and come and go for some time. I'm hoping for another 20 years at least!

Boy did you hit the nail on the head there!

One of my biggest problems was the cog fog. I couldn't even explain it when it was happening because I couldn't find the words to explain it adequately! While I may have "looked fine", I wasn't and I knew it, regardless of what anyone else thought.

I had a near photographic memory before I started down the MS road. I could read a magazine from cover to cover and when questioned, could recall any article word for word. I never had to study for tests because once I read the material, I could pull it all back up at a moment's notice.

Now it's notes and reminders, calendars and memos, calculators and alerts on my laptop, reading and then re-reading, lists on top of lists and family members telling me stuff ten times. It frustrates them, but it frustrates me more. I've learned to live with what has been lost but I don't freakin' like it!

I've turned into that person at the grocery store who stops and peruses the list and examines every label and price, who stands at the checkout and writes down the check and uses the calculator to enter the balance after the check is written, who has to count the money in hand two or three times before handing it to the teller...

I've learned to be patient when others do this now, because I am them. I've learned to check every detail. I've learned to SLOW down and think much more carefully. I've learned that whether or not someone else thinks you should be acting more like your old self, it ain't there and you have to learn a new way to do what you always did with no effort in your previous life.

I've also learned the biggest lesson, that it CAN be done, that you can make up for deficits by doing things a different way instead of banging into the wall time after time, trying to do everything the way you always did it before!

Thanks for your post!