worried about work :( ...brain fog

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worried about work :( ...brain fog

Postby laura55 » Sat Oct 27, 2007 2:55 pm

Hi everyone,

I'm getting a bit worried about my job. I really really love it, its just I'm starting to make some mistakes which I know is cos this MS gives me what I call brain fog...I just can't work things out logically and I'm so worried I'll do something seriously wrong and get fired.

I can't talk to my manager or anything, what can they do? And also Id worry that they would make me change to a different position (which I don't want) or get rid of me on the basis that I can't do my job.

My work are pretty supportive when I;m well, but when I'm off work in a relapse its different and last time I felt my manager was trying to get me to admit I couldn't do it...like saying, so does stress bring on relapses? so do you find your job stressful? etc etc I'm sure you all know what I mean.

Anyways, can anyone suggest anything? I'm going to put a nintendo ds on my xmas list as they seem to have a good brain game which is supposed to exercise your brain, maybe that will help?

Thanks for any comments, Laura xx
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Postby jimmylegs » Sat Oct 27, 2007 4:14 pm

when i can't keep track of my thoughts i find that a few days taking ginkgo biloba gets me back on top of things. i don't know if my not being able to stay on track is the same as not being able to work things out logically though! i have also read that b12 is great for cognitive function so maybe boost your b-complex for a week or two and see if it gets you sorted out a bit? just ideas, hope you get it sorted out!
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Postby dignan » Sat Oct 27, 2007 7:14 pm

As jl said, Ginkgo could be a good idea. Also, a drug commonly prescribed for alzheimer's, donepezil (aka Aricept), can be helpful for MS patients. Some abstracts from Pubmed:


J Clin Psychopharmacol. 2000 Jun;20(3):350-6.

A 12-week, open trial of donepezil hydrochloride in patients with multiple sclerosis and associated cognitive impairments.

Greene YM, Tariot PN, Wishart H, Cox C, Holt CJ, Schwid S, Noviasky J.
Department of Psychiatry, University of Rochester Medical Center, New York, USA. ygreene@neotonus.com

Cognitive dysfunction occurs in up to 65% of patients with multiple sclerosis (MS), but there is no effective treatment for the symptoms. The authors conducted a 12-week, open-pilot study to assess the efficacy and tolerability of donepezil HCl administered in patients with MS and cognitive impairment. Seventeen patients at a long-term care facility with Mini-Mental State Examination scores of < or = 25 received 5 mg of donepezil HCl for a 4-week period, followed by 8 weeks of 10 mg of donepezil HCl. Cognitive, neurologic, functional, and behavioral assessments were conducted at baseline and at 4 and 12 weeks. Statistically significant improvement was observed in several cognitive domains including attention, memory, and executive functioning, as well as different aspects of behavior. These data suggest that donepezil HCl merits further study as a potentially viable treatment option for patients with cognitive impairment associated with MS.


Neurology. 2004 Nov 9;63(9):1579-85.

Donepezil improved memory in multiple sclerosis in a randomized clinical trial.

Krupp LB, Christodoulou C, Melville P, Scherl WF, MacAllister WS, Elkins LE.
Department of Neurology, State University of New York at Stony Brook, HSC T12-020, Stony Brook, NY 11794-8121, USA. lauren.krupp@stonybrook.edu

OBJECTIVE: To determine the effect of donepezil in treating memory and cognitive dysfunction in multiple sclerosis (MS).

METHODS: This single-center double-blind placebo-controlled clinical trial evaluated 69 MS patients with cognitive impairment who were randomly assigned to receive a 24-week treatment course of either donepezil (10 mg daily) or placebo. Patients underwent neuropsychological assessment at baseline and after 24 weeks of treatment. The primary outcome was change in verbal learning and memory on the Selective Reminding Test (SRT). Secondary outcomes included other tests of cognitive function, patient-reported change in memory, and clinician-reported impression of cognitive change.

RESULTS: Donepezil-treated patients showed significant improvement in memory performance on the SRT compared to placebo (p = 0.043). The benefit of donepezil remained significant after controlling for various covariates including age, Expanded Disability Status Scale, baseline SRT score, reading ability, MS subtype, and sex. Donepezil-treated patients did not show significant improvements on other cognitive tests, but were more than twice as likely to report memory improvement than those in the placebo group (p = 0.006). The clinician also reported cognitive improvement in almost twice as many donepezil vs placebo patients (p = 0.036). No serious adverse events related to study medication occurred, although more donepezil (34.3%) than placebo (8.8%) subjects reported unusual/abnormal dreams (p = 0.010).

CONCLUSIONS: Donepezil improved memory in MS patients with initial cognitive impairment in a single center clinical trial. A larger multicenter investigation of donepezil in MS is warranted in order to more definitively assess the efficacy of this intervention.


Mult Scler. 2007 Apr;13(3):376-85. Epub 2007 Jan 29.

Ginkgo biloba for the improvement of cognitive performance in multiple sclerosis: a randomized, placebo-controlled trial.

Lovera J, Bagert B, Smoot K, Morris CD, Frank R, Bogardus K, Wild K, Oken B, Whitham R, Bourdette D.
Department of Veterans Affairs Medical Center, Portland, OR, USA. loveraj@ohsu.edu

OBJECTIVES: To determine if Ginkgo biloba (GB) improves the cognitive performance of subjects with multiple sclerosis (MS).

METHODS: Randomized, double-blind, placebo-controlled trial of GB, 120 mg twice a day or placebo for 12 weeks. The primary outcomes were: the long delay free recall from the California Verbal Learning Test-II; the Paced Auditory Serial Addition Test; the Controlled Oral Word Association Test; the Symbol Digit Modalities Test; Useful Field of View Test; and the color-word interference condition from the Stroop Color and Word Test.

RESULTS: On completion, the GB group (n=20) was 4.5 seconds (95% confidence interval (CI) (7.6, 0.9), P=0.015) faster than the placebo group (n=18 ) on the color-word interference condition of the Stroop test. Subjects who were more impaired at baseline experienced more improvement with GB (treatment*baseline interaction, F=8.10, P=0.008). We found no differences on the other neuropsychological tests. Subjects on GB reported fewer cognitive difficulties in the Retrospective Memory Scale of the Perceived Deficits Questionnaire than subjects on placebo (1.5 points, 95% CI (2.6, 0.3), P=0.016). No serious drug related side-effects occurred and GB did not alter platelet function assays.

CONCLUSION: Overall, GB did not show a statistically significant improvement in cognitive function. A treatment effect trend, limited to the Stroop test, suggests that GB may have an effect on cognitive domains assessed by this test, such as susceptibility to interference and mental flexibility.


Explore (NY). 2006 Jan;2(1):19-24.

The effect of Ginkgo biloba on functional measures in multiple sclerosis: a pilot randomized controlled trial.

Johnson SK, Diamond BJ, Rausch S, Kaufman M, Shiflett SC, Graves L.
University of North Carolina-Charlotte, Charlotte, NC.

BACKGROUND: Multiple sclerosis (MS) is a chronic demyelinating neurological disease afflicting young and middle-aged adults, resulting in problems with coordination, strength, cognition, affect, and sensation.

OBJECTIVE: The objective of this study was to determine whether a ginkgo extract (EGb 761) improved functional performance in individuals with MS.

DESIGN: This study used a double-blind, placebo-controlled, parallel group design. The end point was change between baseline (ie, preintervention) and follow-up evaluation following a regimen of four tablets per day at 60 mg per tablet for four weeks.

SETTING: The study was conducted in academic and clinical-based settings.

PATIENTS/PARTICIPANTS: Twenty-two individuals with MS were randomly assigned to either the treatment or control condition. Groups did not differ with respect to age, IQ, and education.

INTERVENTION: Half of the subjects received 240 mg per day of ginkgo special extract (EGb 761), and the other half received placebo.

MAIN OUTCOME MEASURE: The main outcome measures assessed depression (Center for Epidemiologic Studies of Depression Scale [CES-D]), anxiety (State-Trait Anxiety Inventory [STAI]), fatigue (Modified Fatigue Impact Scale [MFIS]); symptom severity (Symptom Inventory [SI]) and functional performance (Functional Assessment of Multiple Sclerosis [FAMS]).

RESULTS: The ginkgo group had significantly more individuals showing improvement on four or more measures with improvements associated with significantly larger effect sizes on measures of fatigue, symptom severity, and functionality. The ginkgo group also exhibited less fatigue at follow-up compared with the placebo group.

CONCLUSIONS: This exploratory pilot study showed that no adverse events or side effects were reported and that ginkgo exerted modest beneficial effects on select functional measures (eg, fatigue) among some individuals with MS.
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Re: worried about work :( ...brain fog

Postby HarryZ » Sun Oct 28, 2007 7:12 am

Laura,

My wife (passed away recently) had MS for over 36 years. From 1996 to 2000, her MS turned into SPMS and she started to experience this "brain fog".

She started to use the non mainstream transdermal patch medication, Prokarin. This helped her fatigue and "brain fog" immensely. You can obtain more info on Prokarin at " www.edmsllc.com." The drug doesn't work for everyone (sound familiar with MS medications) but it did help her in the 7 plus years that she used it.

It might be worth some looking into for yourself.

Harry
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Postby laura55 » Sun Oct 28, 2007 8:24 am

Thanks so much everyone for your answers! I will have a look at what info you've all put on.

Thanks again,
Laura x :D
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Postby Wonderfulworld » Sun Oct 28, 2007 10:22 am

Hi Laura
I have been dx'ed 9 years now, and like you I've had periods where I really wasn't "with it" at all, brain fog like you wouldn't believe.

I read a really useful online guide to how to be in the workplace with chronic illness http://www.cicoach.com/7Habits.pdf - it was useful for me.

Regarding the brain fog, I would agree with the others that b vitamins and ginkgo help, I also have taken symmetral (for fatigue but that's so closely related to brain fog) at times. I'm not sure if symmetral helped but it might be worth a prescription if the fogginess persists.

I also found if I took alpha lipoic acid and n-acetyl-l-carnitine they helped speed up the post relapse fogginess. If you're in the UK holland and Barrett have both fairly cheaply.

And finally I think us MS'ers are sometimes too hard on ourselves. I have known enough co-workers who had hangovers, relationship problems, depression, or even just spent hours on persuing angles in their work that weren't relevent. I hope that when I'm productive I am VERY productive and make up for all the brain fog days :lol:
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Postby GeoGuy » Mon Oct 29, 2007 9:52 am

Hi Laura,

I know what you mean about having days when the thought process isn't what it used to be. For me, it seems to be associated with not getting enough rest/sleep, which means I really have to get 8 hours a night to keep the fatigue and the "brain fog" that usually accompanies it to a minimum.

By all means, try the supplement of your choice, some good ones have been recommended. I hope you find one that helps. Myself, I have stayed away from stuff that has a description which includes phrases like 'boosts immune function'. After all, I'm paying a lot of money to reduce my immune system activity!

Let us know what you try and how it works for you.
RRMS since 01/07.
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Postby kebsa » Mon Nov 26, 2007 3:17 am

Brain fog is a big issue for me too, along with severe fatige. I have just had a flare up and while i usually enjoy crosswprds, sudoku and other similar puzzles, i found i just could not concentrate for long enough to do even the simplest puzzles. Now several weeks down the track things are improving but i still find that i am struggling at times. I have the same concerns as you about work, i only work par time but ifind it is getting hARDER, my previous employer had made a big deal of the MS even though at that stage i was having few symptoms (particularly cognitive symptoms) I eventuallly got my supervisor off my back but it took months and caused a good deal of stress that then did lead into a relapse. I am now very wary about telling my employer anything about my MS, most indivuduals are great but you only need one person in a position of power to make life very tough!
Here in Australia the MS society has a division that aims to help those of us whose jobs may be at risk due to the MS or who are seeking employment- i have found them to be very useful indeed. With my current emploer ( i have only worked for this oe since August) they have been able to assist in accessing funding for workplace accomodations such as a height adjustable desk to allow for my wheelchair and electric door openers into and out of the department. They can also provide advocacy when things get tough- check out the ms socety and see if they can help you
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