MS cognitive fog is one of the most challenging symptoms I face

The balance issues associated with my multiple sclerosis (MS) are clearly visible to others. However, one of my more problematic MS symptoms is largely invisible, especially since I’ve developed strategies to minimize its effect on my functioning. This symptom is cognitive impairment, often referred to as “cognitive fog” or “brain fog.”

Poor memory, difficulty focusing or paying attention, slowed information processing, and challenges in problem-solving can all be manifestations of cognitive fog. This issue is common in MS, affecting up to 65% of those with the condition. Cognitive symptoms can range from mild to severe and can significantly impact daily life, personal relationships, and work performance. I would rate my own challenges as moderate, but on two occasions, I became really concerned.

I will start by describing the two isolated occurrences that really worried me. About five years ago, I was preparing a letter to place in the mail. I had addressed the envelope and placed my return address information sticker on the back — all that was left to do was to add a stamp. This is a simple task that I have completed hundreds of times in my life. But on this particular day, I couldn’t remember where to place the stamp. I knew it needed to go on the upper corner of the envelope, but was it the left or the right side?

This scared me. I couldn’t believe that I wasn’t able to remember. Fortunately, I was able to Google it and correctly place the stamp.

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Then, about six months ago, I was unable to determine which finger my wedding band belonged on. My husband and I celebrated our 25th wedding anniversary last year, so this task should have been second nature.

I have decreased sensation or mild numbness in my fingers, so I couldn’t “feel” which finger was correct. Plus, it was winter, so I didn’t have a tan line. Once again, the internet solved my problem.

I am happy these types of memory lapses don’t occur frequently, but they are concerning to me.

More commonly, I have short-term memory lapses. One example is not remembering someone’s name several minutes after being introduced. Sometimes I don’t even recognize someone I’ve just met.

There are also times when I cannot recall a recent conversation. I’ll wonder, “Did we really talk about this?” If someone verbally requests something of me at work, I ask them to send me an email so I have it in writing and won’t forget to respond.

Another strategy I’ve found helpful in addressing my forgetfulness is carrying a small notebook (one in my work bag and one in my purse) so I can write down everything important in my professional and personal life. Post-it notes are my best friend; I probably use 15-20 every day at work so I don’t forget my thoughts and things I need to accomplish.

I also use technology to keep me organized. I put everything in my Outlook Calendar and color-code professional and personal appointments to ensure I don’t miss any meetings. I use the Microsoft To Do app to keep track of all my work projects and due dates.

My boss has been very understanding of my cognitive limitations. I am now assigned to committees whose work can be completed over short periods of time. My boss realizes that I will be less productive and efficient if my projects require knowledge or information recall over long periods. I feel fortunate to have these accommodations so that I can still be a productive and helpful colleague.

I have discussed my cognitive issues with my neurologist, and it is something we are monitoring. She recommended getting at least eight hours of good-quality sleep each night, as tiredness can worsen cognition.

I have also read that brain games can help sharpen cognitive skills. I particularly enjoy Wordle and Word Crush.

Cognitive fog is one of the more challenging symptoms associated with my MS, but I am developing effective ways to cope and maintain my quality of life. My goal is to keep this symptom invisible to others for as long as possible.

Note: Multiple Sclerosis News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Multiple Sclerosis News Today or its parent company, Bionews, and are intended to spark discussion about issues pertaining to multiple sclerosis.