What is a "flutter" you ask? This is a term I first heard about while reading a book called, "Women Living with Multiple Sclerosis" by Judith Lynn Nichols. In this no holds barred collection of antidotes and stories from women who live with this disease, "flutters" are used as a way to explain those mental lapses where one can find themselves putting the phone in the fridge or trying to use the television remote to make the dog lie down. Other terms have been used to describe this phenomenon such as "cognitive flatulence" or "brain farts."
What causes these Nutty Professor types of behaviors?
Nichols says that these flutters are caused by "the slowing of brain waves in the temporal lobes."
Whatever the cause or name these neurological glitches, although sometimes humorous, can wreak havoc in your life.
I have always prided myself in being well organized and mentally sharp. But since my diagnosis of Multiple Sclerosis I feel that I am not the sharpest tack anymore. One of my friends who does not have MS once commented to me that she feels this particular symptom is common for everyone. She told me matter of factly that the loss of mental acuity is just a sign of getting older. In her efforts to make me feel better, she actually made me angry. Perhaps my lessened abilities would be understandable if I was eighty but I am only in my forties No, this is different than just normal aging. It isn't just forgetfulness here but more of an actual impediment to thinking.
I don't know about you but I can actually feel my thoughts becoming sluggish as though my mental wheels and cogs were grinding to a slow crawl. There are times I simply feel too tired to think. And this feeling of mine is confirmed in the research about MS and cognition. In the fourth edition of "Multiple Sclerosis: The questions you have the answers you need" Doctor Rosalind C. Kalb discusses studies which verify the existence of what is known as "cognitive fatigue." Whereas people without MS tend to do better after doing the same mentally challenging tasks upon repeat performance, folk with MS tend to do worse over time because of this mental fatigue.
One of the images I tend to think of when I think of Multiple Sclerosis is the slowing down of nerve impulses to make my muscles work. But this slowness extends far beyond simple muscle movements but also to our thoughts and cognition.
So when we talk about these "flutters" what parts of our cognitive functioning are we addressing?
The National MS Society defines six primary areas where cognition may be affected due to MS.
These areas include:
- Memory (usually more short term memory problems of retaining new information)
- Attention and concentration
- Making sense of and processing information coming in through our five senses
- The ability to plan and prioritize (Executive functions)
- Visuospatial functions (visual perception and constructional abilities)
- Verbal fluency (being able to find the right words when we speak
How do these neurological flutters manifest in everyday life?
Oh let me count the ways!
Some of my more recent MS flutters include:
- Remembering to pay some bills but not others.
- Showing up for a dentist appointment a month early. I had gotten the right day but wrong month.
- Feeding the cat with my son's raisins
- Making poor substitutions of words as in "I want a porcupine" instead of "I want a cheeseburger" at a fast food restaurant.
- Dipping potato chips into cream cheese instead of dip and not understanding why it tasted so different.
- Stamping my library books with a due date but forgetting to check them out first.
It is interesting that as I write this article my mind is very slow. I am having trouble putting my words together to make my ideas flow. I omit words and have to go back to fill them in. On other days I have few difficulties with thinking, writing, or talking. It makes time management somewhat difficult. I can never be able to anticipate how long it will take me to do a task such as paying my bills or writing a post because my mental fatigue is highly variable.
We are reassured by our doctors and by the literature that these cognitive issues associated with MS are not as serious or as pervasive as those who suffer from Alzheimer's or dementia. The person who has Alzheimer's disease will experience a loss of neurons in the gray matter of their brain. We who have Multiple Sclerosis will have more damage to the white matter of our brain. Whereas we may have some difficulties with retrieval of recent information, the Alzheimer patient will, in time, lose the ability to recognize even family and friends and will have difficulty to perform the tasks of simple personal care. Our cognitive difficulties will not be as debilitating as this and cognitive impairment is usually fairly stable compared to individuals suffering from dementia where a more progressive course of cognitive disability is expected.
Perhaps it is unfair to compare diseases but one must take hope where you can find it. The cognitive issues associated with MS are serious no doubt. Some people quit their jobs or stop doing activities such as driving due to these cognitive impairments. We may be slower in our thinking and may have to make adaptations. But our long term memory, our sense of self and identity, and our core intelligence will remain intact.
I realize that my neurological flutters are here to stay. I am adapting to them as best I can. Post-Its litter my house. I write down everything including my children's birthdays so I don't forget. I take the extra step of talking out loud through steps I must take to complete a task. I insist that people talk one at a time so that I may understand the conversation. I schedule more time to do most anything. My days are less frantic and more thought out and methodical. Spontaneity has been replaced with lists and logic.
It isn't necessarily a bad thing. It just is. Despite my neurological glitches I am still me. And sometimes that is the best you can hope for.
So what about you? What MS flutters do you experience? How do you adapt to your cognitive issues? Please share your stories here. We want to hear them.