CHEMO BRAIN

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Chemo Brain is a strange thing. Doctors don't really know what to make of it or what to do. Is it physical, psychological or imagined? It's definitely "in your head" no matter how you look at it. Is it even related to chemotherapy? It's not on any list of side effects from chemotherapy drugs.

One thing is agreed. Many chemo patients have complained about impaired thinking and assumed it had something to do with the chemo drugs. Studies are just now starting to investigate this strange complaint.

Here are some of the documented complaints in these new studies:

• Forgetting things that one shouldn't forget
• Trouble concentrating on tasks
• Forgetting names, dates, memorable events
• Difficulty multi-tasking
• Slower thinking, processing and completion of mental tasks
• Forgetting common words

Personally, after my 1st chemo treatment, back home that night, I received calls from relatives and friends wanting to see how I fared. For the life of me, I could not concentrate on their words or answer simple questions, let alone carry on a conversation. It was like I had a buzz from a drink or cold medicine. As soon as I felt my mind wandering (to nowhere) I handed to phone to my mom and said, "You take it." I felt bad brushing off my sister's call but I could not function! Luckily this only happened for that one night. I put myself to bed the other nights, not trying to socialize. I was always fine the next day.

According to recent studies, "mild cognitive impairment" ranges from a one-time-only event to long term condition. Some people complain of slight changes in ability while others are hit harder, like I was. It appears more often in patients with higher doses of chemotherapy drugs.

Experiments have linked nerve damage to some chemotherapy drugs but the effect on the brain cells is too new for results. Experts are concerned about chemotherapy treatments that are aggressive and high dosed. Possible treatment options that protect the brain are being studied as are existing medications that might also help treat chemo brain.

The causes and triggers of chemo brain are unknown at this time. Pictures of brain activity show changes in chemo patients that don't show up in non-chemo cancer patients. For some participants, these differences are still showing up 5 to 10 years after treatment ends.

Right now the best guesses as to the cause of chemo brain include the cancer itself, chemotherapy drugs, medication used to manage side effects of chemo drugs, patient age, stress, low blood counts (chemo kills off blood cells), depression, fatigue (chemo makes one anemic), and hormonal changes. Both men and women complain of chemo brain. About 25% of chemo patients report having thinking problems.

Personally, I think my chemo brain was a combination of things:

• I had to suck down 5 bags of drugs.


• I was in a strange place with people I didn't know fussing over me - poking a needle into my chest for the IV hookup, all of which was overwhelming and stressful.
  
• I definitely think depression is a part - surgery, tests, poking and prodding, chemo...it's a sudden loss of control over one's life.


• Fatigue - chemo kills off the red blood cells and makes you anemic and tired. After my subsequent chemo's I pretty much slept for a week, getting out of bed for meals and helping my daughter with schoolwork only.


• Hormonal changes were definitely part of my experience. Ladies' ovaries are shut down by the chemo. Younger ladies bounce back after the treatments are over. I was old enough to be thrown into permanant menopause. I don't know about guys' hormones. I am relatively young so I don't think advanced age is on my list of possible causes. Most of my "mates" were old enough to be my parents or grandparents. The nurses called me "The Kid."

So what do us foggy-headed people do about this? Well, here is a list of what might help out:

• Write down your schedule rather than try to remember everything


• Make to-do lists
  
• Do puzzles and other thinking games or exercizes


• Get lots of rest


• Exercise to help improve mood and decrease fatigue


• Eat vegetables (studies show it helps the brain)


• Create routines and rituals


• Forget trying to multi-task for awhile


• Keep a diary of times you have trouble thinking (times, food, meds, activity etc)


• Accept the problem as temporary and have a sense of humor about it. Give yourself permission to be a little kooky.


• Tell friends and family about it so they are aware of what you are going through

If chemo brain gets too severe, meet with a neurologist, psychoneurologist, or psychologist. These experts can test brain function and suggest mental activities to help you overcome or lessen the effect of chemo brain. Hopefully in the next few years, more will be known and more can be done to avoid or treat chemo brain.
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