Brain Fog Versus Something More Serious
Much has been written about polio survivors’ brain fog. It can be disconcerting for a person, especially one who is used to being fully “in charge”, having a quick witty retort, and being a leader in their family, workplace, and/or social network. The person experiencing it may feel less competent than in the past. And they may worry that they are developing dementia, Alzheimer’s disease, etc.
According to healthline.com, “brain fog is a symptom of other medical conditions. It’s a type of cognitive dysfunction involving memory problems, lack of mental clarity, poor concentration, and/or inability to focus”. It may also be called “brain fatigue” which is a good description because just like muscle fatigue an individual episode does not last forever and recovery from the fatigue is possible.
Polio survivors are not the only group of people who have reported brain fog in association with whatever underlying medical condition they have. Individuals with many auto-immune diseases, those with chronic fatigue syndrome, those whose blood sugars drop below 50 or 60 mg/dl, and now, several of the COVID “long haulers” have noted similar problems.
Almost everyone who has had several nights of non-restorative sleep, is physically or mentally fatigued, has gone several hours without eating or has consumed a high sugar snack and “crashed” a couple hours later has had times when they cannot remember a word that normally would be a regular part of their vocabulary, can’t quickly add up a series of numbers, cannot remember someone’s name, etc.
Most polio survivors, who contracted polio in the U.S., are now age 65 or over and some “forgetfulness” is considered normal, such as forgetting where you left the car keys, where you put that item “so I won’t forget” but now you can’t find it, only remember a person’s name after 5-10 minutes into a conversation with them, or temporarily forgetting where you parked your car in that supermarket parking lot. I’ve seen a floor mat for sale in catalogs that uses the rhyme/song “Head, shoulders, knees and toes” but changes it to say, “Glasses, wallet, keys and phone” and recommends it be placed on the floor leading into your garage or out of your home!
What can you do to minimize the brain fog or forgetfulness?
First recognize that it is a problem for you.
Second, observe and identify if there are some factors that make it worse for you –
Does it happen more later in the day when you are tired?
Does it occur when you haven’t slept well?
When you haven’t eaten for several hours? Etc.
It may be wise to postpone making important decisions or ones that have long-term consequences in these situations.
For example, maybe you should reconcile your bank balance in the morning right after breakfast (if that is the time you are mentally the sharpest).
Make lists - just the act of handwriting something builds extra pathways in your brain making it more likely that you will remember it even if you misplaced the list!
Limit the choices. If you have handicap parking privileges USE them. It will decrease your physical fatigue and markedly reduce the number of possible places where your car will be parked.
Be patient and kind to yourself. Beating yourself up will only make the problem worse.
When is it more than brain fog/ brain fatigue/normal forgetfulness?
If you’re concerned, speak to your primary care physician about it.
If you have the issue, try and schedule your appointment in the morning when you are the least fatigued. Then, remind your primary care physician about polio fatigue/overuse prior to being given any tests.
A brief screening test that is frequently used by primary care physicians is the Mini-Cog that is available at https://mini-cog.com Click on “Standardized Mini-Cog”. Note: the symbol “<” means “less than”, so when it says “A cut point of <3 on the Mini-Cog” it means that a score less than 3 indicates that a work-up for dementia should be undertaken.