The devastating effects of fibro fog.

The devastating effects of fibro fog!

Most of us have put the milk in the cupboard and the cereal in the fridge. Most of us have occasionally misplaced our keys or struggled to concentrate during conversations, or had difficulty concentrating on paperwork. However, for people with fibromyalgia, these problems happen more frequently, and can be more severe.

The ability to put a sentence together and know that the fridge, is called a fridge; to have the ability to understand what someone has told you; partake in conversation and decision making are things we all take for granted. These are basic skills which the majority of human beings develop from a young age. You don't ever think that these simple things will become problematic much less non existent. The usual symptoms of fibromyalgia, I expect, are familiar to those who have this beast. However the symptom that is the most distressing for me is "fibro fog". I sit there having a conversation and forget what I am saying mid sentence. I forget the actual topic we are talking about. I've done the shopping, when I come in, my son helps me to put the food away. He asks me where to put the oranges, I can't think of the name so I "hand signal" a bowl shape and point to the fruit bowl. I am selling my car which in the past would have been effortless but now, I am worried about the decisions I have to make, so ask my husband to do it for me. I sit in my car and wonder for a while, where am I going? then, how do I get there?

I was once a feisty independent women. I knew what I wanted and how I would get it, I had a career I was proud of and worked hard for, but I am a different person now. losing self belief, losing self confidence, losing friends and a social life. Losing the ability to live the life I once had. I have to think differently, I have changed the way I do things, I have to cope with the fact I am a different person now. I have to use my brain differently and I am learning new ways to do this.  All of this has had an enormous effect on my family and it seems, from forums and social media, that these are common problems in all FMS patients. 

Cognitive impairment is a common manifestations of fibromyalgia and it may be argued, that it is more disabling than pain and fatigue. Having had fibromyalgia for 15 years, I have seen a steady progression in all of my symptoms including reduced cognition. Since experiencing significant "fog" particularly during flare ups, which incidentally are about every 10 -14 days, I have not been able to work. My work as an advanced nurse practitioner involves conversation about health and illness. I need skills in decision making and the ability to explain quite complex physiology in an understandable way. Being a wife, mother, and gatekeeper to everything household, requires the same skills. It doesn't matter what level of academic success you have achieved and no matter what you do to earn money, the effect of poor cognition has the same devastating effect on us all. There is evidence that fibro fog may be exacerbated by the presence of depression, anxiety, sleep problems, endocrine disturbances, and pain, Glass (2008). What remains unclear is what is causing these cognitive challenges.

In a 2015 study by Tesio et al, in which 60 people were observed – 30 with fibromyalgia and 30 without. They found various impairments of attention and memory in the fibromyalgia patients when compared with healthy controls. They also found that these impairments were independent of depressive symptoms, which is significant, as many clinicians will assume depression when cognition problems occur.

According to Bertolucci (2013) there is some evidence that the central nervous system is functionally and structurally affected by fibromyalgia but there are no naturally occurring molecules or genes that can be identified on scans that detect and quantify these cognitive disturbances. There are, nonetheless various theories about reduced oxygen levels and disturbances in certain brain chemicals which are responsible for the fogginess.

The lack of physiological evidence means that traditional scales and tests or even self-reported questionnaires are the only form of diagnosis. In clinical practice this may provide an easy screen for the presence of cognitive impairment in us FMS patients although having said this, I have never been offered any tests to identify severity and in my work I have never come across cognition tests specifically designed for fibromyalgia and this is important as Fibro fog is very different to other cognitive disorders because it waxes and wanes during the course of our lives. It seems that "fibro fog" like the plethora of other symptoms is just something else we have to cope with and live with.

References

  • Bertolucci PH, de Oliveira FF.(2013) Cognitive impairment in fibromyalgia.Current Pain and Headache Reports . vol 17:page 344. http://solidviews.com/zYktU0
  • Glass JM. (2008) Fibromyalgia and cognition.J Clin Psychiatry;69 Suppl vol 2: pages 20-24.
  • Tesio V,  et al (2014) Are Fibromyalgia Patients Cognitively Impaired? Objective and Subjective Neuropsychological Evidence http://solidviews.com/sepYTRJq

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