Monday, April 30, 2012

Chemo Brain

I'm in geek mode today (or is it panic mode?) and reading about something called "chemo brain". A very real and common effect on the brain after chemotherapy that can last a few months or years. Its kind of like having a mild form of dementia really. I feel a lot better after reading some published articles and also comments from cancer survivors because I was starting to panic and feel like I had dementia! And that's scary when you're someone who has worked with people with dementia for years and their families. But nope, its chemo brain! I'm self-diagnosing.

(It also doesn't help that I recently read a book about someone with dementia and watched the movie "Iron Lady" about Margaret Thatcher...who has dementia...it was hitting a little too close to home! The movie was incredible though...just FYI).

The symptoms vary with people affected by chemo brain...you can experience a range of things like confusion, word finding difficulties (you know, that thing that you drink out of...oh a cup!), forgetting things you usually know really well (like people's names) or even forgetting things like appointments and forgetting the way home, difficulty concentrating, etc...yikes right?!

And most of us find out about chemo brain by experiencing these symptoms and reading about it on the internet or talking with other cancer survivors. Not from our doctors. What? Seriously? No offense, but cancer and chemo are a pretty common thing these days...better hit the books doc and get current. Or even easier, just google it like your patients do! Anyway...that's my anal speech therapist coming out. We are uber thorough. But truthfully, it'd be kind of nice to have a 'heads up' BEFORE experiencing the symptoms so patients don't panic or struggle without help and think there's something wrong with them. Cancer is tough enough. Give us a break.

Off my soap box and back to chemo brain. Its all thanks to chemotherapy which can be a good thing in one respect but not so brain-friendly. Some of these chemo drugs (if not all) cross the blood-brain-barrier (BBB). The BBB is kind of like a gated community...its semi-permeable and you have to qualify to get inside. Meaning that it allows some materials to cross into the brain but not others. Basically, it protects the brain by preventing "yucky" or bad things getting in. But sometimes even the best gate keeper can be broken down or duped. And chemo is one of those yucky things that somehow bypasses the gatekeeper and CAN get in. 2 of the 3 types of chemo I had can definately cross the BBB. Not to mention the potential that all the other drugs they gave me could also contribute.

I joke that I have a mild cognitive impairment or what I call a chemo-induced brain injury (CIBI). That's my new term! But its actually kind of true. I noticed chemo brain later in my treatments...I'd completely forget appointments and forget that I even made them, I'd lose keys, things like that. Which is something that never happened to me. Never. But I expected it to be transient, thinking it'd go away after chemo. No big deal. Some of the oncologists in my world acknowledge it but call it "brain fog" and you get the sense that it goes away. Nope. It can actually last a long time and be very debilitating. Some people can't hold down jobs because of it. I'm almost 4 years post diagnosis and 3 years post chemo and I still have it.

I can't be bothered to read long emails or long articles like I used to until I work up to it, my mind can go completely blank when I see stuff like that and just shuts off. I have difficulty multi-tasking and completing projects or even getting started. It feels overwhelmeing and like its too much effort. Even if I'm excited about them. I can be very forgetful including forgetting things people tell me, or remembering what I did the day before. Or even hours or minutes before! I blame it on chemo brain and usually warn people about me. It can be scary if you focus on it too much so it was good for me to read about it again today and seek relief in the accounts of others and realize that's all it is. Chemo brain.

Being an SLP, I laugh because this is the kind of thing I help people with and now I'm helping myself with the same strategies, only I'm a bad patient. I don't always use the strategies that I know would help. The symptoms can be subtle and most people won't notice it, but the person experiencing it notices it, big time. It can be scary and weird to be having 'senior moments' when you're 40 years old. (although, to a teenager, 40 IS old). And people who know you can get irritated by it even when they know what it is and its not intentional. Like when I forget something someone told me, and they have to remind me. Ugh. I'm not being an a-hole I promise. LOL.