Life with Chronic Conditions: Dealing with Brain Fog

 Is it medication? A disease? Am I just loosing it?

Many people with a chronic condition express frustration about the symptoms of “brain fog:”

• can’t remember

• have difficulty concentrating

• forgetting things easily

• don’t grasp what people are telling you

• forgetting words or using the wrong one

• having difficulties reading, concentrating on what you’re reading or comprehending what you’ve read.

Brain fog can come and go. It can be a bit of an annoyance, a source of ongoing frustration or it can significantly impact your life. Many say that it  makes them feel “heavy,” like there’s a thought (or action) you’d like to have (or do) but aren’t able to. You may feel as if you’re walking around in a haze, confused and having trouble concentrating.

Various conditions and treatments are associated with cognitive impairment including but not limited to: chronic pain, Celiac’s disease, hypothyroidism, autoimmune diseases, chronic fatigue syndrome, fibromyalgia (Fibrofog), heart failure, concussion and brain injury, cancers and their treatment (chemo brain), as well as normal bodily changes, such as menopause and pregnancy (Prego brain).

The causes aren’t well understood, and while it’s likely there are multiple causes, it can be a frustrating and debilitating condition.

Things to consider

• By treating conditions such as anemia, depression, sleep and early menopause, brain fog can be reduced: Therefore it’s important to talk to your medical provider about what you are experiencing. Make a list of questions and concerns before medical and other types of appointments. Take an advocate with you to help remember what you wanted to ask and what you are being told. Note that pretty much everyone experiences some form of brain fog when they go for medical appointments so it’s always good to have someone with you.

• Keep a brain fog journal. Record when you have them and if there are any noticeable triggers. E.g. Do they occur when you’ve had too little or too much sleep? Do they happen when you take a certain medication; if you have a flare of other symptoms; eat certain foods; when you are stressed; after exercising; first thing in the morning; if you over do it etc.? Pointing to a cause can help you be less frustrated and may help to reduce circumstances where they are more likely to occur.  Below is a sample of how you can track your brain fog. Careful tracking can help you and your provider come up with an approach that will work for you.

	Episode
Date/day of the week BF occurred
Time of onset
Time it ended
Warning signs
Intensity of the BF(on a scale of 1-10 with 10 being the worst
Symptoms
Activities/circumstances at time of onset
Time of most recent meal prior to onset/food drink most recently consumed
Medications being taken
How much sleep did you have before BF
Does the BF occur first thing in the morning
Did the BF occur after exercising or other activities?

• Avoid known triggers: Common triggers for brain fog include: energy drinks; caffeine; too much sugar; being too active; trying to multi task; being over stimulated; fatigue; stressed; not getting restorative sleep; side effects of medications.

• Keep things organized: Reduce clutter and daily living chaos as much as possible. If you find the fog is worse in the morning, lay clothes out the night before. Keep a checklist posted on the front door so that before you leave the house you’ll be reminded of everything you might need. Write things down (entering them in your reminder section of your phone is fine). Other tips

-       Use pill caddies (medication boxes) to help in remembering to take medications

-       Put the items you need and use every day near your bed, if mostly bedridden, or simply in the same place if housebound or with limited mobility.

-       Always keep items you use regularly, such as your keys, in the same place.

• Build relaxation into your day. Practice restorative yoga, Qigong, Tai Chi or just lying on your bed listening to soothing music. Studies indicate that stressful situations make memory problems more likely.

• Aerobic and brain exercises improve memory and functionality: Research indicates that exercise (e.g. walking) and staying engaged mentality can reduce cognitive dysfunction. Memory and thinking exercises may help your brain repair broken circuits that may contribute to brain fog.

• You are what you eat: Certain foods appear to be helpful in retaining memory, such as nuts, while others, caffeine, sugar can have the opposite effect. Note that if you like getting your nut fix from nut butters, be sure to eat those that are just ground nuts and do not contain added oils and other ingredients.

• Let those you live, work and socialize with know about your brain fog. Develop a code word to let them know when you are having a Just saying “brain fog” will clue people in.

Take a Break: Geometric Signs & Symbols in Rock Art

The Paleolithic caves of France are famous for their prehistoric rock art. Along with the animal and human imagery, 26 symbols have appeared repeatedly. These symbols appear in other parts of the world as well, leading to the possibility that symbolic communication through geometric signs arose with early humans. Take a break and check out the Worldwide Geometric Signs Chart.

Not interested in today’s activities, try the Take a Break Pinterest Board.

Take a Break: Celebrate the First Day of Spring & Super Moon

Spring officially arrives today, March 20, 2019 at 5:58 EST. So celebrate by going outside and taking pictures, drawing, painting or writing a poem about what the first day of spring looks like in your neighborhood.

This year, the first day of spring coincides with the last super moon of 2019, just hours after the vernal equinox. A super moon occurs when the full moon is at its closest point to Earth. This means it appears bigger and brighter than usual. Take time to go outside and observe this astronomical delight.

The March equinox marks one of the four major turning points in Earth’s cycle of seasons. the planet is tilted on its axis, so that for most of the year, one hemisphere or the other is closer to the sun and is experiencing longer days. But this tilt seems to vanish on the equinoxes in March and September, and both halves of the planet get equal amounts of day and night. For the Northern Hemisphere, the March equinox marks the start of spring, while in the Southern Hemisphere, it’s the official beginning of autumn.

Not interested in today’s activities, try the Take a Break Pinterest Board.

Journal Watch March 2019

CHRONIC PAIN

Blood Test for Pain: A study published in Molecular Psychiatry tracked hundreds of participants at the Richard L. Roudebush VA Medical Center in Indianapolis to identify biomarkers in the blood that can help objectively determine how severe a patient's pain is. The blood test, the first of its kind, would allow physicians far more accuracy in treating pain -- as well as a better long-term look at the patient's medical future.

Diabetes linked to back pain: People with diabetes have a 35 percent higher risk of experiencing low back pain and 24 percent higher risk of having neck pain than those without diabetes, researchers have found. PLOS ONE

Knee Pain Not Tied to Activity Levels in Knee Osteoarthritis: Knee pain is not associated with daily walking levels in individuals with mild-to-moderate, symptomatic knee osteoarthritis (KOA), according to a study published online March 6 in Arthritis Care & Research.

Menopause Symptoms Linked to Chronic Pain in Midlife: Menopause symptoms are associated with chronic pain among midlife female veterans, according to a study published online March 4 in Menopause.

Autoimmune Disorders May Up Risk for Carpal Tunnel Syndrome: Common autoimmune disorders are associated with an increased risk for carpal tunnel syndrome (CTS), according to a study presented at the annual meeting of the Association of Academic Physiatrists.

COMPLEMENTARY & ALTERNATIVE MEDICINE

People with osteoporosis should avoid spinal poses in yoga, study says: Yoga postures that flex the spine beyond its limits may raise the risk of compression fractures in people with thinning bones, according to new research from Mayo Clinic. Mayo Clinic Proceedings.

Yoga May Help With Rheumatoid Arthritis Symptoms, Severity: Yoga may be effective as a complementary or adjunct therapy for patients with rheumatoid arthritis (RA) taking disease-modifying antirheumatic drugs (DMARDs), according to a study published online Feb. 1 in Restorative Neurology and Neuroscience.

Acupressure Reduces Lasting Symptoms in Breast Cancer Survivors: Acupressure is associated with improvements in co-occurring symptoms in breast cancer survivors with fatigue, according to a study recently published in JNCI Cancer Spectrum.

Most Patients Do Not Disclose Complementary Medicine Use: Lack of inquiry from providers, fear of disapproval, belief CM is safe among reasons for nondisclosure. Just one-third of users of biologically based complementary medicine (CM) disclose their use to traditional health care providers, according to a review published online Feb. 7 in Scientific Reports.

Acupuncture Alleviates Moderate-to-Severe Menopause Symptoms: Decreases seen in hot flushes, day-and-night sweats, sleep problems, emotional and physical symptoms. BMJ Open

Peer support, healing hands may curb prescription opioid misuse in Chronic Pain Patients: Study shows holistic approach may help prevent drug deaths in vulnerable populations. A program offering group support, acupuncture, mindfulness, massage and gentle exercise may help prevent patients on prescription opioids from spiraling down to drug misuse, overdose and death, according to a new study. Journal of General Internal Medicine

FDA ACTION

• FDA Administration Commissioner Scott Gottlieb, M.D., announced his resignation. Ned Sharpless MD, head of the National Cancer Institute will temporarily oversee the FDA

• Warns Americans Not to Buy Drugs from CanaRx, who sell unapproved and mislabeled medicines to Americans.

• Warned that a safety clinical trial has revealed that tofacitinib (Xeljanz, Xeljanz XR) 10 mg twice daily is associated with an increased risk for pulmonary embolism (PE) and death among patients with rheumatoid arthritis (RA)

• Warned that the gout medicine Uloric (febuxostat) carries a higher risk of death than allopurinol

• Allowed marketing of a new device, ClearMate, intended to be used in an emergency room setting to help treat patients suffering from carbon monoxide poisoning.

• Approved a new indication for a heart valve repair device that is intended to reduce moderate-to-severe or severe mitral regurgitation

• Approved a new generic of Diovan (valsartan). Valsartan is an angiotensin II receptor blocker (ARB) that treats high blood pressure and heart failure.

• Approved Spravato (esketamine) nasal spray, in conjunction with an oral antidepressant, for the treatment of depression in adults who have tried other antidepressant medicines but have not benefited from them (treatment-resistant depression).

PREVENTION

Moderate muscle strength may lower risk for type 2 diabetes: New research shows building muscle strength may lower risk for the disease by 32 percent. Mayo Clinic Proceedings

Getting a flu shot while hospitalized lowers the chance of a heart attack: Largest study to date bolsters evidence for heart benefits of vaccination. There's now another reason to get your yearly flu shot. Not only can it protect you from the body aches, fever and fatigue associated with a bout of influenza, it may even prevent you from having a heart attack. The study of nearly 30 million hospital records shows that people who got a flu shot while hospitalized had a 10 percent lower risk of having a heart attack that year compared to people who visited a hospital but did not get the vaccine during their stay. American College of Cardiology's 68th Annual Scientific Session

E-Cigarettes May Threaten Goal of Achieving Tobacco Endgame: Concern increasing that use of newer tobacco products may catalyze transition to tobacco products, drugs. There is considerable concern regarding the potential negative impact that electronic cigarettes and other new products may have on ending all tobacco use and nicotine addiction, according to a presidential advisory issued by the American Heart Association and published online March 13 in Circulation.

E-cigarettes linked to heart attacks, coronary artery disease and depression: Concerns about the addictive nature of e-cigarettes -- now used by an estimated 1 out of 20 Americans -- may only be part of the evolving public health story surrounding their use, according to new data. New research shows that adults who report puffing e-cigarettes, or vaping, are significantly more likely to have a heart attack, coronary artery disease and depression compared with those who don't use them or any tobacco products. American College of Cardiology's 68th Annual Scientific Session 

Sustained Smoking Cessation May Delay, Prevent Seropositive Rheumatoid Arthritis: While smoking is a strong risk factor for seropositive rheumatoid arthritis (RA), sustained smoking cessation could delay or even prevent disease development, according to a study published online Feb. 21 in Arthritis Care & Research.

Ultrasound readings of left or right foot can predict good versus poor bone quality: Ultrasonography (US) of the calcaneus is efficient for screening bone health, according to a study published in the March issue of the Journal of the American Osteopathic Association.

Periodontitis may raise the risk for developing dementia: Gum disease (gingivitis) that goes untreated can become periodontitis. When this happens, the infection that affected your gums causes loss in the bone that supports your teeth. Periodontitis is the main cause of tooth loss in adults. It is also a risk factor for developing dementia, one of the leading causes for disability in older adults. Journal of the American Geriatrics Society

Light physical activity linked to lower risk of heart disease in older women: Light physical activity such as gardening, strolling through a park, and folding clothes might be enough to significantly lower the risk of cardiovascular disease among women 63 and older, a new study has found. This kind of activity, researchers said, appears to reduce the risk of cardiovascular disease events such as stroke or heart failure by up to 22 percent, and the risk of heart attack or coronary death, by as much as 42 percent. JAMA

A nap a day keeps high blood pressure at bay: Catching some midday shut-eye linked to similar drops in blood pressure seen with other lifestyle changes, some medications. It seems that napping may do more than just reboot our energy level and improve our mood. New research being presented at the American College of Cardiology's 68th Annual Scientific Session found that people who took advantage of a midday snooze were more likely to have a noticeable drop in blood pressure compared with those who didn't nap.

NUTRITION/SUPPLEMENTS/VITAMINS

What is association of dietary cholesterol or eating eggs with risk of cardiovascular disease, death? Eggs are a source of dietary cholesterol. This observational study pooled data from six study groups for more than 29,000 people to determine the associations of consuming dietary cholesterol or eating eggs with risk of cardiovascular disease (CVD) and death. Adults who ate more eggs and dietary cholesterol had a significantly higher risk of cardiovascular disease and death from any cause. People need to consume lower amounts of cholesterol to have a lower risk of heart disease, the study authors said.

Eating mushrooms may reduce the risk of cognitive decline: Researchers found that seniors who consume more than two standard portions of mushrooms weekly may have 50 percent reduced odds of having mild cognitive impairment. Journal of Alzheimer's Disease,

Low-carb diet tied to common heart rhythm disorder: Study suggests using caution when restricting carbohydrates for weight loss Low-carb diets are all the rage, but can cutting carbohydrates spell trouble for your heart? People getting a low proportion of their daily calories from carbohydrates such as grains, fruits and starchy vegetables are significantly more likely to develop atrial fibrillation (AFib), the most common heart rhythm disorder, according to a new study. American College of Cardiology  

More vitamin D may improve memory but too much may slow reaction time: How much vitamin D can boost memory, learning and decision-making in older adults, and how much is too much? A unique study found that overweight and obese older women who took more than three times the recommended daily dose (a daily dose is 600 IUs) of vitamin D showed improvements in memory and learning -- but also had slower reaction times. The researchers hypothesize that slower reaction times may increase the risk of falling among older people. Journals of Gerontology: Series A 

Daily intake of nutritional supplements cannot prevent depression: The largest randomized clinical trial to study the effects of nutritional strategies on the prevention of major depressive disorder concludes that daily intake of nutritional supplements cannot prevent depression. Science Daily

TREATMENT

Tramadol May Up Mortality Risk in Osteoarthritis Patients: The initial prescription of tramadol compared with commonly prescribed nonsteroidal anti-inflammatory drugs may be associated with increased all-cause mortality among patients with osteoarthritis, according to a study published in the March 12 issue of the Journal of the American Medical Association.

Underweight Status Increases Shoulder Arthroplasty Complications: Underweight patients have a high number of adverse events and postoperative infections after total shoulder arthroplasty, even compared with super morbidly obese patients, according to a study presented at the annual meeting of the American Academy of Orthopaedic Surgeons.

Patients with irreparable rotator cuff tears may have another surgical option: The arthroscopic superior capsule reconstruction (SCR) surgical technique offers patients with irreparable rotator cuff tears restored shoulder function and the opportunity to return to sports and physically-demanding work, according to research presented today at the AOSSM/AANA Specialty Day in Las Vegas, Nevada. The study, which examined patient outcomes up to five years after surgery, built upon earlier research, which examined short-term patient results.

 Operative Treatment Seems Most Effective for Adult Lumbar Scoliosis: In as-treated analyses, surgery is superior to nonoperative care at two years among patients with adult symptomatic lumbar scoliosis, according to a study published in the Feb. 20 issue of The Journal of Bone & Joint Surgery. 

Recommendations Developed for Ulcerative Colitis Management: Recommendations have been developed for management of adults with ulcerative colitis (UC); the American College of Gastroenterology clinical guideline was published online Feb. 21 in the American Journal of Gastroenterology.

Surgery no better than medication at preventing serious complications of atrial fibrillation: Catheter ablation, a common cardiovascular procedure, appears no more effective than drug therapies in preventing strokes, deaths, and other complications in patients with atrial fibrillation. However, patients who get the procedure experience much greater symptom relief and long-term improvements in the quality of life, including fewer recurrences of the condition and fewer hospitalizations, than those who get only drugs. The findings are from two new studies published in the March 15 issue of the Journal of the American Medical Association.

Few treatment guidelines for heart disease are based on rigorous study: Less than 10 percent of the treatment recommendations U.S. doctors rely on to manage care for heart patients are based on evidence gained from multiple large, randomized clinical trials -- the gold standard for obtaining scientific data. In fact, the proportion of well-supported recommendations for heart care has actually declined compared to 10 years ago, when an earlier analysis found a similar dearth of rigorous studies supporting treatment guidelines. The latest study, led by the Duke Clinical Research Institute, appears online March 15 in JAMA.

Adding Bempedoic Acid to Statin Therapy Reduces LDL Cholesterol: Bempedoic acid, an inhibitor of ATP citrate lyase (ACLY), added to maximally tolerated statin therapy, significantly reduces levels of low-density lipoprotein (LDL) cholesterol in patients with atherosclerotic cardiovascular disease and/or heterozygous familial hypercholesterolemia, according to a study published in the March 14 issue of the New England Journal of Medicine.

OTHER

National Health Spending Set to Increase 5.5 Percent Annually: Long-observed demographic and economic factors expected to drive growth in health spending. National health spending is projected to increase at an annual rate of 5.5. percent from 2018 to 2027, with fundamental economic and demographic factors the main drivers, according to a report published online Feb. 20 in Health Affairs.

Homes With High Ventilation Rates Tied to Respiratory Issues: People living in homes with high average air exchange rates (AAERs) are more likely to report chronic cough, asthma, or asthma-like symptoms, according to a study published in the February issue of Environmental Research.

Veterans More Likely to Have Heart Disease: After the war is over, veterans face a new threat. They are more likely to have heart disease at a younger age than nonveterans, and this could herald a new health crisis on the horizon. Journal of the American Board of Family Medicine.

Take a Break: Try Chair Yoga

This past Saturday I did a post on Yoga. Today’s take a Break a break is trying chair yoga, which is a very gentle form. Below are some videos to try.

Mindful Chair Yoga: 15 minute Beginner Practice 

Chair Yoga-Yoga for Seniors/ Yoga With Adriene 

 3 minute Chair Sequence 

Not interested in today’s activities, try the Take a Break Pinterest Board.

Life with Chronic Conditions: Yoga

Research shows there are considerable health benefits to yoga, particularly for those with chronic conditions. In spite of pictures you may have seen, yoga is not about twisting your body into a pretzel, but rather it’s a mind-body practice of physical poses, controlled breathing and meditation or relaxation.

Recently, I’ve been looking for practices for someone with Atrial Fibrillation, who found that moving too quickly could trigger their symptoms. There are lots of classes and styles so it can be confusing. Therefore it’s best to do some research before you just attend a class.

Before starting any exercise program, talk to your medical provider. Find out if there certain poses you should avoid and ask for recommendations for local classes, tapes and/or on-line videos. Note, new research from the Mayo Clinic suggests that Yoga postures that flex the spine beyond its limits may raise the risk of compression fractures in people with thinning bones. If you have high blood pressure, you may need to avoid yoga poses in which your head and heart are lower than the rest of your body, such as the Downward-Facing Dog posture. Again, your medical provider will know your condition and can provide the best advise about what is safe and what to avoid.

Consider the following:

• Look for a teacher that is experienced with chronic conditions. Checking for classes at your local hospital, health center of condition specific support group are good places to start. Many hospitals now offer complementary and alternative programs, which include yoga.

• Avoid “gym yoga.” These classes will have terms like “power” or “intense.” Instead look for terms like “restorative” and “gentle.” Types of yoga classes that are more appropriate include: yoga therapy; chair yoga; Hatha Yoga; Yin Yoga; Restorative Yoga; Yin Yoga; Yoga Nidra (sleep yoga); Lyengar.

• Hot yoga or Bikram form is not recommended for those with heart disease, problems with dehydration, heat intolerance, a history of heat related illnesses, such as heat stroke, and women who are pregnant. Women who experience hot flashes can find this type of class can be a trigger for more hot flashes.

• Watch yoga videos on-line or observe a class to get a sense of what will appeal to you.

• Notice how you feel during the class as well as afterward.

• Start slow.

Check out Yoga and Chronic Illness: Choose a Practice That Works for You. 

In researching yoga that would be appropriate, I came across the following restorative chair yoga for those with chronic pain that is taught by someone dealing with this issue.

Life with Chronic Conditions: Recession Proof Your Life

The majority of economists think that a recession is right around the corner. It’s not a question of “if” but rather “when” it will arrive. This isn’t rocket science since research suggests that every six-seven years, the US has a recession of sorts. Given the boom of recent years, it’s pretty straight forward, “what goes up must come down.” If you want to learn more why executives and chief financial officers are worried, check out What is a Recession, and Why Are People Talking About the Next One? 

By organizing now, a recession will not be as damaging as it could be, regardless of when it hits and for how long it stays around. If you do it right, you wont have to pay much attention in future years to what the economy is doing because you’ve developed a “live below my means” mentality, that can help you weather recessions and crisis.

For clarification to “live below your means” is that you basically spend less money than what you bring. It means you don’t live pay check to pay check but rather adopt a life style that at the very least lets you live within your means, but more importantly, let’s you save money each month.

GET FINANCES IN ORDER

• Got Stock? Turn off the news: If you have stocks you don’t need to be checking them daily. In the last recession, many learned of the largest daily decrease (11/29/08) sold their investments when the market plummeted only to miss the largest stock market increase just two weeks later. As my father in law, who was an economist and made his living as an investor, would say, “stocks are a young man’s game.”

• Stop using credit cards: If you are paying for things you can’t afford, you are living above your means.

• Evaluate what you do for a living. Unless you are planning retirement in the next several years, it’s important to examine what you do for a living and try to determine if it’s recession proof. Certain jobs will always be needed but others come and go with the economy. Employers keep those who they view as the best “Return on investment.-“ productivity levels make or save the company money. Make sure your resume is updated and you are well networked in your field. Acquire new skills and keep yourself relevant if not indispensable.

• Even if you think your job is secure, consider a side hustle. Do you have special skills you can do on the side or teach? Check out Side Hustle Nation for lots of ideas.

• Do you have an emergency fund? Can you survive if you don’t draw a paycheck for six months or even longer? Even if it’s emptying pockets and purses at the end of the day, checking sofas and chairs and dumping all loose change in a bucket, start saving. Every dime counts in a weakened economy.

• Refinance and pay off high-interest debt: If you have student loans at a high interest rate, refinance them to a fixed lower rate now. Do what you can now to pay off loans and get debt under control now

• Don’t buy what you can’t afford or what you don’t understand. People get trapped in loans they really can’t afford with interest rates that can be variable as well as balloon payments. If you need to borrow money, make sure you understand what the terms of the loan are before you sign.

• Be the boss of your money: Assign a job for every dollar you bring in. Depending on your financial situation, divide money into the following categories monthlies (what you have to pay each month such as utilities, rent/mortgage,  food, gas); need (something you need and are saving up for); debt repayment and savings.

• Pay Yourself: When you’ve finished paying off school debt, mortgage, smart phone or whatever else, keep making the payment but this time to an interest bearing savings account.

• Live off one income: All to often we match our lifestyle with the income we’re making. However, setting things up so one income is used for monthly living expenses , while the second one pays off debt, invests or goes into retirement. This approach can be a major help if one of you looses a job during the recession.

LIVE BELOW YOUR MEANS: Having done a variety of posts on this topic, below are resources to help you “Use it up, wear it out, make it do or do without.”

Ways to Save Money on Monthlies (Bills) and Health Costs

Living within your means: Un stuff yourself

When you have some money but not enough. 

Check Your Medical Bills 

 I can’t afford my Meds

Shop Around for the Best Pharmaceutical Prices