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Welcome to the Virtual MS Center!

Ask any question you want about Multiple Sclerosis and one of our experts will answer it as soon as possible.
CLICK HERE TO ASK YOUR QUESTION!

What Can I Do To Remember Things Better?

3/20/2015

 
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Question:
I read a blog you posted about memory and cognition for people with multiple sclerosis.  Any tips on exactly what to do? Like what are things I should be doing everyday to help my brain?

Answer:
Here are some ideas: 

  1. Stop. Think. Let the information sink in.  You are still capable of remembering new information, but because of the changes in how fast your brain is managing information, it is going to take a little bit longer.  Give yourself that time.
  2. Stop. Listen.  Are there distractions around you that might make it difficult to “encode” what you need to (T.V., radio, background noise)? Can you get rid of those distractions?  If you can hear it your brain is working on processing that noise- and not on remembering what you need to remember.
  3. Stop. Decide. What do I need to remember? This is a conscious decision, don’t expect any information to just “sink in”.
  4. Choose a strategy that works for you in that moment.  Do you need to write in down? Then find a piece of paper and write it down.  Do you need an appointment card?  Should tell someone to help you remember (the two heads are better than one strategy)?  Do you need to repeat the information so you can remember it long enough to write it down? Can you generate a crazy image in your head to help you remember? Can you associate the new information to something you already know?  Can you group things you need to remember so you can remember more?
  5. Technology. Many smart phones have voice recording.  Figure that out.  Go ahead and do it now.  When you have a thought and you don’t want to lose it, speak it into your phone.  Send yourself a text.  Take a picture of what you need to remember (like the number you parked next to in that huge lot). Leave yourself a message on voice mail.  Set the alarms and timers to send you reminders to start (and complete) tasks.


Lori Kostich M.S. CCC-SLP, MSCS
Mandell Center for Multiple Sclerosis
#multiplesclerosis #memory #cognition #MS

What Are Cognitive Deficits?

3/11/2015

 
Question:
What are cognitive deficits?

Answer:
I am going to make a confession. I have a pet peeve.  My pet peeve is how often the words “Cognitive Deficits” are thrown around when talking about (and to) pwMS.  When my patients first come to me, none of them can really explain to me what the phrase “Cognitive Deficits” means.  All they know is that it is used a lot in connection with a diagnosis of MS, and that they know it has something to do with how they think.  And that it’s a little scary.

This is how I clarify it.

Cognition has to do with our ability to think. And cognition has parts.  Some of these are attention, memory, problem solving, reasoning, planning and organization.  Because all of you with MS are so unique, you really can’t throw the blanket phrase “cognitive deficits” on everyone.  Some individuals have increased difficulty paying attention, some have problems figuring out the steps needed to complete a task and some can’t remember where they need to be tomorrow.  Some individuals can do all of this, but it takes twice as long.

That is the role of the therapist, to tease out how the changes in the ability of the pwMS to think, is having an impact on their daily lives.  Does that increased difficulty paying attention mean that the pwMS is not able to get all the information needed from meetings at work? Does the increased difficulty figuring out the steps needed to complete a task mean that housework is not being completed or the dishes are always piled up to the ceiling?  Is the pwMS forgetting where they are going as they drive down the road?

The link below goes into more detail…

http://psychology.about.com/od/cognitivepsychology/f/cogpsych.htm

Cognition can be evaluated by several different professions.  Neuropsychologists will provide the most comprehensive analysis of attention, memory etc. Speech Language Pathologists and Occupational Therapists can do simpler cognitive or cognitive- linguistic evaluations, and then set functional goals with the patient’s input and treat the deficits. Psychologists, social workers and counselors can also administer tools to assess what “part” of cognition may be having a negative impact on daily function.

These changes can happen early in the MS disease process, so if you feel you are thinking differently, ask for a referral to be evaluated by one of the professions mentioned above.

Lori Ann Kostich M.S. CCC-SLP
Mandell Center for Treatment and Research

#cognition #cognitivedeficits #multiple sclerosis #MS

Another Response Regarding Cognitive Function in MS

12/20/2014

 
Lori Ann Kostich M.S. CCC-SLP
Mandell Center for Multiple Sclerosis Treatment and Research

“I want to get back to the way I was.”  As a Speech Language Pathologist who works with persons with Multiple Sclerosis  (pwMS) I hear this often.  PwMS are referred to me by our Neurologist and Neuropsychologist because they report, or demonstrate changes in cognitive –communication or cognitive-linguistic status, and the medical staff believe the pwMS will benefit from a course of therapy.  The response I am compelled to give to that initial statement, is, based on the current treatments available, there is no turning back time.  The changes in the brain are happening, and they are what they are.  The ability to process information slows, and the ability to learn new information (how I think of short term memory) becomes more difficult.

But, having said that, therapy from a Speech Language Pathologist, Occupational Therapist, Social Worker, or Psychologist, can be very effective in helping a pwMS manage the changes in cognitive function.  Therapists have training and experience helping pwMS develop new routines, change personal habits, make workflow adjustments at the pwMS’ place of employment, and help family members understand the changes the pwMS is experiencing.  As part of my practice, I spend a great deal of time doing working on attention and training strategies such as visualization, to help with managing new information.  The most important part of each therapy session is asking the pwMS that I am working with how they are going to APPLY what was trained in the therapy session to their daily routines.  Therapy addressing cognitive functioning is not like blood pressure medication where you take it and you get better. The onus is really on the pwMS to take the training and strategies home (or to work) and practice them and “tweak” them until whatever issue is better.  The most successful outcomes I have had have been when the pwMS worked just as hard outside the therapy setting as they did when sitting across the table from me.

Commenting on medications that some of my patient’s claim makes them think better, is out of my scope of practice.  So I am not going to.  But, please keep in mind that the effects of any medication last only as long as the medication is in a person’s system.  In my opinion, it is better to participate in a course of therapy to learn how to manage the cognitive-communication/cognitive-linguistic symptoms for the long term (if you teach a man to fish…).

If you are noticing changes in your ability to pay attention, remember new information, or a decrease in your ability to stay organized tell your neurologist, especially if this is affecting your ability to work.  A referral can be made to a Neuropsychologist, Speech Language Pathologist, Social Worker etc.  Ask for the help.  This type of therapy will not make the lesions go away, but it can give you some control over the cognitive changes that are happening.

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    PLEASE NOTE: This information/opinions on this site should be used as an information source only.  This information does not create any patient-HCP relationship, and should not be used as a substitute for professional diagnosis and treatment.  Please consult your health care provider before making any healthcare decisions or for guidance about a specific medical condition.
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      • "Ask Dr. Debbie" Research Blog
      • Multiple Perspectives In Multiple Sclerosis Research Blog
  • About MS
    • What is MS?
    • Diagnosis
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  • Symptoms
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    • Depression and Anxiety
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