A few days ago I got out of the shower, dried and dressed myself and started to brush my rapidly-thinning hair, only to find that my hair was full of conditioner. My heart sank….I’d forgotten to wash it out in the shower. The only other time I’d ever done that was when I was pregnant and suffering from preggo-brain. At times during pregnancy I was so brain-addled that I couldn’t even remember my own phone number. No such excuse this time – can only blame it on the chemo. As I was back in the shower, washing out the conditioner, I realised there were other things that had passed me by. The day before was 1st of July and it wasn’t until late in the evening that my youngest came running in to “pinch-and-a-punch-for-the-first-of-the-month” me. Oh No!!!!! Not once in their whole lives had I ever forgotten to “pinch and punch” them on the first of the month. I even KNEW that it was the 1st of July, as I’d texted a relative with a birthday message, and yet even then I hadn’t twigged that it was the FIRST of July. I know this seems like a ridiculously minor thing in the great scheme of everything else going on at the moment, but this and the conditioner were a sign that chemo-fog is trying to get me. This has been quite an upsetting realisation.
Post-chemotherapy cognitive impairment (also known as chemotherapy-induced cognitive dysfunction, chemo-brain or chemo-fog) is a well-recognised phenomenon where chemotherapy causes cognitive impairment. Unfortunately, following a quick search of the literature, it appears that no-one really understands how the chemotherapy drugs cause this impairment, why some people are affected and others aren’t, nor how to predict whether the effect will be transient or cause permanent cognitive damage. With such unknowns, to me chemo-fog is one of the most terrifying aspects of my treatment for breast cancer. I tell myself that I had high-dose chemotherapy for 18 months more than 30 years ago as a teenager, and that it can’t have damaged my brain too much as I went on to obtain a PhD in medical biology and have built a solid career and international reputation based on my brain output. However, I now know a lot about ageing and the decline in regenerative capacity of stem cells with age, and figure there must be some point in time when the body says enough is enough with the chemical assaults it is hit with, and its ability to bounce back. My job, my reputation, my financial independence and my sanity is absolutely dependent on my cognitive function – my memory, my ability to multitask, my ability to plan and project manage. Even a small decline in cognitive function will mean the end of me as I know me.
I am determined to do everything within my power to ensure that the drugs do not fry my brain, and that the impact is minimal, but how do I really know how to do this, when even the experts in the field don’t know exactly what it is that causes chemo-fog, and therefore how to prevent it, or ameliorate the effects? Truth be told, this is one of the drivers for wanting to write this blog – I don’t really care if people read this blog, I just want to be using my brain to try to put coherent thoughts together so that I keep in practice for how to do that! I guess we’ll see over time if I’m succeeding, or whether there is a decline in ability and output over time. I’m a Word With Friends addict, so I’ll definitely be keeping that up….although of late I seem to be being beaten more than I used to be….and then I start to stress…. am I losing it already? I will definitely be trying to practice my breathing and relaxation / meditation, knowing from the reading that I’ve done that many of the symptoms of chemo-fog are consistent with those of being stressed, and that the body and brain need to be de-stressed in order to think straight. I will also be discovering the where-with-all for juicing and drinking buckets of green tea – I want all the natural antioxidants I can get to mop up those free radicals and prevent the damage they cause!
Finally, there is my new-found respect for social media, particularly LinkedIn and Twitter. I am reading the scientific literature and exploring a dearth of other areas of interest, more broadly than ever before. While I am not reading scientific papers in the in-depth way I’m used to reading them, I seem to be broadening my knowledge of a wider range of things much more than when I stay focussed on my own niche area of expertise. Most of my professional colleagues and contacts on these social media forums have no idea that I am currently undergoing treatment for breast cancer and am actually not at the office very often at the moment – my posts on LinkedIn are being ‘liked’ and shared far more often than before and I’m even being retweeted. It seems that others in my network are also enjoying the new snippets of information I’ve been finding and discussing. I’ve also discovered Ralph Waldo Emerson. Wow! How have I never read his literature before?..most likely because always having limited time to read has meant that I have had to stay focussed on scientific papers and topics specific to that required for my job. His essay on Nature is pure joy to read and ponder on. Who’d have thought I’d be learning so much!
I would love to hear from others any suggestions that you may have as to how to lessen and ride-out the effects of chemotherapy on the brain. Meanwhile, I will be setting my calendar to remind me when 1st August comes around, and in another few weeks I’ll no longer have the need to use shampoo and conditioner so that solves that problem.