The Foggy Brain Dead Zone
Have you ever seen an old Sherlock Holmes movie? All the old films ends with Holmes and Watson chasing the nefarious villain through a maze of London alleyways covered in a dark, dense fog that almost blinds them. Yeah. That's what it's like in my head some days. Brain fog. Brain fog.
Describing brain fog
Have you ever read The Dead Zone by Stephen King? The hero, Johnny Smith, wakes up after a coma and discovers he has a degree of brain damage. The dead zone is the part of his brain where he knows what words are describing but can't picture it in his mind. The image simply isn't there. Of course, he also gets the power to glimpse into the future when he touches someone, but I can't relate to that power. I relate to not placing words when someone's talking to me. Yeah. That's what it's like in my head some days. The dead zone.
The dead zone.
The foggy brain dead zone.
I like scientific phrases like that.
Maybe I should write a new horror book. My hero would be a middle aged lady with COPD who solves crimes from her bed with premonitions. All the excitement would be in her fog-filled bits of brain where she hunts down words. I'd make a million.
What is brain fog?
It's like this:
“Remember? We talked about this last week.”
“We need your name, date of birth, and Social Security number.”
“So what did you think of the story I sent you?”
It's not that I don't know my own name or date of birth, etc. It's just that as soon as I'm asked for that kind of information it hides in the foggy alleyways of my brain.
Or if I'm feeling classy I substitute, “Well...”
I find myself uttering that one non-word syllable a lot lately. “Um...” It's begging to sound like I'm meditating all the time because I say it so much. “Um, um, um...”
Have you ever been in a conversation and realized that you hadn't grasped what your friend was saying for some minutes now? You knew the words they were saying but they just had no meaning for you? Have you ever completely blanked out when someone asked you a question? You knew you knew the answer but your brain just couldn't come up with how to communicate that answer?
That is brain fog. Most people with COPD or other chronic illnesses have it. Lucky us.
Brain fog is not an official medical term, if you can believe it. “Clouding of the Consciousness” (boy, we like weather analogies) or “cognitive impairment” are the phrases used in proper medical circles. Some people call it brain fatigue but that just conjures up images of sleeping and that makes me want to take a nap. Actually, I'll take any excuse to take a nap. I like to nap.
What causes brain fog in COPD patients?
Low oxygen levels
It's not all in our imagination. For once it's true that it's all in our heads. The link between brain fog and COPD is real.1
A study by Borson, Scanlan, et al confirmed that there is a definite link between cognitive impairment and COPD.2 The findings suggest that lower amounts of oxygen when we're active, what we know as desaturation, leads to higher amounts of an essential vitamin-like nutrient called choline. Elevated levels of choline causes specific changes in white matter and brain neurochemistry that sustains mild cognitive impairment.
Another study, “Reduced Regional Gray Matter Volume in Patients with Chronic Obstructive Pulmonary Disease: A Voxel-Based Morphometry Study”used 3D MRI imaging of both brains of patients with COPD and of healthy people to show that there were differences in the two. Their findings suggest that changes in the grey matter in several areas of the brain for COPD patients may cause the confusion and memory loss we sometimes feel.3 Again, they link it to having less oxygen in our blood.
Luckily for us, the loss of our brain function is pretty small. The Brazil Journal of Pulmonology published an article in March 2015 of another study which found that “the prevalence of cognitive impairment in patients with COPD was found to be associated with the severity of the disease, being 3.9% among patients with mild COPD, 5.7% among patients with moderate COPD, and 7.7% among patients with severe COPD.”4
Depression and anxiety are also culprits of brain fog5. Depression can be so overwhelming it's hard to remember things and to pay attention. When all you're doing is thinking about being miserable it can be difficult for your brain to switch to think about what people are saying to you or what you're supposed to do that day.
Tips to manage brain fog and COPD
The study by Soo Borson and James Scanlan in 2008 suggested that blood oxygen levels should be tested during our activities.6 Which translates into the Six Minute Walking Test, if you're familiar with that. It's basically what it says. You are hooked up to a meter that measures oxygen levels in your bloodstream as you walk for six minutes. This lets your doctor or specialist know if your levels go down, which can cause damage and problems with memory, etc. They can then prescribe oxygen supplementation and the earlier that's prescribed, the better.
The same study recommended sleep study tests as well to measure any degree of sleep apnea. Sleep apnea can also cause oxygen deprivation. Again, your doctor can prescribe a CPAP, which is a machine that gives you extra oxygen as you sleep.
The Brazilian study urged assessing our cognitive function as a routine part of our evaluation as COPD patients.7 This could help your doctor or specialist know how your COPD is affecting your mind as well as your lungs.
Always take your prescribed inhalers. These help you breathe better and help raise your oxygen levels. Medication for problems we can also have with COPD, like high blood pressure, allergies, GERD, depression, anxiety, etc. are just as important as our inhalers. So you need so make sure you take them too.
Stay away from smoke and air pollution.
I think we hear this one so often that I don't need to explain it. Just know that it's good advice.
I always like to exercise in the morning. No, that's not true. I don't actually like it.
But I take a walk every day that I can anyway.
Do your pulmonary rehabilitation exercises. Swim, walk, do yoga, play a wind instrument, whatever helps keep your lungs functioning and your heart happy. The COPD Foundation (copdfoundation.org) recommends exercise as a way to improve shortness of breath, and help retain muscle condition, which is important because we are so limited.
I haven't researched the scientific impact of keeping your brain busy on your brain's health but I bet it wouldn't be hard to find studies that show it's true. I love to give my brain a workout – in the form of reading, researching, playing brain games and word puzzles, and continuing to learn. Even if it doesn't help physically, at least it keeps me from being bored. And a bored Michelle is a bad Michelle.
I hope this article helps you to understand that your brain fog is real, it's pretty normal for us COPD patients, and there are things that can help us.
Meanwhile, I'll be over here in the corner writing down some alleyway word hunt mysteries...
Do you live with any sleep disorders (eg. insomnia, RLS, sleep apnea) in addition to COPD?