Chemo Brain 101

Chemo Brain. I hadn't heard that term until I needed to. It's another one of the side effects that occurs in varying degrees to people who have undergone chemo. I feel it, though not as badly as some people have reported (knock on wood). It's definitely not the same as the gradual slipping of memory I'd already been experiencing prior to breast cancer. I hear that the worst of it might diminish within a year or so. I hope so. Things in my head are quite a bit more muddled than they used to be and things that used to be "on the tip of my tongue" are now more likely to be hiding in any one of the vast number of cells in my body, some of which may have been killed off entirely since that's what chemo is designed to do ... kill as many cells as possible and hope that only the good ones regenerate. If chemo can purge your body of visible things like hair, nails, and skin and take away the feeling in your hands and feet and the taste from your tastebuds, doesn't it stand to reason that it's going to mess with your head, too? Oh yeah. Definitely.

It's hard to explain something that people don't see and that I also try to hide so that you might not notice it. Every now and then I find myself embarrassed by it ... caught off guard ... and sometimes when I beg forgiveness and blame my "chemo brain", and if I'm talking to someone who is around the same age as me, they might say something like, "welcome to the club" or "we're at that age, Heather", at which I smile ... Wanly. Sadly. Feeling very misunderstood. I know people are probably just trying to make me feel better but it's also a little frustrating because chemo brain is on a whole different level than just aging/menopausal brain. We are not in the same club at all. Let me try to explain.

Peaches and Cream complexion = our brain in our teens and 20's and into our 30's.



A few pimples here and there = our brain in our 40's and 50's ... aging ... menopause ... memory slips ... annoying. Using a little cover-up.


Bad acne = chemo brain. This goes beyond "gee, I hope this goes away before my date on Friday night". There ain't no cover-up to hide this ... except maybe a paper bag.


Here's what a conversation with my brain might go like while I'm with some friends ...

Heather to Brain: "This would be the right time to tell that story ... you know the one ... I just can't remember a couple of key bits. Can you pull the book off the shelf and give me a little refresher?"

Brain to Heather: "Sorry. No can find. The catalogue says the book is in but it doesn't seem to be on the shelf. It's probably been put in the wrong place".

Heather to Brain: "Can you do a quick scan of the shelves and see if you can find it. It must still be on the same floor".

Brain to Heather: "Sorry again. We're in a recession here. Big budget cuts. Most of our experienced staff have been given early retirement and there's just a skeleton staff left and half of them are off sick. The cataloguing is all backed up and half the books are badly out of order and it doesn't look like we'll have qualified staff to take care of those things any time soon. We have a few volunteers doing some work but they haven't had much training and they're not well supervised so standards have slipped. Sorry I can't be of more help. By the way, there won't be anyone to answer calls in the next little while because we're going for lunch."

Heather to Group of Friends: **smiles blankly**

I hope this helps people better understand how my brain is working ... or more like NOT working. Unless you've recently had chemo (and I hope you haven't had to), we're not at all in the same club in the brain department. Thanks for being patient with me.

Here, from the Mayo Clinic, are common symptoms of chemo brain, of which several are experienced by most women as we age, but let me tell you ... having experience with both, this is significantly more noticeable.

Signs and symptoms of chemo brain may include:

• Being unusually disorganized (I feel this mostly when I'm already tired)
  
• Confusion (same with this)
  
• Difficulty concentrating (I already feel improvements here)
  
• Difficulty finding the right word (oh yeah)
  
• Difficulty learning new skills (time will tell)
  
• Difficulty multitasking (I feel improvements here)
  
• Fatigue (mental stamina is improving)
  
• Feeling of mental fogginess (about a month ago, it felt like someone opened my brain and let the air and sunshine in)
  
• Short attention span (improving but still limited)
  
• Short-term memory problems (definitely - much worse than before chemo)
  
• Taking longer than usual to complete routine tasks (yes)
  
• Trouble with verbal memory, such as remembering a conversation (significantly worse than before ... so annoying)
  
• Trouble with visual memory, such as recalling an image or list of words (also significantly worse than before)

A 2008 study (reported here at CTV News) found that the experience of "chemo brain" is very real. The drug, 5-fluorouracil (5-FU), is the F in the FEC combination of chemo drugs that I had three rounds of.

The research concludes that a common chemotherapy drug, known as 5-fluorouracil (5-FU), causes stem cells in the central nervous system to die off well after treatment has ended. The resulting side effects are often referred to as "chemo brain."

Other reading on the topic:

• Scientists Find 'Chemo Brain' No Figment Of The Imagination. ScienceDaily (Oct. 8, 2006)
• The Fog That Follows Chemotherapy. New York Times (August 3, 2009)
• Chemo Brain Discussion at Breastcancer.org. It's somehow comforting to know you're not alone and that often you're better off!

There. Chemo Brain 101 or, what makes me laugh, Chemo Brain for Dummies.

Chemo Brain 101