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Navigating Through Chemo Brain

How to help yourself when you experience chemo brain.

Navigating Through Chemo Brain

“Many women treated for breast cancer say they have problems remembering, thinking, and concentrating during and after treatment. These problems are commonly called “chemo brain” or “chemo fog”.” – source: breastcancer.org

Many cancer organizations share their tips on navigating through Chemo Brain. We’ve curated a list of all the best tips. Oh, and you can submit your tips or add comments to tips submitted by others.

#1 Tell others

"Another thing you can do to better manage chemo brain is tell family, friends, and your cancer care team about it. Let them know what you’re going through. You may feel relieved once you tell people about the problems you sometimes have with your memory or thinking.

You’re not stupid or crazy – chemo brain is a side effect you can learn to manage. Even though this isn’t a change that’s easy to see, like hair loss or skin changes, your family and friends might have noticed some things and may even have some helpful suggestions. For instance, your partner might notice that when you’re rushed, you have more trouble finding things.

Tell your friends and family members what they can do to help. Their support and understanding can help you relax and make it easier for you to focus and process information." - source: cancer.org

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#2 Trouble remembering names?

"Think of a silly thing to jog that memory- I remember my neighbor Rena's name by thinking Xena Warrior Princess. Sounds silly, but I never forgot her name again!" - source: oncolink.org

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#3 Relax

"Stress and anxiety can affect your memory and concentration. Relaxation techniques can help to reduce stress and anxiety, including listening to calming music, practising deep breathing, listening to a relaxation CD or using an app.

Some people find using mindfulness helpful. Mindfulness is about focusing on the present moment to try to reduce stress and improve your quality of life. Many people also practise mindfulness on their own – there are lots of books and websites dedicated to mindfulness, as well as apps." - source: breastcancercare.org.uk

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#4 Minimize distractions

"Employers are required by the Americans with Disabilities Act to make reasonable accommodations for health-related issues such as chemobrain. A more soundproof environment, like an office or a cubicle in a different location, can decrease distractions and improve concentration in the workplace." - source: mdanderson.org

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#5 Treatment with psychotropics

"Some people benefit from taking stimulants such as methylphenidate (Ritalin), dextroamphetamine (Adderall), or modafinil/armodafinil (Provigil/Nuvigil). These tend to be most helpful for fatigue and improving attention and concentration." - source: dana-farber.org

“No medications have been approved to treat chemo brain. Medications approved for other conditions may be considered if you and your doctor agree they may offer some benefit.

Medications that are sometimes used in people with these symptoms include:

– Methylphenidate (Concerta, Ritalin, others), a drug used to treat attention-deficit/hyperactivity disorder (ADHD)
– Donepezil (Aricept), a drug used in people with Alzheimer’s disease
– Modafinil (Provigil), a drug used in people with certain sleep disorders
– Memantine (Namenda), a drug used to improve memory in people with Alzheimer’s disease, may help during radiation therapy to the brain” – source: mayoclinic.org

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#6 Place items in the same place

"Place items such as car keys, cell phones and planners in the same place." - source: llscanada.org

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#7 Plan your day

"Keeping a record of your symptoms may help you work out if certain things make your memory worse. For example, you may notice that symptoms seem worse first thing in the morning, or when you’re tired or hungry. This can help you to plan your day so that you do more difficult tasks when you feel at your best." - source: macmillan.org.uk

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#8 When talking or listening

"Sharing information can be difficult if you have problems with concentration and memory. Here are some ideas to help. If you feel overwhelmed with information:

- Ask people to repeat things.
- Ask people to slow down.
- Avoid distractions around you. Do ask the person to move to a quieter area.
- When speaking on the phone, do so in a quiet area.
- If you feel tired, avoid large group conversations." - source: cancer.ie

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#9 Physical activity

"Physical activity, such as walking, swimming or gardening, can help make you mentally alert. It is also important to get plenty of rest and try to reduce your stress. Yoga or meditation can help you relax and think clearer." - source: cancer.ca

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#10 Check Red Blood Cell Counts

- "Anemia is a condition that occurs when the body does not have an adequate amount of red blood cells."
- "Anemia can cause cognitive issues."
- "Ask your healthcare team to check your red blood cell counts if they are not doing so already." - source: pearlpoint.org

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#11 Following Routines

"Organization is important when facing memory problems. Having a daily routine or keeping a daily schedule can help you focus and stay on track. Try picking a place for commonly lost objects such as keys and medications, and put them there each time. A journal or planner can help you remember where things go." - source: asbestos.com

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#12 Check in with your brain

"Practice difficult tasks. If you need to tackle a complex task, you may want to practice it until it becomes very familiar." - source: rochester.edu

"Check in with your brain. If you feel spaced-out or your mind wanders, try asking yourself every few moments, "What am I doing right now?" or "What am I thinking about?" This keeps you from drifting and helps you refocus." - source: rochester.edu

"Keeping your mind active may help – for example, doing crosswords, sudoku and puzzles." - source: cancerresearchuk.org

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#13 Eat Well

- "Choose foods that promote healthy brain functioning such as fish (omega-3 fatty acids), dark leafy greens, fresh fruits and vegetables, and whole grains."
- "Avoid alcohol and other substances that alter cognition." - source: pearlpoint.org

"Cut out the junk. Focus on lean proteins and a colorful assortment of vegetables (especially dark leafy greens) and fruits that nourish the brain. Avoid saturated fats (cheese, whole milk, lard, butter, fatty animal products) and trans fats (in some fast foods and baked goods such as pie crusts, donuts, crackers, etc.) that can clog arteries and cause poor blood flow to the brain (there's a reason trans fats are banned in restaurants in a few states). Omega-3 fats are the good guys (wild salmon, fish oil supplements, herring, flaxseeds, chia seeds, walnuts, etc.). Researchers believe they improve mood and protect against inflammation and cognitive decline." - source: huffpost.com

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#14 Don’t try to multitask

- "Focus on the priorities that are most important to you. Delegate tasks or leave other things undone."
- "When you approach a task that requires a lot of mental energy, break it down into smaller goals."
- "Don't try to multitask, especially in situations where it could be dangerous, for example, when driving or while cooking." - source: rogelcancercenter.org

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#15 Organise your medications

- "Ask your pharmacist for a dose aid (e.g. a dosette box) to help you organise your medications according to when they should be taken each day. These come in various forms and you or your carer will need to fill this daily or weekly."

- "Alternatively your pharmacist may be able to organise for your medications to be packaged into daily doses e.g. a Webster-pak®. This is a medication packaging system that organises a week’s worth of medication into individual compartments, making it easier to manage your medications and help prevent forgotten doses or double doses."

- "Set an alarm to remind yourself to take your medications." - source: eviq.org.au

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#16 Use a planner or personal organizer.

"Make lists. Carry a pad with you and write down the things you need to do. For example, keep lists of things to buy, errands to run, phone calls to return, and even the times you need to take your medicines. Cross items off as you finish them."

"Use a planner or personal organizer. These can help you stay on top of day-to-day tasks and keep track of appointments and special days like birthdays and anniversaries." - source: cancercare.org

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#17 Get plenty of rest

"Being overly tired can wear on anyone's memory. Get the sleep you need and take breaks during the day to wind down and relax. When your schedule gets hectic, you're more likely to become absent minded. Take time every day to stop and unwind." - source: mdanderson.org

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#18 Seek support

"See an oncology social worker if you are having trouble coping with memory problems."

"Think about joining a support group for people in cancer treatment. They may have the same problems. You can share coping ideas." - source: healthlinkbc.ca

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#19 Keep it simple

"Get organized, in whatever way works for you. Put your medical bills in a shoebox if filing is too difficult. Toss your keys in a bowl by the front door when you come home. Let others host the big holiday celebra­tions or manage new projects at work for now. Let go of perfection; “good enough” is just fine most of the time, and especially right now." - source: prostate.org.nz

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#20 Preparing for an appointment

- "Keep a journal of your memory lapses. Describe the situations in which you experience memory problems. Note what you were doing and what type of difficulty you experienced."

- "Make a list of all medications, as well as any vitamins or supplements that you're taking."

- "Take a family member or friend along or bring a recorder. Sometimes it can be difficult to remember all the information provided during an appointment. Someone who accompanies you may remember something that you missed or forgot. Record the conversation with your doctor so you can listen to it later."

- "Write down questions to ask your doctor." - source: stelizabeth.com

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#21 Be social

- "Enlist social support: Have family and friends share the responsibilities for tasks, such as organizing large holiday dinners."
- "Be social! Get out among people as much as possible."
- "Use GPS when driving." - source: oncnursingnews.com

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#22 Consider learning to meditate

"Consider learning to meditate, since it can help you relax, strengthen your mind and help improve concentration." - source: swedish.org

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#23 Give yourself a break

"Most importantly, I think, is for you to give yourself a break. Fighting cancer is not for sissies! If you have memory lapses every now and then, it is okay. Besides, stressing will just make the issues worse." - source: lungcancer.net

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#24 Answering machine or voicemail

"Let phone calls go straight to your answering machine or voicemail. You can listen to them when ready and prepare how you will respond." - source: cancervic.org.au

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#25 Track your memory problems

"Keep a diary of when you notice problems and what's going on at the time. Medicines taken, time of day and the situation you're in might help you figure out what affects your memory. Keeping track of when the problems are most noticeable can also help you prepare. You'll know to avoid planning important conversations or appointments during those times. This record will also be useful when you talk with your doctor about these problems." - source: gundersenhealth.org

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#26 Develop realistic expectations

"Trying to hide, rise above or ignore the cognitive challenges you face increases stress and fatigue. This, in turn, can lead to more cognitive challenges. You will manage these challenges more effectively if you have realistic expectations, pace tasks throughout the day and week, and allow time for stress reduction and rest."

"Decrease the demands on your memory. Use a calendar, make lists, take notes and set up reminders." - source: allinahealth.org

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#27 Tip – labelling each pill with the day of the week.

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#28 Thank goodness for knitting!

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Today is one of those days that I need the serenity of mind that only crafting and in particular, knitting, seems to bring me. Since chemotherapy I have experienced PCCI or chemotherapy induced cognitive disfunction. It's light heartedly referred to as chemo brain or chemo fog. It becomes more noticeable the more things you try to take in or do and becomes more of an issue as cancer patients attempt to return to work. For most people these symptoms end within a year of completing treatment but while you've got it, I can confirm it's really quite scary and not taken seriously enough. Up to half of women treated for breast cancer experience PCCI and up to two thirds of men treated for prostate cancer do too. That's a lot of people struggling. Returning to work in whatever form that takes, either as a self employed business owner like myself or a full or part time employee, is tough anyway, but having no recall of even some of the most basic activities, is quite frankly, terrifying. It's not always the same either - yesterday for example, I couldn't remember how to copy an area of text in a word document on my computer. I just sat there staring at the screen. Today I couldn't remember my daughter's name. One of the other issues is spacial awareness, which is why many people who have stopped driving during treatment are scared of getting back behind the wheel. Discussing it with health practioners hasn't got me very far at all. One even went so far as to joke that I'd best get used to it as it happens to all women as they get older! I'd love the opportunity to discuss this further with someone who's looking into PCCI whilst I'm going through it and can explain the issues. Ironically once out the other side I'll probably forget much of the detail. Sadly no one seems interested which is also very frustrating. One thing I have found is that by taking a step back when my brain feels completely overwhelmed and doing something like knitting seems to clear some of the fog and enables my brain to relax and even sometime gain some clarity. Thank goodness for knitting! #mindfulness #fuckcancer #fubc #breastcancer #cancerawareness

A post shared by Susan Crawford (@susancrawfordvintage) on

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#29 Start a home project

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#30 To-do list has been mega overwhelming

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#31 Doing all these 6 steps really helps my brain to stay alert

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#32 Downloading the @macmillancancer app to manage your meds

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#33 A friend recommended this app to improve memory

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