Tuesday, December 29, 2009


Janet writes: When we search for interesting material to link to on this blog, we sometimes come across things that cause more questions than answers. I saw one article that recommended physical therapy for your cognitive problems? Well, I suppose, if you go to the PT who does it all, but most of the time you would see an occupational therapist (OT) or a speech and language pathologist (SLP) for cognitive issues. I have included links here if you don’t know the differences between the therapies, since I get this question all the time. (I am an OT.) Go to these sites and look for the links that say information for consumers.

Here’s another question. I read a brief article on Web MD entitled Multiple Sclerosis: MS Related Thinking Problems. This article states that two of the early signs of cognitive problems in MS are difficulty finding words and trouble remembering tasks, which is true. It also states that a person’s doctor will make sure that these problems aren’t caused by something other than MS, like normal aging, medication, or depression. My question is, considering that depression is also a symptom of MS and most people with MS take a cabinet full of medications, how do you separate these symptoms from the MS symptoms? Our experience with Tim’s cognitive issues was that it took about a year and much tweaking of anti-depressants before we really could tell what symptoms were caused by depression and what was truly cognitive. It just wasn’t an easy process. The description of cognitive function on the National Multiple Sclerosis Society website goes a little more in depth on the standard description – I think most other websites get it from here.

Which leads me to a third question. When I read all these articles on cognitive symptoms and MS, they all state that about 50% of people with MS have cognitive symptoms. (Please say this with a stuffy, authoritative voice.) This statistic comes from neuropsychological studies, but my question is how many people with MS actually go through neuropsychological testing? A thorough neuropsychological test will reveal cognitive limitations, even mild ones. A thorough neuropsychological test also takes a 4 to 8 hour session with a series of health professionals (after which you are so tired that you can’t even remember your own name) and costs four figures in the US (good-bye savings account!). I think the key word in that statement is about.

Well, here’s one last question. When is Tim going to write something again? That’s a very good question! Tim does not like to write because he is a terrible speller and types slowly. Just before Christmas we purchased a copy of Dragon Naturally Speaking for him to try. As soon as he masters using this program, he will try it out with another blog entry. Stay tuned…

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