Symptom Management

Clearing Cognitive Cobwebs

By Jeffrey N. Gingold



Written a letter lately? If you tried to write one on a desk packed with files, books, bills, and old newspapers, then you understand environmental distraction. Then the phone rings and you feel the urge to check for e-mails and texts, knowing that the cat litter should still be changed. It's already noon. Your mind can’t compartmentalize simple tasks, while MS fatigue drags you down like a thick tangle of cobwebs. Mental diversions flatten your MS-diminished energy and you haven’t yet accomplished one meaningful daily chore. 

 

Being diagnosed with MS is complicated and its life path is crowded with symptoms, exacerbations, medical appointments, and therapies. Completing a simple project in your MS-hampered world requires energy and focus. MS physical and cognitive disabilities are compounded by simultaneously coping with both sets of impairments. Unfortunately, you don’t get to choose enduring one disabling path over the other. Nope. 

 

Initially, MS handed physical disability to me. From my scalp and down to my toes, numbness surfaced on the left side of my body, along with loss of equilibrium, taste, and vision. Like a cliché commercial for an unwanted product: “but wait, there’s more!” After cognitive testing, I was informed my executive functions were affected, buried under fatigue and slowed mental processing. It explained why my ability to recognize familiar faces, locations, memories, and vital details was unreliable.

 

In your MS life have you ever thought “multitasking is now easier?” Probably not. For me, being easily distracted obscures my ability to recall previously understood information, tasks, and conversations. By the time I ask the world to stop interrupting my chain of thought, it’s too late to recall the rest the sentence. Gone without a hint.

 

Simple distractions are devious, silently piling up like coats of attic dust. Repeatedly fretting about overstuffed drawers, book piles on shelves, and stacked boxes of unknown family papers adds to your MS load. Repeatedly staring down cluttered spaces in your home drains mental reserve and interrupts your focus. 

 

One way to manage cognitive distractions in your surroundings is to remove them. If your surroundings are less distracting, then you are more efficient with your depleted cognitive awareness. Don’t waste time struggling to see through layers of cobwebs, remove them.

Piles

Everyone probably has cluttered corners of their household that should be reorganized. Identifying and clearing your environment is a key to better managing your MS. Cognitive cobwebs tangle and drain your attention. 

Decluttering your environment clears your mind like cleaning smeared eyeglasses reveals the view. My wife and I have employed the philosophy of avoiding clutter in our home. We have a two-year rule that guides us: for items that haven’t been touched for two years or won’t be used in the very near future, either sell, donate, or toss it. Space cleared with few regrets.

Set a reasonable goal to clear some shelves and closets, then hold yourself accountable with a partner, encouraging you to honestly declutter. This is helpful if you require physical assistance. Reorganize one room or cabinet at a time, discarding obsolete clothes, furniture, and dust-covered stuff. Pace yourself with the timing of your best MS energies. There may be several uncluttering projects that each take more than one afternoon. Be patient and persistent.

Some Examples:

• That suitcase full of old family films and photos, don’t let them decay. There are image businesses that will take your archives and digitize them to CDs or computer files. Your family history is not only preserved, but can be easily shared. Afterward, quickly toss the old useless recordings.

• How long must you save old tax returns and the supporting documents? It isn’t forever, check with IRS or a tax preparer. Securely store what is required and shred the rest.

• Reorganize and clear those “scary” shelves. Starting with old books, junk containers, outdated reference and travel materials: let them go. If you think that you still need your high school or college notebooks, then this will be a labored process for you. Ask yourself why you would ever look through it again? You probably haven’t, won’t, and neither will anyone else. Harsh reality. Piles of useless information are a burden to store. Look at it one more time, if you must, then toss it. Most of us will not have a presidential library dedicated in their name, welcoming such archives. 

• Do you need to store old cans of paint to touch up rooms that are no longer that color? Doubt it. There are ways to properly dispose of old paint, chemicals, flammables and other dangerous materials. Most municipalities have facilities to safely accept these items, so let them and don’t save it. A cleared shelf is uncomplicated and beautiful, even in the basement, you’ll see.

• Where there is a cluttered closet, shelf or basement corner – picture a clear space, then get to work. Think of museums and their valued spaces and collections. They don’t stack, horde, and display all of their possessions; and neither should others. 

• Accept help to move items and donate them: Generously hand items to Goodwill and record a tax deduction. Some places, such as Purple Heart, will pick up and remove loads and furniture at no cost. It is a good feeling to give something useful to others who may benefit from it. Point and let them take it away with smiles.

• Outdated medication should be properly disposed and not indefinitely stored for the “next time.” Check with your medical provider, but you should probably only save what is currently prescribed for you to use, until it is expired. It is a serious risk to do otherwise and will prevent you from being confused by outdated medication.  

Don’t let your mind be disoriented by any cluttering mounds around you. When they are gone, then so are the attached mental distractions wasting your attention. Declutter and clear your cognitive space for useful thoughts and plans.

Takeaways

As you plot to clear cognitive space, remember to:

• Decide which space to handle and don’t be distracted by “rediscovered” nostalgic items;

• Pace your MS energy to accomplish the clearing task, being reasonable with the expectations and pile depth;

• Decide what to toss, sell, or donate – then do it;

• Accept help from a partner to confirm and follow through on your expectations. They will be a cognitive clearing coach, if you will.

It takes determination to free up mental and physical space. Seeing a cleared area is empowering. Relish it, but don’t be tempted to reclutter your MS reality.

For more tips about managing cognitive challenges, check out Jeffrey Gingold’s books,

Facing the Cognitive Challenges of Multiple Sclerosis, 2nd Edition” (Demos Medical Publications, 2011) and Mental Sharpening Stones: Manage the Cognitive Challenges of Multiple Sclerosis (Demos Medical Publications, 2008).