Dr Ranj discusses Cognitive Dysfunction on BBC Morning Live

BBC Morning Live discusses Cognitive Dysfunction (also known as Brain Fog) with Dr. Ranj and answers questions from the general public including a question from a lady with Fibromyalgia.

Thank you Dr Ranj for mentioning The ME Association as a good resource for information about Cognitive Dysfunction (also known as Brain Fog) and for emphasising you should not push yourself, as this cause symptoms to worsen and to remember to take plenty of breaks to rest (00.24.00)

Transcript

Presenter Sam Quek 

Recently we discussed long COVID on the show with Dr Punam and our inbox was swamped with questions about brain fog.

Presenter Gethin Jones

Yeah, it seems loads of people are suffering with this ranch before we get to the questions. Should we just do a bit of a recap? What is brain fog? What causes it?

Dr Ranj

So there isn't actually an official definition. It's not a medical term, but it's a term we use to describe a constellation of symptoms. Some people use the term cognitive dysfunction, which basically just means your brain isn't working properly and it's a difficulty with executive functioning. So, your symptoms can include things like memory problems, forgetfulness, struggling to find names of things or finding words, confusion and fuzziness and fatigue. Some people even get mental health effects from it, anxiety and depression being the classic examples for me, when I had it. Struggling to multitask and forgetting people's names and that led to a real frustration and anxiety.

Presenter Gethin Jones

It's really weird. I've never seen anything like it, you know just middle of a sentence…..

Dr Ranj

Yes, words just drop out of your head.

Presenter Gethin Jones

I know. Yeah, it's bizarre.

Presenter Sam Quek 

Charlotte, it's not just Dr Ranj is it? You were mentioning before you've suffered from brain fog.

Charlotte Smith, Countryfile

So this rings a lot of bells I travel a lot of obviously and I was in a motorway services. Went into the loo, came out, washing my hands and suddenly realized I had no idea how to get out of that place. And I couldn't work out where the entrance was, what was going on and the thing is it's so scary, isn't it? Yeah, because you're used to sort of being in charge of yourself. So suddenly when you're not, it's absolutely terrifying. I had a few instances, like you say, Dr Ranj forgetting people's names and actually I was too scared to go to the doctor because I thought they were going to tell me I had early onset dementia or something. Terrible, I think probably with me, it was the menopause, probably.

Presenter Gethin Jones

Well, I think we talk about that on a lot on the show, don't we in terms of talking about it, getting out and there if you can seek help. Actually, our inbox is full of people asking how's it get over it. For example, Peter, he says his wife has extreme difficulty holding any sort of conversation and cannot answer the phone out of fear. She won't be able to speak properly..

Dr Ranj

Yeah, so the hardest thing about brain fog is that there are no known treatments as yet, and it's much a case of trial and error trying different things and see what works for you. There are some common strategies that we can all use.

Important to remember, most cases will get better over time, but these are things that you can try. So first and foremost, treat any underlying cause there are lots of different causes, menopause being one, B12 deficiency, Fibromyalgia, ME, chronic fatigue syndrome, thyroid issues, Long Covid the classic one, that's what I had.

So try and treat those, if you can, brain pacing is really important. That's where you break things down into smaller, manageable chunks and take breaks in between tasks. Give your brain space to breathe, prioritize the most important tasks, use visual prompts and memory aids, writing things down in a notebook.

I use cue cards a lot in this show, mainly because of my brain fog, not just forgetfulness. And also I find when I'm having a conversation, people, if I'm struggling, I tell them I'm really sorry. I'm not being rude. I'm not being slow. I've got brain fog. So, I may struggle to remember things or even remember your name.

Presenter Gethin Jones

So, it's okay to say that, in our place of work and that makes a lot of sense.

Dr Ranj

It reduces your anxiety automatically

Presenter Gethin Jones

Course it does, yeah.

Presenter Sam Quek 

Yeah, absolutely. Okay, brilliant. Thanks, Dr Ranj And Pam has also been in touch to say she's suffered from fibromyalgia for 28 years. A healthy diet and daily exercise has reduced pain but she can't seem to get rid of brain fog. Is there anything she can do?

Dr Ranj

Oh, fibromyalgia is one of those conditions, again, we don't understand it very well. We do know involves sensitization of the nervous system and then it malfunctions and the classic symptom that people get is pain. Often these people need specialist care and help. There are other things in places you can go.

Uh, for information, Fibromyalgia action UK has information on managing fibromyalgia on there and it's got a patient forum where people share tips and advice with each other on what has worked for them. The ME Association has got a great section on brain fog. Long COVID physio is a great online resource and all the social media that you can use to get advice.

Other tips, I would say, reduce your alcohol intake, increase your physical activity within your abilities. Remember if you push yourself too hard, it can actually push you back and pay attention to sleep and your sleep hygiene improve your sleep as much as you possibly can, and he has a massive effect on things like this.

Presenter Gethin Jones

Sleep comes up a lot, doesn't it? Mr. Hall suffers from brain fog after catching Covid and found that doing 10 minutes of cardio helped him. He's asking why? (N.B As above, Dr Ranj says: ” increase your physical activity within your abilities. Remember if you push yourself too hard, it can actually push you back”)

Dr Ranj

Well, one of the theories behind the causes of brain fog is that they're sluggish brain flow and not enough oxygen going to the brain. And we know that physical activity, aerobic exercise, like running, dancing, strictly fitness, cycling, swimming, whatever you can do, we know it increases blood flow and it increases oxygen supply to your tissues. So, that could be one of the reasons why it helps it's well worth trying.

Presenter Sam Quek 

And if people are still worrying about brain fog, is there anything, they can do to help themselves.

Dr Ranj

Please don't suffer alone. Please talk to someone about it. Your healthcare professional is there for you. If it's an underlying condition, like Long Covid, you may need to be referred to a Long Covid clinic. Um, use all of those general strategies that we've mentioned already. Like I said, there's no specific treatments, but there's a lot of information we've given them already. So I find that using an acronym, a simple acronym, as a reminder is really helpful.

We've got one called fog F stands for focus on one thing at a time. O stands for organize your day, use planners and reminders to keep you on track and G stands for give yourself brain breaks, time to relax. These are breaks in the day where you do nothing, give your brain just a bit of space to breathe. That was one of the things that I found really effective. Don't take on too much, slow down, start saying no to things and please be patient. This takes a long time to recover.

Presenter Gethin Jones

Yeah, but he can do. That make sense to you, Charlotte?

Charlotte Smith, Countryfile

Yeah, I think that was the thing. I tried to slow down a bit and that helped. Yeah and I think talking about it because I didn't talk about it for quite a long time, because I was embarrassed. Once, I sort of said, this happened, other people said, oh yeah, I've had that and you thought, oh it's the thing. I'm not going mad, Which is really reassuring

Presenter Gethin Jones

A problem shared.

Presenter Sam Quek 

All good now, improved.

The ME Association information

We have the following information on Cognitive Dysfunction (also known as Brain Fog) ,a leaflet about Fibromyalgia and on Energy Management and Pacing below: