This Is Your Brain on Drugs—or Not

By Megan

From The Occasional Hot Flash

I made promises and broke them. I arranged to meet friends and failed to show up. People confided in me, and I lost the gist of what they were saying. I gave up trying to remember significant events like birthdays and anniversaries in my own life, let alone others'. Chemo brain made me a horrible friend for a couple of years—at precisely the time that my friends were being particularly loving and supportive to me. And let's not even talk about my shortfalls at work.

Some cancer drugs have been shown to cause changes in the brain, but even women who don't get chemotherapy seem to suffer from so-called chemo brain. Just the shock of getting a cancer diagnosis—not to mention the strain of managing all the doctors' appointments and learning a whole new vocabulary of medical terms—can set off a spiral of inattention, distractibility, forgetfulness, and difficulty in following complex reasoning. It's embarrassing.

But I'm getting better, partly because the fog is lifting and partly because I've adopted coping strategies. Here's what I'd suggest to other women on the basis of my own experience:

• Get a small notebook and keep it in your handbag to jot down to-do lists. It's very satisfying to cross off tasks you've completed!

• Remind yourself to listen. Sometimes I failed to remember things because I never fully heard them in the first place. Get into the practice of paraphrasing and parroting back instructions to make sure you've understood.
• Write all appointments and engagements in a calendar that you carry everywhere. Not only will it remind you when you need to do things but it will also be a good resource if you need to refresh your memory about when you last had a certain lab test, say.
• If you're someone who's used to scheduling her life as tightly as a jigsaw puzzle, you may need to allow some gaps. Having cancer is like having a second job, and you need some time to deal with the paperwork, read up on the disease, and just unwind.
• Don't even try to multitask. Research suggests that in most cases, people don't actually focus on multiple tasks simultaneously. Rather, the brain switches rapidly from task to task and back again, and with every switch it must refocus. All this starting and stopping results in slower completion of each task, poorer work quality and outright blunders—even in people with the nimblest wits. Instead, devote your full attention to one task until you complete it.
• Get used to pardoning yourself and apologizing to others. People can forgive a lot when they understand that what's making you so forgetful is not carelessness but a side effect of your illness and treatment.

You've probably found other strategies that are helpful to you. What are they? Please leave a comment sharing what works for you, so others can benefit from your experience.

Posted May 14, 2010.