Autopsychotherapy and MS Cognitive Aids

I made that word up! Wait... I coined that word. Sounds much more impressive. After writing my last blog post, I went straight to my word processor and wrote my little heart out. And my head. Who needs a psychologist? ;)

This is what I wrote:

Thoughts March 10, 2013

I don’t know why I am so upset or why I am crying.

I think I am tired. I am worried I will not be able to sleep. I am worried that my sleep problem will never improve. I cannot be functional without sleep. Even with Ambien CR, I am not sleeping well. I am worried that my sleep therapy is not working. It’s not changing anything.

I wonder if I can increase my Ambien CR dosage. I wonder if there is another medicine I can add. I wonder if I should try increasing my Celexa dosage.

I wonder if I am traumatized by my surgery. After all, I was awake and felt them cutting. The wire hitting my dorsal nerves was incredibly painful. Then I had the fear of them giving up.

But they didn’t give up. They tried a little more and got it.

Maybe I am feeling sorry for myself. Maybe my tears are coming easily today, since I am so exhausted. That is normal for me.

I think I am anxious about the week ahead. I am so exhausted already. I was not able to rest, since B was here yesterday. But I love to see B. Can I not have anything I enjoy anymore?

OK, time to look for distorted thoughts.

Worried that I will not be able to sleep. This is fortune telling. Worrying about it might make it worse, because I might be anxious at bedtime. I don’t know what will happen in the future. It’s true that I might not be able to sleep. I can talk with Dr. Rob about it. I can talk with Dr. Eric about it. But I might sleep better again tonight. I hope that taking Flexeril tonight will help.

I would like to speak with Dr. Eric about my behaviors of speaking dream dialogue and acting out dreams. Also the weird breathing—is it snoring? Also fragmentary myoclonus—my finger twitches. I learned that sleep groaning is not from an emotional or psychological disorder. I learned that SSRIs (like Celexa) can exacerbate periodic limb movements, like sleep myoclonus. Maybe speak to doctor about discontinuing Celexa for a while. I keep seeing that clonazepam is used to treat fragmentary myoclonus. Can I try this? The fact that Flexeril helped me sleep makes me wonder.

Wow, researching Flexeril made me hopeful. It has helped a lot of people sleep. It has been shown effective for fibromyalgia, and I can’t help but compare that with MS—both being neurological.

About my possible traumatization from the surgery. I could bring it up with Ruth or Dr. Eric. Probably Ruth, since she knows me better. But isn’t all well that ends well? I don’t know how much it really bothers me.

About my fears of not making it through the week ahead. It certainly will be a busy week. But again I am fortune-telling. It is true that I might not be able to do everything. Or I might be exhausted. So I might need to miss some work. I would like to see all three kids on Monday. I must see J on Tuesday, and I must go to R's meeting. But I can miss R and maybe P. Rest up for R's meeting. On Wednesday I can go in late, start with C's meeting at 11:00. Thursday I should work all day. I know “should,” but it kind of is a should. I missed the last two Thursday mornings, and I would love to pull the boys for their 9:30 session. On Friday I can just go to Head Start for 45-60 min then rest before the pain clinic. That schedule should be manageable.

L will definitely drive me to the hospital on Friday. She can’t drive me to work on Thursday. Maybe A C and D can. Or just A C. I wish I could get a ride to St. Augustine on Tuesday.

I need to make appointments with the MS Clinic and the dentist. The dentist is definitely a need. I don’t want that broken tooth getting infected or breaking more. I would like to call tomorrow.

I am worried about working with A. His mom is so crazy. (Labelling!) But she does love me. Hopefully that love continues. I am really good at getting kids intelligible. She is excited to get back to Cycles therapy, since A has stagnated in the last month or so. I will probably need to coordinate targets with K, which may be difficult, since she dislikes me and is disinterested in trying Cycles. I can let A's mom fight that battle. I hope I can keep A interested and working with me for a full 45 minutes. If not, we can cut it to 30 minutes. I can work on Metaphonological skills, if A will cooperate.

Back to the dentist. Friday midday would work. Or next Monday afternoon. Or Tuesday afternoon, missing the Pals meeting.

I feel so much better. Points of action (as much as I can handle of this):

• Dentist appointment for 3/15 midday, 3/18 pm, 3/19 pm, or after work
• Plan A's session (mom wants to begin with /s/ blends)
• Put out the word that I am looking for rides on Tuesday and Thursday.
• Speak with Ruth about surgery
• Speak with Dr. Rob about Flexeril (possibly start), Klonopin (possibly start), Celexa (possibly stop), bowel issues
• Make an appointment with Dr. Rob (see above availability)
• Speak with Dr. Eric about speaking dream dialogue, acting out dreams, fragmentary myoclonus, groaning, possible snoring, relaxation homework, results of the intake paperwork I filled out (rating scales), chicken and egg with depression and sleep—seems insomnia comes first bc I am only depressed when I am exhausted and sleep deprived
• Look up MS memory strategies. Oops, forgot.

Here is what I found on MS memory strategies

• Memory exercises on a computer? (no evidence or testimonials that it works)
• Home or work strategies with notebooks, organizers, or filing systems to help you remember things

These were strategies that people with MS suggested on a message board:

• Notebooks for doctors
• Print out weekly calendar pages, take notes on them, keep in “go bag”
• Make a place for bills to live before being paid.
• Say it out loud, then write it down.
• MS memory problems or cognitive problems are often attention/concentration problems.
• When trying to remember a list of things that you need at the store, you can visualize the items.  Picture a room in your house, like your foyer.  Imagine a place where you would set items, like the foyer table.  Visualize the item you need on the table.  Visualize another item you need on that table, underneath, or in a weird location in that same room (maybe hanging somewhere in the room, tipped on it's side, etc..  Do this for all your items.
• A variation of this is called method of loci.  Imagine the item in a familiar place or route.  "Pick up" the items when you visualize yourself either walking through your house or driving your car.  You can memorize your shopping list, etc. this way.
• There's many other tips, using other senses, like auditory.  Songs, rhymes, hearing you say the words, lists, nams, etc.  Then there's organizational techniques, like mnemonic devices--  For example:  My Very Earnest Mother Just Served Us Nine Pickles.  This acrostic is the planets in order from the sun out:  Mercury, Venus, Earth, etc.
• Another one that I like a lot is to make an association to remember names of people.  My husband gave me this tip.  He's the world's best at remembering names of people.  I had a friend name Stuart and I couldn't remember his name to save my life.  When I saw him in the grocery store last, I was sweating bullets to get his name out to introduce him to my husband.  He took the pressure off of me and introduced himself.  After we left the grocery store, my husband told me that this was an easy association.  Stuart "Little" because Stuart is not little he was big.  I still remember his name to this day, and have no problems with that.    Associations are big in education these days.  Association and making connections is key to remembering  what you read.  Connect when you see something that you should remember.  That reminds me of . . .
• I've found that when the brain is working its working, when it goes on holiday and forgets to let me know, it doesn't matter what i know, um all the tricks are packed away in the bottom of the suitcase, probably still going around and around the luggage carousel waiting for my brain to claim it lol. 
• I would recommend checking out the ADD, Dyslexic or even CAPD (central auditory processing disorder) community or information sites, lots of usefull information to be found.
• The other problem is a total lack of recall of fairly important conversations. One would think that given the importance of the subject and length to which it was discussed, someone could trigger my memory, but NO. – So true!!