June chitchat

[agate]

Heading into summer now, here we are at June 1. What is new with you? Have you read any interesting books, seen any interesting movies, been anywhere lately?

Are you growing anything just now? I have a new hydrangea plant that a neighbor gave me. I'm hoping it isn't going to turn out to be one of those huge hydrangeas because it is going to have to stay in a pot. Last year's plants came through the winter--a geranium and at least one of the two mums, as well as the 4 hostas and the hakone grass. I'm not buying any new plants for the patio this year.

The building I live in still has no maintenance person. There is one but he isn't coming back until June 25. He will have been gone for 11 weeks by then. In the meantime maintenance just isn't being done. He's having knee surgery or has just had knee surgery (the stories differ).

But the weather here has been perfect lately.

I hope you've been having good weather too, wherever you are.

In case you missed it, May 30 was WORLD MS DAY. I'm not sure how this is meant to be observed but this tells more about it:

Only registered and activated users can see links., Click Here To Register...

[Virginia]

Well, I am finally back on. I am on a new tablet that my brother just set up for me yesterday. I find it much like my old one. I am going to try to send an email on it later today.

Nothing much going on around here this month. I went out this past Monday and got in somewhere around 5:30 to 6:00PM. By about 7:30 or 8:00 I knew I was sick. I have been sick since then. My voice is beginning to sound a little more normal today and I am feeling better. I thought it was an allergy but then I read in the paper that we are getting small particles and toxins high up that we cannot see. They are coming from the fires in Canada. The paper said the day could be bright, but even just stepping out for a very brief period time could cause susceptible people to get sick. I might be one of those people.

Otherwise, everything is going along about like usual. My brother was here yesterday to set up my tablet. A man came to work on my refrigerator and by the time they both left I was worn out.

Agate, I don't know how you can hold up for 4 hour visits. That is just too much. I think asking someone like that to stay for lunch is really risky. Then they may think you are enjoying them so much that you just want their company. While it sounds as though she is a very nice person, it also sounds as though she might be lonely and maybe thinks you are. She probably doesn't realize that you tire more easily than an able bodied person does. I am sure you are not boring but I am also sure you get really tired. I know what MS does.

I am glad you have had really good weather. Ours has still been on and off rain. Since I didn't go out yesterday, I was surprised to find out last night it had been nearly 90 degrees here. Monday when I went out it was a beautiful day, but since then we have had more rain.

I have a couple of house plants which don't do all that well and that is all I try to grow. I used to do a little more when I was in my house, but I can't seem to get anything that blooms to last here. It is too much sunlight or not enough.

Hope everyone has a good June and your weather is not too hot.

[agate]

Congratulations on the new tablet, Virginia! It's too bad you haven't been well, and if it was air pollution that caused your illness, what can you do but try to avoid the air? Would wearing a mask help?

I'm still wearing an N95 mask when around people but I'm probably being overly cautious. If and when the wildfires start causing pollution problems around here, more people will start wearing masks.

You're so right about mentioning mealtime as a way of prompting a guest to depart. I wish I'd thought that through better. By the time she actually left I was getting everything wrong, getting more and more muddled.

I have trouble admitting that MS does affect the brain. But it does. Or aging does. Or both.

[Virginia]

I sometime get that way when I am very tired. A neighbor called yesterday and twice today. I appreciate her checking on me but I don't think that is what she was doing. She was bored and expected me to be. I am worn out with trying to talk when my voice still sounds so bad and congested.

The paper did recommend mask earlier in the week. I will be sure to find out what is still recommended before I go back out. Something is wrong with this tablet. I am going to get off for tonight.

Tim, hope you. are doing well.

[agate]

Yes, the voice gets tired too, apparently. Nowadays my voice sounds bad most of the time--reedy and crackly and congested. I keep popping sugar-free lemon drops to cut down on some of the hoarseness and dry-mouth problems but they're not a cure-all.

[Prot]

I'm still trying to improve my sleep pattern. Without a doubt ageing does affect us all cognitively,irrespective of whether we have MS, but not as much as it used to do. This is why on intelligence tests results are age adjusted.


These are IQs without correction for age.

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This is what ChatGPT had to say re MS and cognition.

Overview of Multiple Sclerosis


Multiple sclerosis (MS) is a chronic autoimmune disorder characterized by inflammation, demyelination, and neurodegeneration within the central nervous system. The immune system mistakenly attacks the myelin sheath—the protective covering of nerve fibers—leading to impaired signal conduction between the brain and the body. MS can follow various courses, including relapsing-remitting, primary-progressive, and secondary-progressive forms, each with differing patterns of symptom onset and progression (Only registered and activated users can see links., Click Here To Register...).
Cognitive Impairment in MS

Prevalence

• Affects up to 65% of patients. Comprehensive neuropsychological studies estimate that 45–65% of people with MS experience some degree of cognitive difficulty at some point in their disease course (Only registered and activated users can see links., Click Here To Register...).
• Often under-recognized. Cognitive symptoms can be subtle initially—patients may attribute “brain fog” to fatigue or stress rather than MS itself (Only registered and activated users can see links., Click Here To Register...).

Domains Affected

1. Information Processing Speed
   • The hallmark deficit in MS, manifesting as slowed mental “reaction time” or needing extra time to think through tasks (Only registered and activated users can see links., Click Here To Register...).
2. Memory
   • Particularly new learning and retrieval; patients may struggle to remember recent conversations or appointments.
3. Attention & Concentration
   • Difficulty sustaining focus, multitasking, or following conversations in distracting environments (Only registered and activated users can see links., Click Here To Register...).
4. Executive Functions
   • Impairments in planning, problem-solving, and decision-making can emerge, affecting daily activities like organizing tasks.
5. Visuospatial Abilities & Language
   • Challenges in spatial perception or word-finding (“tip-of-the-tongue” phenomenon) are reported in a subset of patients (Only registered and activated users can see links., Click Here To Register...).

Impact on Daily Life


Cognitive deficits can interfere with employment, social participation, and activities of daily living:

• Work performance: Slower processing and memory lapses may reduce productivity or necessitate workplace accommodations.
• Driving & Safety: Impaired reaction times and divided attention can compromise safe driving.
• Emotional Well-being: Frustration, anxiety, or low mood often accompany cognitive changes, further exacerbating difficulties (Only registered and activated users can see links., Click Here To Register...).

Assessment of Cognitive Functioning


Standardized neuropsychological tests are employed to screen and monitor cognitive changes in MS:

• Symbol Digit Modalities Test (SDMT): Sensitive to processing speed deficits.
• Paced Auditory Serial Addition Test (PASAT): Measures sustained attention and working memory.
• Brief International Cognitive Assessment for MS (BICAMS): A concise battery recommended for routine clinical use (Only registered and activated users can see links., Click Here To Register...).

Regular screening—ideally annually or upon patient/caregiver report of decline—facilitates early detection and intervention.
Management Strategies

1. Cognitive Rehabilitation
   • Tailored exercises and compensatory strategies (e.g., memory aids, structured routines) delivered by neuropsychologists or occupational therapists to bolster affected domains (Only registered and activated users can see links., Click Here To Register...).
2. Pharmacological Interventions
   • Although no medications are FDA-approved specifically for MS-related cognitive impairment, studies have explored agents like donepezil or memantine with mixed results; ongoing research is needed.
3. Disease-Modifying Therapies (DMTs)
   • By reducing inflammatory activity and new lesion formation, DMTs may indirectly slow cognitive decline over time.
4. Lifestyle & Supportive Measures
   • Exercise: Aerobic and resistance training can improve neuroplasticity and cognitive reserve.
   • Cognitive Reserve Building: Engaging in intellectually stimulating activities (reading, puzzles) and maintaining social connections may buffer against decline (Only registered and activated users can see links., Click Here To Register...).
   • Fatigue & Mood Management: Addressing sleep quality, depression, and anxiety is crucial, as these factors exacerbate cognitive symptoms.

---

By recognizing the multifaceted nature of cognitive dysfunction in MS—its prevalence, affected domains, and real-world impact—healthcare providers and patients can collaborate on timely assessment and individualized management plans to preserve function and quality of life.

[agate]

Tim, a question for you. Chat GPT is a variant of AI as I understand it? The information you posted is providing a few indications of sources, and they are considered reliable sources of MS information. I believe that when I do a Google search for something nowadays, the information that comes up on the top of the screen is the AI result, and I've been noticing that it seems to be a summary of all of the information that AI could find when it went looking. Is that how it works? In other words, is AI doing for us what we would have to do before AI came along--look through all of those (many many) Google search results and fish out those that look like the information we're looking for? That's mighty nice to have and should be a time-saver. But I don't understand why there is so much discussion on various Websites and from various organizations about the huge importance of AI and what immense changes it's causing. There's something here I'm not getting. Maybe you know?

[Prot]

You are right. It's a variant of A1. You are also right that an AI result(overview)appears as the 1st result.It's very much quicker, though not necessarily better result wise, than a conventional search. I like to use it because it organises and presents the information much better than I could.I have a marked deficit when it comes to organising and planning, struggle to prioritise when it comes to multistep tasks.

There are two main contentious areas when it comes to AI. Only registered and activated users can see links., Click Here To Register... and education/research papers. Only registered and activated users can see links., Click Here To Register... Only registered and activated users can see links., Click Here To Register...

[Virginia]

There are many variants of AI as I understand it. I had rather be without it. I have discussed the many benefits of AI, such as a cure for diseases and so on. However, the downside is as great or greater. It can already talk in a voice that sounds as exactly like another person. In other words if a child calls a parent and says I've been arrested. It may not be your child. AI only needs to hear your voice for a few seconds to sound like you. It goes on and on and it is going very fast. I heard a man who works in AI say recently that sooner than we thought there would be 20% unemployment because of AI. The list goes on. I find it more scary than the good it can do.

Tim, hope your sleep problems will soon get straightened out and you will feel like new!

[agate]

Virginia, the world is getting to be more and more like a science fiction story, isn't it?

I haven't wanted to be involved with AI either but I've had the impression that everyone is already affected by it whether they want to be or not--or maybe it's just everyone who uses a computer or a cellphone, but that is almost everyone in many parts of the world.

[Virginia]

Most people are already involved I think Agate. My nephew and niece often use it to compose letters for them. I think my brother does also. Then they read over them and make them more personalized if need be. They say it is very fast.

My brother was here setting up my tablet a few days ago. I noticed he had pulled up an AI program on my computer to help him.

At this time, I am not interested in getting into it.

[Prot]

Do you think there's a body-mind connection? I ask because second half of Monday I felt the worst I've felt mentally since moving to Wiltshire in 2017. Tuesday I had chills and aches. Went for a pee at least 13x. Today I'd gone from chills to feeling slightly feverish.It's a probable UTI, something I've had before,several times, but not for ages.

[Virginia]

Tim, I definitely think that our physical condition can have an effect on our mind and our thinking. I am sorry you are having a hard time mentally as well as physically.

I wonder if you can get some medication for your UTI and get that cleared up then maybe your thinking might get back to where you were. UTIs are really hard on me and I expect for most people.

[agate]

That does sound like a UTI, Tim. I hope you can get medical attention soon. I dread UTIs myself and hope you can get the symptoms under control as well as wipe out the bug. Or bugs. Sometimes more than one type of bug is found when the culture is done but you do often have to wait for the culture results before you can be put on whatever drug is needed to target your particular bug or bugs.

[Prot]

Thank you both. Today still not right, but better than I was.