I was pleasantly surprised during a recent trip up to Powells Books in Portland to find not only a decent selection of books about MS, but even one that dealt with the subject of cognitive challenges in MS. Because cognitive issues are something that I struggle with, and haven't really been able to find a whole lot of information on, I was pleased to get my hands on this book. The cover was even totally appropriate. A boy standing in the missing piece out of the middle of a huge puzzle. Nice stereotypical metaphor, I dug it.

Jeffrey N. Gingold wrote this book after having been diagnosed with MS and finding the cognitive issues he was facing weren't really being properly addressed by his primary neurologist. Upon finally having some neuropsychological testing done and having the issues brought to the forefront, he was inspired to share his story. Justifiably so, there aren't really any other books out there which offer an insight into the way that cognitive issues can cause isolation and even feelings of complete frustration and fear, at least not that I've found thus far. This is a book which walks us through the process of his diagnosis, which can be a bit repetitive, but mainly focuses on the advent of his cognitive dysfunction. He walks us through the way that he was able to address it, work through it, and begin to use it as a tool for advocacy.

While I am not going to deny that I would have loved to have been reading a book like this written from the point of view from someone a little more like me, I guess that’s sort of like asking the rain to be purple during a drought. Even though I am not a lawyer finding myself struggling to find my words in the middle of an opening argument, I can certainly relate to this "loss of presence". There were many moments reading through this book where I finally sort of felt like, "wow, this is for real, this is not all in my head" so to speak. Hearing someone speak to these issues that I had been dealing with, and struggling to try and express this in intelligible form to others, was all here. I think that Gingold does well to give some examples of the way that slowed cognitive processing leads to not only frustration with ourselves, but also a loss in self-esteem as well as social isolation. 
 
Gingold doesn't leave us just feeling sorry for ourselves, or allowing himself to wallow in pity. It is obvious there is a process we have to go through when dealing with new and seriously strange cognitive issues, of which we may not even have a name yet. Gingold helps us learn how to work through it. From making sure that our needs are being addressed and understood by our doctors, to giving suggestions for ways in which to work with these cognitive setbacks. It is blatantly obvious that cognitive issues are still not being properly addressed by many doctors who are treating MS patients, and it is absolutely vital that we have a pretty good understanding of what is happening in our own bodies and minds, in order to get the care that we need from our doctors. He points out well that second opinions or even third are sometimes needed if we feel like we're just treading water with our neurologists.  
 
As Gingold describes it, cognitive issues can seriously become a sort of "mental wheelchair". Yet another invisible symptom which can leave us feeling totally misunderstood and completely lost in terms of connection with others. The statistics do show that fifty percent or more of people living with MS are dealing with slowed cognitive processing, which affects everything from "word fishing" to a complete "loss of presence". The aspects of these issues, when looked at from the perspective of a twenty-something can also be especially frustrating in a social aspect. When you are young and not trying to be a social misfit, it can be frustrating when you feel like you can't keep up. I think that Gingold does as a good a job as possible to explain these issues from his perspective, and I think that even those of us who aren't married with children and a high paying career can still relate. He gives some great examples of ways to lessen the blow of symptoms, and to be advocates for ourselves, making sure that our voices are being heard, and that we aren't shutting ourselves off for fear of being seen as a total "head case". 

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