Thursday, April 12, 2012

Fibrofog is NOT like Alzheimer's

As will be the case from time to time, I have not been able to write for a couple of weeks. Primarily, the cause has been fibrofog, a common symptom of fibromyalgia which causes an inability to think clearly. When I try to explain fibrofog, people often chirp in, “Oh, it’s like in Alzheimer’s.” Fibrofog is not like Alzheimer’s.

The major difference is that Alzheimer’s is a progressive condition brought upon by actual damage being done to the brain. This damage is irreversible. The damage to the brain continues to get worse until it kills you. It is a horrible condition, devastating to those who suffer from it, and it takes a tremendous toll on the caregivers and loved ones around them. Fortunately, the fibrofog associated with fibromyalgia is nothing like that.

Your brain is made up of 100 million neurons that interconnect at over 100 trillion points. It is the signals traveling across the neurons that give us our sense of self, our feelings, our memories, and our thoughts. In Alzheimer’s, these neurons are progressively destroyed, and as they are, the person they create begins to disappear.

We still do not fully understand the cause of Alzheimer’s, but we do understand the damage to the brain that it causes. In advanced Alzheimer’s a view of the brain is rather shocking. The brain literally shrivels up. Here is what is going on. The cerebral cortex shrinks. As it does, it impacts the ability to plan, to remember, and even to think. The hippocampus shrinks even more, impacting the ability to create new memories. The fluid filled spaces in the brain, the ventricles, grow larger as the brain shrinks.

Neurons send out the chemical neurotransmitters to other neurons, a chemical reaction triggered by electrical stimulation. This is how the brain communicates with itself in incredibly complex ways. In Alzheimer’s, several things go wrong with this most basic of brain functions.

A protein fragment, made up of sticky clumps of beta-amyloid and referred to as plaque, builds up between neurons. This can block communication between the neurons. It can also trigger an immune system response, sending out immune system cells that can destroy the neurons.

In the neurons themselves, the normally straight pathways that deliver vital nourishment to the cells become tangled, which can starve the cells. These pathways begin to tangle and then deteriorate entirely, and the neuron dies.

In the beginning of the seven stages of Alzheimer’s, it is difficult to tell the difference between Alzheimer’s and the normal conditions of aging. By about stage 5 things are getting pretty bad. Chunks of memory begin to disappear and Alzheimer’s patients begin to lose the ability to do many day to day tasks by themselves. In stage 6, they lose the memories of recent experiences, may not be able to recognize people around them, can’t dress themselves, become suspicious and delusional (one of the worst aspects for caregivers), and tend to wander and get lost. By stage 7, they are pretty much gone, with little ability to respond to their environment, talk coherently, or control their own movements.

Fibrofog does not lead directly to death. The maximum life expectancy for someone with Alzheimer’s is 20 years, with eight years being the average.  Fibrofog has little in common with later stage Alzheimer’s. But what about the earlier stages of Alzheimer’s?  Are there similarities there? We’ll take a look at that in more detail in part 2.

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