Monday, May 28, 2012

When Mom's Chemo Brain meets Teenage Brain

May should be named National Stress Month.  
For adults who live with chronic illness AND have school-age kids in the house, it becomes crazy time.
Your calendar is not your own.  Every note or email from the school contains an important deadline or event that must be tended to immediately.  The best laid plans can be turned upside down with one announcement.

My dear kids (ages 17 and 16)  are in high school, so May is the time for AP exams, End of Course Tests, final exams, and final projects.  There are also sports tournaments, awards banquets, honors night, musical production, and final meetings of various school clubs.  Thank you's for all their teachers and coaches all must be purchased and readied for the last day of school.  

Granted, my kids did all the heavy-lifting.  They are bright, talented young people and put in the effort to achieve their successes.  They know that they are responsible for learning about all their deadlines and managing their time appropriately.   Even with periodic reminders, tasks are forgotten until the last minute.  Then panic sets in.  It is predictable.  I shouldn't be surprised.  I shouldn't take it personally.  They have teenage brains.

What Exactly is a "Teenage Brain"?   
Recent neuroscience research shows that the human brain undergoes a massive overhaul between the ages of 12 and 25 years.  It's like a massive re-wiring and new network made up of axons and dendrites and neurons.  The connectivity and insulation improves, enabling the brain to process information quicker, recall old information, and influence the decision-making process.

At the same time, the brain matures first in the back part of the brain (responsible for basic functions like movement, vision, basic processing) then to the top and front regions (which handle more complicated functions like memory, decision making, planning, and creativity).    All these changes make for an awkward time for teens and the adults who love them.  Teens have their moments of mature reasoning coupled with impulses, self-interest, emotional outbursts, and attraction to risky behaviors.

Teenage brains are also most susceptible to brain chemicals like dopamine (a neurotransmitter that helps in learning patterns and making decisions) and oxytocin (which makes social connections more rewarding).   The teens/twenty-somethings can assess risks as well as adults.  Yet they often value the perceived rewards higher than do adults.  

Who are you and what have you done with my sweet child?
What the heck were you thinking?
What do you mean you don't remember?

When the teen answers, "I don't know," she speaks her truth.
That's when I have to take a deep breath.

What is Chemo Brain?
Patients will likely give you a different answer than many physicians.  Because it hasn't been extensively studied, some doctors are reluctant to give the phenomena much credence.

Persons who are undergoing certain chemo therapies for cancers, seizures, or migraines may experience memory lapses of routine items; difficulty recalling names, places, or dates;  difficulty in concentrating on a task or conversation;  difficulty in multi-tasking;  becoming easily distracted.

We typically realize something is wrong before others around us notice, and we try to compensate in various ways.  For example, I made sure EVERYTHING was put on my calendar on my computer and phone.  The problem was that I would forget to check the calendar every night to plan for the next day.  I missed appointments simply because I didn't look at my calendar.   I went to the pharmacy to pick up medicine that I had picked up the day before.  This is completely frustrating and demoralizing.

My dear kids know that mom's brain doesn't function as well as it used to (beyond the usual 'getting older' forgetfulness).  Whether my forgetfulness, distractedness, and inability to multi-task are due to the chronic illnesses or the medications, it doesn't really matter.  I need the medications to remain as healthy as possible.  Some days or weeks I have much more clarity of thought and function than others;  I feel much more like my true self.  But when the subtle changes occur and I forget important things, we call it "Foggy Brain" or "Chemo Brain."   That's their cue.

When Teenage Brain meets Chemo Brain, the stress level rises.
The teens know if they need something from me, it must be written on the family calendar in the kitchen.  Telling me something once in passing or when I'm about to go to bed does not count.  
Still, they rarely remember to write it down.  I shouldn't be surprised;  they don't remember where they put the car keys, the important notebook with their final project, or their ballet/tennis/running shoes.
Side note:  Apparently moms are expected to have the "Find It" gene;  when mom doesn't know where something is that she doesn't use or hasn't seen, dear teen gets indignant.  Really?!

So this May, a few things fell through the cracks of our fractured organization system.   They got frustrated when I didn't remind them of something and I got frustrated when they told me about something at the last minute.   When the stress got too much and a Behcet's flare and gout attack made me slow down, we all managed to stop, take a breath, and work as a team.

Teenage brains are very capable of compassion for others when it's most needed.  And a healthy sense of humor helps, too.

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