UKH

So then, I've a (to me) important exam on Friday morning.  It covers material I know reasonably well, but is being performed against severe time constraints (doing the mock I got about 50% of the available marks and took over twice the time available).  Unsurprising I'm not especially hopeful. 

This is isn't helped by me suffering from what I recently understand to be termed "brain fog" thanks to a few autoimmune issues and some drugs I'm on.  This slows down how quickly I can take in , process, and analyse information although I tend to get there in the end.

What I'm wondering is if there is anyone battling a similar problem who has useful advice on steps I can take to optimize my performance on the day.  Current strategy is: varied but not overly substantial breakfast, large coffee and codeine just prior to starting.  Banana and/or smoothie for halfway point.  Any insightful input welcomed.

TIA

A little dab o' speed will be just the ticket.

youtube.com/watch?v=hPfVIoB9C0c&

Sleep. That's the best cure. Get a better routine in the week leading up to it, stay hydrated.

Yup, fibromyalgia! I find adrenaline / cortisol can kick in (tempered by codeine) and over ride the fog, just leaves me feeling washed out afterwards. 

I've also recently learnt that whilst capabale of excelling in theory, in practice, it takes more than it gives. Viva mediocrity!

Beyond that plenty of sleep, plenty of breathing, arrive with plenty of time. If its open book judicious use of labels..

Sorry, no direct advice in a medical sense.

It’s easy to get bogged down in one question and loose time, set yourself limits for each question, park any working thoughts on a note on the paper and move on.  Avoids exhausting time and primes your subconscious to do it’s magic in the background whilst you do another question.

If I was advising a student who had said this, I would recommend they seek two concessions with my support - one for additional reading time at the start and one for 25% extra time for the exam itself.  Many students with medical issues are unwilling to ask for this as they feel it’s not “fair”, but I do not share that view and nor did my colleagues.

You seem to be implying that part of the fog is due to the drugs. If that's the case, is there any way you can stop the drugs for however long it takes for them to "wash out" before the exam?

Of course this depends on what effects that then causes, which would require much more personal details about your health etc.

Please note, I'm not asking for those details, I wouldn't be able to give any kind of sensible advice from them (although there are likely to be others on UKC who could). This is merely a "tactical" suggestion that may be a complete non-starter.

My first thought also was to ask for extra time; if you are suffering from a documented medical issue and have a prescription you can produce, then it must be worth asking.

In terms of the exam itself - how do you approach time management?  Are you the type of person who methodically does Q1, then Q2, then Q3..? 

If so, my stock advice is this: spend the first two minutes simply reading the whole paper.  Do not even pick up a pencil yet; just read.  You're looking for questions that you think you can knock off relatively quickly - you will come back to these and answer them first.  But allow yourself to linger for a few moments on the ones you don't like the look of.  By the time you get around to them, your brain will have ben mulling them over in background for some time, and may well have worked part of it out.  When this technique works really well, it feels like deja vu - you sort of 'remember' doing the question even though you haven't done it yet.

The other thing to mention, if you have perfectionist and completionist tendencies - when you get to the really hard questions, don't be afraid of throwing a load of stuff at them, hoping that it might get a few marks, and moving on. Getting bogged down and then losing the time you needed to access easier marks elsewhere is not helpful.  I sometimes tell students that what they are aiming for here is to jot down some thoughts, so that the marker is going to sit there and think "dammit - they clearly don't know what they're doing here, but I am forced to give them these marks anyway"! 

Edit: your food strategy looks good, although depending on the length of the exam I might try a smaller coffee before and another halfway through, if you can take a flask? 

I had this for most of my time at school and uni due to dyspraxia, only one staff member ever acted in a disparaging manner about it and that was my project supervisor in third year. He was a knob in lots of other ways too.

I think Jamie covered the exam technique very well. It's important to read the whole paper first and start on questions that will build confidence and let your brain tick over in the background on the others. You shouldn't be answering hard questions (for you) until all the easier ones are complete.  At that point, if you are running out of time rather than leaving a question unfinished or just started it's much better to list the key factors and techniques relating to answering any remaining questions.

You clearly haven't talked properly to your examiners or you would already have extra time allocated for the exam under clear medical circumstances. It's never too late to do this and it's especially important to do so if you do fail, to ensure you get the extra time (you were always entitled to) for any resit.

All that, plus doing breathing exercises just before starting the exam. 

As others have said if you are suffering from a health condition which is being treated by your GP you should be able to request for extra support, which will most probably be extra time.

Speaking as someone currently suffering from brain fog, if it's a long exam asking if you can stop the clock and step away from the desk to rest your brain could also be helpful (no idea if this would be allowed).

Such breaks are certainly possible at GCSE and A level - one of my clients this year had both 25% extra time and unlimited rest breaks (during which she had to step away from the paper).  I don't know what exam Andy is taking, though; different rules may apply.

The like button isn’t big enough for that comment.  The subconscious is a powerful tool, but it needs priming.

I'm no medic, but I know a little about nutrition.

Some autoimmune prescription drugs like dexamethasone can affect nutritional absorption and uptake. They can irritate the stomach and gut lining. Metabolism can either be slowed down or sped up, depending on what drugs they are. Codeine is an opioid, which can in itself be the cause of brain fog.

Is it possible to take your medication one hour after food intake to give more time for nutrient absorption?

Rapid-release carbs ('white foods') like white sugar, pasta, white rice, white bread will cause an undesirable short-lived insulin spike, whose aftermath will result in significantly lowered cognition and mental (and physical) agility - often actually lower than before you ate it. 

Slow-release carbs on the other hand like vegetables, fresh fruit, nuts are great, because energy and cognitive functioning will be maintained for much longer. You obviously need good sources of protein too like eggs, quinoa etc.

Good sleep has been mentioned, but also useful for alertness, focus, and getting up in a good state is to stimulate useful cortisol: getting outside for some decent light exposure on the eyes within an hour of waking (safely...), exercising early, having a cold shower/swim, being fasted, and certain breathing techniques.

You'll find out more and other relevant stuff in https://hubermanlab.com/ 's podcasts! 

The OP reminded me of this...

Neurohacking...

https://bigthink.com/mind-brain/neurohacking-upgrade-your-mental-abilities

It seems a bit gimmicky to me and I certainly wouldn't take too much heed of case #3 which is about how a specific case of brainfog was treated and is almost certainly not appropriate or even safe! The article itself is an enjoyable distraction, though. I've linked it to broaden out the discussion.

I reckon Wintertree and Jamie have offered the most robust advise with some sensible tips from Allan about nutrition.

Is brain fog an actual thing or just a pop medicalisation of like, being a bit tired?

If you're taking loads of opioids of course you're not going to be thinking clearly?

A few attitudinal changes to go with the other sound advice:

I don't know what autoimmune issues you have but there's a good way to think about them: you have them, they don't have you.  I have MS, but it doesn't have me.  I don't define myself by my illness, it's not the first, second or umpteenth thing I'll tell you about myself should we ever meet.  I have it but it doesn't have me.

The brain fog thing can often mean that you feel overfaced by what's in front of you and that can lead to stress, panic even.  I understand that, but there is a way to cope with it.  Start small with the thing you think is easiest; jot down what you think you need to include as a series of bullet points, think about the shape of what you need to write, what comes first, what next, what last.  Even something technical has a shape like this, a narrative thread.  Then start: just on the first bit.  That small bit is all you need to think about, just that.  Then do the join to the second bit.  Go back to your bullet list.  Got everything, still sticking to your narrative?  Good.  Then tell the story some more.  Repeat until finished.  Then take a moment, pat yourself on the head, and repeat.  

Breaking a Big Thing down into lots of little things makes it less intimidating and more achievable, and you can do all those little things, you just have to work out the structure and get them down in the right order.

Hope that helps.  Good luck!

T.

Yes. It is a term that is used for a range of forms of cognitive impairment. It can accompany various medical and psychological health problems. It's a common symptom of stress. It's also a common experience for women during menopause.  I think, in that sense, it's something that many people experience as a part of normal life events but could also be described as a 'symptom'. Not sure to what extent that specific term might actually appear in diagnostic criteria (as opposed to being a more everyday term for such things) but it is definitely a thing.

Join a Facebook car forum, any will do but something like Ford Fiesta ST would probably provide the full fat experience. 
It won’t do anything for the brain fog as such but after a couple of weeks exposure you’ll feel like a comparative f*cking genius. 
 

Hope that helps 👍🏻

Hi Andy,I have had lupus for 13years so I understand the brain fog.think it comes with most auto immune illnesses.i used caffeine/codeine combo for phisycal activities, but I would have thought it's not ideal for mental challenges.my only advice is do very little leading up to the exam and good sleep if possible.good luck I feel for you,I got lupus in my forties I presume you're quite young.dougie.

Sigh.  Yes you're absolutely right.  I'm just making it up for attention.

Ah, wish I were young.  Late fifties sadly.  Interesting take on the codeine thing.  I'll bear it in mind.

It might do, but I doubt the university is going to award a post grad degree on that basis.  They appear (quite unreasonably in my view) to expect some sort of concrete proof of my genius.

That's what I come on here for

We might not always show it, but we really do appreciate all the time and effort you go to make us look clever.

Considering the fact that your various incarnations on here have had their pants pulled down more times than a Tory back bencher in a Berlin fetish bar, this is yet more evidence of your monumental capacity for self delusion and grandiosity.

Keep up the good work though Rom 😂

Weird. I just asked a few doctors that I know, two of whom work on neuro wards and they said it was another made up condition. 

I note the NHS has no page about it, nor do any major western hospitals or trusts in Europe or the US.

But what do they know. I can't say I'd be taking some random persons advice on the forum to take what are effectively designer drugs to magically cure yourself.

Do you also have a gluten allergy that hasn't been tested? Asking for a friend...

UCL have recently received funding to look into brain fog as an aspect of long Covid: https://www.ucl.ac.uk/news/2021/jul/long-covid-ucl-leads-ps8m-studies-treat...

It's not a condition and to my eye nobody on here has referred to it as one. 

It is a non-scientific term for a range of symptoms that people experience from a range of diseases.  It doesn't take much to find leading medical institutions such as the CDC and the NHS describing this class of effects and all using the term "fog" in relation to various disease with recognised or emerging auto-immune links.  I've put together three examples for ME/CFS, fibromyalgia, and long Covid.

You seem to both be arguing against something nobody has said and simultaneously denying symptoms widely recognised by the medical community.

There has in the past been a tendency to dismiss ME/CFS because clinicians could not identify a causal mechanism and so some would assume it was less than real - and to this day I come across this view.

I hope/think that the research in to long Covid is going to move this on significantly.  Likely some immune responses stimulated against the host during periods of immune dysregualtion?   How to identify the auto-antigens on a per-patient basis "de-program" memory B and T cells for that patient?  Exciting times ahead for bespoke therapy.

E.g.

• https://www.cdc.gov/me-cfs/symptoms-diagnosis/symptoms.html - Problems with thinking and memory. Most people with ME/CFS have trouble thinking quickly, remembering things, and paying attention to details. Patients often say they have “brain fog” to describe this problem because they feel “stuck in a fog” and not able to think clearly.
• https://www.nhs.uk/conditions/fibromyalgia/ - problems with mental processes (known as "fibro-fog"), such as problems with memory and concentration
• https://www.nhs.uk/conditions/coronavirus-covid-19/long-term-effects-of-cor... - problems with memory and concentration ("brain fog")

I was in two minds about getting in to a ruck about this as it had been a I(hopefully) constructive and kind thread for the OP, who is no doubt sick and tired of hearing from some people about how it's not a real effect.  

Odd that you ask questions of random people on the internet given that you, quite wisely, don't wish to take the word of some random person on the internet.

I didn't suggest that 'brain fog' is a condition.  I said that it is an everyday term that is sometimes used to refer to the cognitive symptoms that can accompany some medical conditions. And also as an everyday term to describe cognitive aspects of things like stress and menopause. 

I'm not going to get into an argument about whether there are any medical conditions that have cognitive symptoms, because that would just be silly. But to illustrate, take a look at this:

https://www.nhs.uk/conditions/multiple-sclerosis/symptoms/#cognitive

I don't see the term 'brain fog' there, which isn't surprising, but there's info about cognitive symptoms.  The web page refers to "problems with thinking, learning and planning" and these are all things that are part of cognition. This is the kind of thing that people mean when they refer to 'brain fog' and it can happen for a number of reasons.

I see you've now had two likes. I'll take that as firm evidence you're currently running at least 3 accounts.

Good night's rest, good breakfast with minimal carbs, and take some B Vitamins after eating.  Skip the codeine if you can, it's an opiate and a narcotic, and will do the opposite of sharpening your mind.

Good luck, I used to freak over exams but got through them in the end, as will you I'm sure.

And still dividing opinion, it seems:

https://www.bbc.co.uk/news/health-58241864

What a misinformed, sanctimonious response. While brain fog isnt a recogonised standalone condition it is a symptom of multiple conditions.

If you suffer from chronic pain and fatigue the relief of codeine lifting it (all be it temporarily) will enhace your cognitice function..

At least in comparison to feeling like you've been run over by a truck b2b trying to operate in a giant vat of treacle on zero sleep

Whilst possibly not a recognised medical term, it's undeniably a commonly used term for a collection of real symptoms. E.g.:

https://www.nhs.uk/conditions/hay-fever/

Headache, pain around temples/forehead, tiredness, all symptoms of hay fever according to the NHS. Colloquially referred to by many as brain fog (just Google "hay fever brain fog").

Knowing what little I do about you from the forum I am quite confident that you'll surprise yourself. Best of luck! 

That pretty much sums how I feel some (many) days.  You're just missing the periods of regular agonizing nerve pain that occasionally occur (not too often thankfully, but occasionally).

I wasn't really looking for advice on drug taking - bit surprised you seem to think I was. The various neurologists I've seen have that covered thanks.  I was asking about coping strategies from any others who get similar symptoms.  Doesn't seem entirely unreasonable use of a public forum to me, but you seem to think otherwise.

Ah, so allergies are made up too?  I don't have any that I know of, but I'm open minded enough to acknowledge their existence. What other health conditions are made up in your (apparently) expert opinion?  Asking for a friend.

This^^^
 

Reading time is one of the most important and useful strategies ever for exams.
As Jamie said your mind is already processing the questions. It can be a bit stressful if the exam doesn’t include reading time, but it is absolutely worth the few minutes it takes.

This might already be something that you do but something that can help brain fog and confidence is working through the easiest questions first and marking up problems that are a bit more challenging. Doing the easy problems first also can help you get in the right thought process for the harder ones.

Someone also mentioned requesting extra time due to medical reasons.  Definitely do that if you can!!