AVM Survivors Network

Cognitive Fatigue - aka which came first, the chicken or the egg?

You know, I thought I could put this here or in the general list column. I chose here and if the moderators want to move it, we certainly can, as long as @ModSupport and @DickD make sure that Merl saved some of the chocolate for the rest of us. (Confused? Go read the commends on my “Awkward questions” post.)

While eating breakfast this morning, I was surfing the web (a.k.a. improving my medical knowledge) and I came across this article. Pour yourself a cuppa joe and have a seat and I’ll walk us through a couple of things… Cognitive Fatigue

It seems to me that what they are saying is that cognitive fatigue can come from two different ways. Things affect your brain (injury, stroke, disease etc.) and those make it much harder to do life and much more exhausting. I have often commented how hard everything is since my brain surgery. Now I know a little bit more about why.

The other way it happens is the physical fatigue carries over into the brain. After a Navy Seal has been in combat for 48 hours with only 4 hours of down time during that time, their cognitive abilities are not going to be as sharp as they were. Or a marathon runner - most of them would be better at calculus before a marathon than they would at mile 24.

One of these carries over from the physical to the cognitive. That one you can have some impact on. One of these goes from the brain to the body. That one you can’t really impact. So…

Work with me here, but let’s take it one step further. Let’s assume that a patient’s cognitive challenges are determined to be 50/50. Half of them are brain to body and half of them are body to brain.

Then if we were to work logically, consistently and patiently on the physical issues and not try to jump into them too fast, theoretically, that should help the cognitive issues?

So if I could work back up to being able to walk 2 miles in 30 minutes and eat healthy enough to drop 30 lbs that could help me think better? And not forget what I went to the store for? Or remember where I put my car keys?

Dreaming? I don’t know…

What do you think?


There’s another factor. Depression and anxiety arguably affect fatigue and cognition at least just as much as other factors. Often times, more so. In my case, this is fact.

1 Like

TJ, I think you’re wonderful. You make me smile in the face of AVM’s. I love the way you put AVM’s in perspective. If I could walk 2 miles, I’d have to call Uber to get back home. If I didn’t forget most of what I get up to do, I’d have no exercise at all in my life. For instance, take the garbage out. Okay. Shut the door. Now where is the garbage? Go back inside and grab the garbage. Go out again. Get in the car and leave the Handicapped Marker on the counter near where the garbage was. Go back in again. Now that’s about 1-mile of walking back & forth. Get in the car and have to dig real hard to remember where I wanted to go in the first place. Thanks for making me feel “normal”!

Sharon D…


??? Saved some ??? HELL NO, Chocolates for eating, not saving :smile: :smile: :smile: :wink:

I do like your theory regarding fatigue in that each feeds off of the other. But for me they are never of equal quantities and can vary massively from one day to the next, so trying to find that balance can be near on impossible. For example, yesterday I was ‘OK’ and thought ‘Yea, I’ll mow my front yard’ (She who must be obeyed (wife) had been dropping subtle (as if) hints) So I did it and all was fine yesterday. I have a ride on mower so it’s not a seriously physically draining task BUT, OHH BOY was I feeling it this morning.

Although I was wearing sunglasses and a hat, it was a bright day. Was that too much?
It’s been REALLY dry, so lots of dust. Was that too much?
I had to tidy up the yard first, lots of bending up/down. Was that too much?
etc, etc, etc…

This is just a few of the factors I ‘try’ to manage with a simple task of ‘mow the lawn’ and individually the effect can be minimal but add them all together and the compounding effect can be huge. Both Tacos4life and Sharon raise some very valid points in the equation ie Depression and anxiety and memory. I jokingly say I have no problem with memory, then turn to the wife and say “And who are you again??” :smile:
So as I’ve said before it isn’t just a simple A+B=C, but rather A + B - C \ D x E √ F…

If I had a median ‘Normal’ to start from then maybe gauging when enough was enough wouldn’t be so difficult, but there can be so many contributing factors all of which are variable. I try to look at things logically. The whole task takes too much out of me, so I’ve tried to alter it all, break the task up ie clean the yard up one day, mow the next day but again those balances seem to all be out of whack and I pay for it the following day.

To add to all of this is the mental aspect.
I set a goal (mow the lawn) :white_check_mark:
Complete the task :white_check_mark:
Pay for it in agony :x:
Is it worth it all? :white_check_mark: and :x: and :question:
Then I kick myself for being a lazy sod if I don’t do it or don’t complete the task
I complete the task knowing I’ll pay for it later.

Mentally, this is exhausting which only adds to the overall fatigue and my fatigue cup overfloweth, which again feeds the mental fatigue more and around it goes again.
Trying to find some sort of balance is near on impossible.
And all of this is with one simple job ‘Mow the lawn’, add all the other parts of the day and I’m BEYOND exhausted.
Might be best I just stay in bed, then I don’t have to manage any of it :smile:
(P.S. I gotta :smile: about it cos if I don’t I’ll :cry: )

Merl from the Moderator Support Team

1 Like

Yep, and then you get depressed because you are so dang tired that you about fall asleep as soon as the kids leave for school and on Sunday afternoons, (today for instance - took a nap for an hour, and then proceeded to fall asleep three more times while trying to read a book this afternoon.). And then rinse, repeat and line dry when done.


Thank you. I’d be lying if I said I’ve always got a good perspective on it, I don’t. It sucks. But like my therapist and I have talked and spent a lot of time diving into, it’s okay to not be okay, but you need to give yourself time to be sad or not okay and then suck it up and move on.

I have thought many times, I don’t want to spend the next 20 plus years (I’m 55, so…) feeling sorry for myself. So instead, I keep circling back to the thought, “If I can’t do that, what can I do? Or if I can’t do it that way, what way can I do it?”

My primary care doc told me something at my first appt after the whole surgery and side effect fiasco, "I had a patient in yesterday where I had to tell him, John, you have Parkinson’s. Parkinson’s doesn’t have him, he has Parkinson’s. What’s the difference? If your AVM has you, then it has control of all of you and it is in charge. If you have an AVM, then it is something you have to deal with and it’s something that changes your life but it’s not you and it is not something that controls what you are deep down inside.

And, as a friend of mine used to say, “that, and $3.50 adjusted for inflation will get you a cup of coffee.”