Memorizing courses while on medication

[3DogNight]

Short background: Have had four major back surgeries (involving fusions) and several minor ones in the last 8 years. As a result I now have a 12" rod with plates and screws holding my lower back together. Will most likely need another surgery in the fall/winter as yet another vertabrae/disc has began to deteriorate. I also have fibromyalgia. Have not really ridden since 2001. I am fortunate in that my current surgeon is very understanding when it comes to how much being able to ride means to me, even if I am only able to do it for a very short amount of time. He currently sees no harm in it, as there may come a day when I am not able to get on any longer due to the continuing bone/disc degeneration. He is very much about quality of life, as opposed to quantity (which I strongly agree with).

Started riding about 8 weeks ago, twice a week, (surgeon DOES know about this) because we finally found the right combination of meds that will alleviate enough of the pain to let me ride but not make me so zoned out that I can’t otherwise function (drive).

The years of being on very strong narcotics, plus the side effects of the meds I am currently on, have severely affected/continue to affect my memory. At one point, I was on so much medication (thanks to a not-so-great pain management doctor) that I literally cannot remember almost two whole years. Another thread completely.

Problem now is, at least as it relates to riding, memorizing courses. I used to be able to look at a course sheet once, and completely remember the course, along with fence numbers, forwards and backwards. Or have my trainer tell me the course one time, and execute it exactly as told. Now, I have to be told several times, sit for several minutes and go over it in my head, looking at the actual fences, and then still end up leaving out fences or adding some of my own. And I would swear that is what I was supposed to do. The memorization ability that was there in the past no longer exists. Other than having trainer sit there and scream to me what fence I should be going to next, does anyone have any suggestions as to how to better remember the course (short of drawing is on my forearm, which I would probably then forget to look at)?

I am a very proud/stubborn person and very often refuse to let on exactly how much pain I am in or that I am having problems with something that used to come so naturally. I finally told my trainer last night why I was having such a hard time with courses that her 12 year old students get through with no problems (the side effects of the meds). While the meds allow me to be able to ride, there are definite side effects that prohibit me from riding like I did 10 years ago. I used to compete in jumpers and eq on the AA circuit, now I can’t remember a course that would get me around at a local schooling show. She was very understanding, but had no tips to help me. It’s not that I don’t understand what she is saying, I just forget it within minutes. Any suggestions?

[AnotherRound]

Just thought I would offer an idea - you may want to look into neurofeedback - its a tremendous help for managing pain, for managing medications. Its not woowoo, or magikal, its a process of actually training your brain to respond differently to certain situations. For example, there is a kind of neurofeedback for sleep insomnia. Anxiety and depression can be helped with neurofeedback. Physical limitations and problems with pain and pain medication management are greatly improved with neurofeedback.

You may want to look into it. I think there is some information on a page called http://www.eeginfo.com but I don’t know if that is general neurofeedback information or what. You might benefit from adding it into your therapies. Hope you do better. It may enable you to manage yourself in such a way that you don’t always need certain meds as muich, or something. YOu may find a way to reduce the meds you take. Wouldn’t that be something!

Cheers!

AR

[AnotherRound]

Also, regarding memory (I think there’s neurofeedback just for that one particular thing - memory, too!) there are many different ways to absorb information, and it may be that this has changed for you. Stress can reduce your ability to remember, and age, as well as mediation.

You said that you used to be able to “look” at a course and remember it. If memory for you is a visual thing - for example, I can’t remember what I am taught if I hear it only - I have to see it (read it) or write down what the professor says so I can see it - then it is caught in my memory - you may need to find a visual way to learn the course so that it sticks.

Try getting the course and copying it with a pen, or writing it down as she tells it to you. That may be enough to make it sink in. Try having someone read it aloud to you while you read it. That may do the trick. Try visually imagining the course; try physically walking the course. Don’t chastise yourself for having to change your way of learning. It happens to us sometimes as we age, and it happens with medicaiton, too. However, there are other parts of your brain which can be trained, or the same region, retrained, to function better, but that takes repetition and practice. YOu will never have the memory of a 12 yo old again - I used to read a long - pages long - poem once and have it memorized and could recite it the next day. It don’t work like that no more! Even without the med issues you describe.

Somepeople HAVE to hear something out loud and reading it doesn’t do it for them. If your memory style has changed (ie, some area of your brain is less able to retain memory now because of meds) you may be able to develop a new style of learning or memory and need to practice it.

Just some of my thoughts and suggestions.

[Bluey]

If nothing seems to work good enough, you could also change what you consider important and a worthy quality of life to riding where it doesn’t involve memorizing courses.
If you can’t memorize courses, think wow, I can at least ride.

I live by the old:
“Happiness is not having much, but needing little”.

[whicker]

Strategy and Headsets

Jane Savoie wrote That Winning Feeling, a great rider sports psychology book. It gives many different ways to memorize courses and tests. I have found it to be extremely helpful.

I have dyslexia and get lost on course if I don’t remember to use her methods. I am one of those who need to physically walk the course. For dressage tests, I set up an “arena” in my living room, with “post it” letters stuck on furniture. Then I pretend that I am the horse and go through the test with the paper test in hand. I do the Monty Python walk, trot, canter and other movements myself. That way my subconscious brain can take over the directions. That leaves more brain to use on getting the horse to do what I ask.

Another thing to try is a headset/microphone set. They are very useful for teaching and quite popular for working in areas that you don’t want to be over heard. Like warm-up rings. Search the forum for the threads on the best kinds. My instructors have used them and we love it.

The instructors voice is a quiet normal speaking tone for a conversation in a quiet room. All the extra background noise can be cancelled out. The instructor tends to easily give more information, like when you stop to talk on a break. The horse doesn’t get upset from being shouted at, and the rider and horse don’t tense up from being shouted at.

If you actually wanted to show, you can get a USEF dispensation to use it in classes. You would also be able to ride in Para-equestrian classes, too.

[3DogNight]

Thank you everyone for all of the suggestions. Other friends have mentioned neurofeedback to me in the past, so that may be something to try. I will definitely check out the website that AnotherRound mentioned. I believe my insurance will even cover it. Getting older and forgetting things is bad enough, walking into a room five times and forgetting each time why you went in there gets frustrating when you know it’s due to the medication that allows you to be able to walk into the room in the first place.

Just the other day I needed to call my vet to get a supply of Adequan sent to me - took me almost an hour to remember what the medication was called so that I could call the vet and ask for it. I suppose I could have called and just asked for ‘that injectable medication that she gets for her joints’, but the fact that I couldn’t remember the name almost had me in tears - and I’ve ordered it for years.

I am VERY grateful that I am finally able to ride again - memory issues aside - let alone walk around the block, travel in the car for more than an hour at a time or stand at the sink to wash the dishes. I guess I just get frustrated when things aren’t working the way they did ‘before’. Believe me, I don’t take the very simple things for granted any longer.

Thanks for listening to the rants of an older, forgetful woman

[TrueGrit]

Make a list - check it twice…

Chronic pain negatively affects short term memory.
Chronic pain MEDS negatively affect short term memory.

As a chronic pain sufferer for the past few years, I wish I could offer some really helpful tips, but sorry to say, there are moments when I blank too.

Most important for me is making sure I’ve covered the ‘basics’ - plenty of sleep & good nutrition. Multi-tasking is a thing of the past -just can’t do it at all anymore. So I make lists, try to concentrate extra hard when it’s important - and apologise! :lol:

A headset on course is a great idea! I know I’d never be able to remember my way around anymore - I’ll keep this in mind - I hope - for if/when I am able to get that far again.

[gdgd75]

Med Changes

I am not sure what course of meds you are on for pain but I do know some are worse than others - especially when combined together or different meds. If you have not talked to your new pain management doctor about this memory loss I would be sure to make a point of it - it may be indicative of some other neural issue. I would consider changing medicines and I would watch my mental alertness/acuity over a week or so and see if you have better times of the day or night than others and then plan any activities that require mental resources for those times.

Hope this helps - one other thing - you may try doing mentally engaging activities like crosswords or number puzzles - this may help build new neural pathways - also it was explained to me once that memory can sometimes be like a road you have not been down in awhile - maybe the spring rains washed out a bridge and you have to find an alternate route. Just contemplating this analogy has helped me remember things I had long since forgotten.

Adam

[3DogNight]

Current drug regimen is vicodin 7.5/750 (4-6 per day as needed), 300 mg Lyrica/day, 400 mg Celebrex/day, 50 mg - 100 mg Elavil as needed to aid sleep, 100 mg Trazadone/day and 50-100 mg Valium/day as needed.

This is worked out with my surgeon, based on how I’m feeling month to month. We will increase/decrease strengths as needed to control the various symptoms that I experience. We discuss side effects at each appointment, and what I am willing to live with in order to be able to do more. I believe that the Lyrica and/or Celebrex are what contribute most to my memory issues, but they are also the most effective at controlling the pain from the fibromyalgia and the neuropathy from the back issues. It’s a double-edged sword in that the meds that seem to help the most also carry the side effects that I feel the worst.

Definitely doing better then when I was on the fentora/morphine/neurontin/methadone combo, which is what reduced my memory to almost zero (this was the pain management doctor’s cocktail). I’m going to do my best to make it through the summer on the meds, then in the fall/winter have my next surgery.

I just take it day by day, and never forget that I am lucky to be able to do as much as I’m doing right now. What else can you ask for?

[Diamondindykin]

@gdgd75;4839260

I am not sure what course of meds you are on for pain but I do know some are worse than others - especially when combined together or different meds. If you have not talked to your new pain management doctor about this memory loss I would be sure to make a point of it - it may be indicative of some other neural issue. I would consider changing medicines and I would watch my mental alertness/acuity over a week or so and see if you have better times of the day or night than others and then plan any activities that require mental resources for those times.

I second this. I was in a very bad rollover accident almost five years ago and have severe chronic back and neck pain from it. The doctor at the time (18 months) had me on Vicodin and muscle relaxers. I could not remember anything at all…I had no short term memory. My boss jokes about it to this day.

A couple years ago when they realized that there was nothing more that they could do for me they sent me back to my regular family doctor who immediately put me on Morphine. WOW what a huge difference in my quality of life :yes: It lasts 12 hours versus 3-4 with the Vicodin and there is no memory loss with it. I am on a pretty high dose and have not noticed ANY side effects. Actually thanks to the Morphine I have a somewhat normal life again.

Good luck!!

[TrueGrit]

Diamondindykin, can you tell me the product name of your Morphine - or is it generic? I ask because I take these types of meds as well (both long acting and regular), and though they are all in the same class - opiates - it’s interesting how the different opiates effect us all differently.

[Diamondindykin]

@TrueGrit;4846110

Diamondindykin, can you tell me the product name of your Morphine - or is it generic? I ask because I take these types of meds as well (both long acting and regular), and though they are all in the same class - opiates - it’s interesting how the different opiates effect us all differently.

I take MS Contin, 45 mg. twice a day. We tried 60 mg. twice a day but it was too much and made me tired. On my current dose I notice nothing except no pain

[TrueGrit]

Thanks very much, I shall share this at my next doc visit.

I’m on 40 mg. OxyContin, with 10 mg OxyCodone for breakthrough. Plus all the other various anti-inflamms, muscle relaxant, sleepytime meds, etc.

Short term memory is definitely impaired - just as the doc said it would be. But it beats writhing in pain. At least I’m kinda functional.

[Diamondindykin]

Yea, I truly understand TrueGrit!!! The morphine had really improved my quality of life. I do still take Vicodin occasionally but the morphine usually takes care of the pain.

Another concern of my doctor was my liver. The Vicodin is very hard on the liver and the morphine is supposedly much safer. I still have my liver and kidney function tested every six months to be sure but so far so good and i have been on it almost 3 years.

[3DogNight]

I was on Kadian ER (morphine sulfate extended release) 200 mg twice daily along with MSIR 15 mg (instant release morphine) up 5 times/day in between for 4 years. It worked great at relieving the pain, but it was hard to determine the side effects as I was on so many other meds with it.

I will speak to my ortho surgeon and rheumatologist about switching back to this combo and see if the memory issues clear up. I really think its the Neurontin/Lyrica/Celebrex that causes the memory loss, but they do help the neuropathy pain. The Kadian really only helped my immediate back pain, not the issues springing from the nerve damage or the fibro.

At least getting to do a little something is better than doing a whole lot of nothing.

[WaningMoon]

My gods, that is a unbelievable amount of Valium, are you sure you don’t take 5-10mg a day? A horse wouldn’t get that much I don’t believe. The tabs come in 2mg,5mg,10mg and 20mg.

I am surprised they have you on Vicodin, although maybe that is what works well for you. I would be asking for something extended release. I was on 600mg of morphine sulfate er a day for a long time and it did NOTHING for my pain. Then they put me on fentanyl and I felt detached from myself and my heart raced on it. Then they put me on Methadone, which turned out to be the wonder drug for me. Does nothing for my sciatic pain but does a lot for the stenosis type pain. I take 16 10mg tabs a day. I also use med marijuana and that is a HUGE help, depending on teh type of pain I am most bothered by that day. I have been dealing with constant pain since 1979.

I hope you feel better.

Apparantly they have stopped making the 20mg tablets for outpatient use. They are doing a lot of this now due to the abuse potential. They stopped making mine in 40mg tabs, that is why I have to take 16 of the 10mg ones.

[3DogNight]

Waning Moon - It’s definitely the right amount of Valium - 10 mg at 2/dose, 3 to 5 times per day as needed for muscle spasms. I have been on methadone in the past, but it was in combination with fentanyl, which gave me the same side effects that you described, although it did seem to help the pain. I was on several other meds at the same time so it’s hard to know what was actually helping or causing side effects. The methadone was a low dose, if I recall it was 20 mg - 4 x daily.

I believe in all honesty that when I was seeing my pain management doctor ( who prescribed a number of wonderful cocktails over the course of 3 years and whom I stopped seeing 3 years ago), that I was his personal giunea pig. I have an extremely high tolerance to meds once I have been on them for a few weeks, hence the current high doses of valium and Vicodin. He (pain doc) told me it was because my synapses/receptors work differently than the normal persons ?? and it affects the way I process the meds and feel the pain. Every month he would continue to raise the strength/dose of all my meds as my body became used to the them and the pain returned.

What convinced my husband to pull me out of his practice and find someone who could straighten things out was when I was on fentanyl (fentora), taking 800 mg 6 x day. I started blacking out and falling in random places (on the stairs, in the shower, standing at the sink). After several trips to stitch up my chin and forehead due to hitting counter tops and other solid objects, he made the decision to find me someone new. At that point, I had very little cognizant ability. We went to the Cleveland Clinic, among other places, and they helped a great deal. I don’t know if it was strictly the fentanyl that caused the reaction, or the combo of it with the other drugs I was on.

There are definitely some wonderful pain doctors out there, this one just happened to not be one of them, although surprisingly he came highly recommended. That is why I so strongly advocate thoroughly investigating your doctor if you plan to go the pain management route.

Right now, aside from the memory issues and the pain that nothing seems to help, I have felt better (more in control of my senses) than I have in quite a long time. At least now I can drive, ride several times a week, and hold a sensical conversation (although after this novel of a post, you may not think so). I think that one of the hardest things about socially dealing with the back pain and fibromyalgia is that outwardly I look fine for the most part. People say they would never guess anything is wrong with me (until they see me try to walk after sitting, or stand back up after bending over ;)) It gets tiring explaining that not all pain is caused by an outwardly appearing source, and that even though I may look fine, what is going on inside of my body is something I wouldn’t wish on my worst enemy. The meds, and the side effects from the meds, are a necessary evil, but ARE necessary to have any type of quality of life at this point.

I’m hoping that in the fall when I have my next back surgery to fix what appears to be my last currently degenerating vertabrae/disc, I will again be able to reduce the amount of meds needed. I know that I will always be on something, as the fibro combined with the chronic back pain make unmedicated life nearly impossible. If I could get by with half of what I’m taking now, it would be the lowest amount that I have been on in 10 years, and further reduce the damage to my organs that the meds cause.

I’m thankful that this forum is available, as trying to explain to someone who has neither experienced this debilitating type of pain nor taken the amount of meds that I have taken to relieve it is like trying to explain to someone who has never been there what it is like to walk on the moon. Add riding to the mix, and practically no one seems to understand. So thank you to all of those that listen and offer suggestions/advice/encouragement. It’s much more than I get from my family (other than my darling DH who supports me 100%), who thinks I should be packaged in bubble wrap and permanently affixed to the couch.

[showhorsegallery]

It’s very frustrating to not be able to remember things. I’m like you used to be, never had trouble remember a course.

Last show I did (which was a long time ago) I was on medication that I didn’t realize was affecting me so strongly. It didn’t matter how hard I studied the course I couldn’t remember the order of the fences and ended up jumping out of order and getting DQed. My trainer was even trying to yell jump numbers at me but my brain wouldn’t compute.

Luckily I didn’t have to be on that medicine long term.

I think it might be a good idea to try and see about an in-helmet microphone headset thing where your trainer could give you directions and you could listen while you ride.

[whicker]

Stem Cell Therapy

I was re-reading this thread and had another idea to try.

Have you considered some form of stem cell procedure? It has been incredible for dealing with back issues for my family.

I have been off pain meds since I first started the treatments and my back is working so well that I don’t qualify for para-equestrian any more. I am able to ride a spook and jump. I have multiple compressed vertabrae in odd positions and squashed discs. Then there is the whole pelvic girdle/SI joint ligament system hyper-extended. ( I’m the one who got hit by a deer while galloping my big DWB) I use the PRP/prolotherapy form to rebuild my back.

My DH has dengerative disc disease and had the discs injected with the BMAC form of stem cell, and it helped enormously.

Then there is my daughter, who was in a car accident, then had a botched surgery on her shoulder. The pain pump the surgeon used wasn’t cleared to be used in shoulders. It killed the bone and wiped out much of the shoulde joint. The class action suit is ongoing now, and she was just in the New York Times about it. She has had a new form of stem cell to rebuild her shoulder. The damaged areas are ALL growing new correct tissue. She couldn’t lift a fork before, and now she can lift a 10lb weight at close to full range.

As an introduction to regenerative therapies, take a look at Dr. Mayo Friedlis’s website:
www.treatingpain.com

Dr. Friedlis is one of the great gurus in the field. He is the one who works on me.

Pm me if you want more info. There are other gurus that Friedlis can recommend.

[3DogNight]

Just a quick update . . . Went to our first show in 8.5 years last weekend, and it was WONDERFUL! Just being able to ride again after such a long time off is so incredible, but to actually get back in the ring gave me such a feeling of power over my illnesses. Even though I’ve only been back riding for about 3 months now, I feel so much stronger. Although I can’t really feel my right leg, my trainer said that she noticed a definite improvement in the strength - she can see my leg moving now, where when I first started riding it would just hang there and I had very little control over what it did or where it went.

We competed in two divisions (3 classes each) over 3 days. Of the 6 classes, I only forgot my course once. Not as bad as I thought it would be. We ended up with 3 firsts in the Training Jumper division, and a 3rd and a 4th in the Low Schooling Jumpers.

The hardest part, physically, was not the riding, but the standing/sitting around all day waiting for our few minutes in the ring. I had to substantially increase my medication over the course of the weekend, but managed to keep the pain under control and not totally zone myself out. I am not one to just show up, ride in my classes, and then leave. I was at the showgrounds at 5:00 am each morning, mucking stalls and feeding, and stayed till 6:00 pm, at a minimum, before heading home. Just being back in that environment and getting to catch up with everyone I used to compete with was so exhilarating. I am looking forward to the next show already, which may be sometime in July. My goal is to remember all of my courses next time (and of course, stay on and make it to the other side of all the fences).