And now a summer cold

I have been writing about recovering from a setback.   The positive side of this setback is that I have many tools from life experience after concussion and from rehabilitation (when I finally got there) to deal with my setback.

This week, I came down with bad summer cold.   It started with a sore throat.  I thought it was one more thing that was part of the setback.  And then it went to my head and my head started being congested.   By Sunday morning I was miserable.  I wanted to take my son to Church anyway.   Church is part of our routine, and when I am off routine because I am sick, its harder on him.  I have learned from experience that it will be better for me health wize to push a little harder, so that he’s on his routine.  So we went to Church.

What I didn’t expect was to find out that other mom’s had been sick from something that started as a sore throat and ended as a bad summer cold.  They said the sickness lasted for five days.  Another mom told me that it had become pneumonia for her and for 4 of 5 of her friends.

I came home armed with information for my husband.   I had a cold that might get worse.  I would need his support to rest, I would see the doctor on Monday. If I had what was going around, it might last as long as 5 days.   5 more days!   Man am I tired from compensating around my setback and feeling my grief.  Now this!

But the choice was accept it and deal with it well, or not.

And its brought me to my knees.   Chills, Fatigue, Fuzziness in the head, congestion, the works.

Seeing the doctor was incredibly validating.

Yes, I had whats going around,

yes, it was in my chest and had become bronchitis,

yes, it was long lasting,

yes, I was doing all the right things,

yes, I was getting better on my own (from sleeping and resting and limiting my activities further than previously including cognitive rest), and

yes, if it lasted much longer then it was bacterial and not viral and to take the medicine he prescribed.

It was so good to see him and be validated and told more about my path and what to expect and what others around me could expect.

The funny observation that I have to make here about having this bad cold is the following.

Everyone understands what a setback a bad cold can be both in terms of energy, time and in terms of head fuzziness.

So everyone around me was very supportive.   People helped with my son, my husband really leaned in more than he already had been doing, and I could get empathy and support easily in conversation with friends and strangers. I could use short hand about what was wrong and they got it. People gave me leeway and wished me well.

So even though I had an awful cold and even though I had been needing to rest for 6 months, I was actually able to relax more into getting well.   It was what it was and I got it and they got it.

So different from my experience of my setback caused by my dental appointment.  Where no matter how well I explain what my head is doing as a result of the sleeplessness and headaches, its so far out of people’s reference that they often look quizzical.   Not that I would have understood it either if I hadn’t lived it!

As I was getting better from the cold but head still fuzzy from the cold and from the setback and probably some combination of both, I did something that was really funny if you think about it.   I thought I would make myself a smoothie and I used a metal spoon to get peanut butter out of the peanut butter jar.  My brain wasn’t working so I am not even sure my thought process would have gotten me to a wooden spoon, I just did what I needed to do to get the peanut butter out of the jar.

And then I left the spoon in the high speed blender because the peanut butter wouldn’t come off it.  And I made the mental note that I needed to find something to get the peanut butter off the spoon.   My head was fuzzy and perhaps I got distracted or perhaps my executive functioning skills were worse since my brain was fuzzy or perhaps I couldn’t focus or concentrate or compensate around my attention issues like I normally do.  Who knows?

But I do remember later, seeing the mental spoon in the blender and thinking I need to do something about that.   I added frozen blueberries and some very frozen broccoli.  And then I put the top on the blender and pushed the button.

You might be thinking that there would be a noise when the high speed blender met the metal spoon.  And there was!

But my brain was fuzzy.  I did react to the noise.   I had forgotten what my eyes had told me about the need to pull the metal spoon out, or perhaps the signals in my brain were so loud and no executive was acting to regulate them as an unfuzzy, uncompromised brain would do automatically.

In response to increase noise, I actually turned up the speed of the blender.   I thought the noise was coming from over frozen broccoli, and surely higher power would help.

And, when that didn’t work, I tried turning up the blender for longer!

When that didn’t work, my frustration led me to decide I just wouldn’t have a blended up smoothie.

So I took off the blender top.  And found a very mangled spoon.  I also discovered that my high speed blender blades were mangled too, but hadn’t lost the toussle completely.

I poured out the smoothie, decided to throw away the spoon and wrote a gentle not to put in the blender that I had mistakenly “hurt” the blades.

Being gentle on myself seemed to be the most important thing to do right then.

And then I went back to bed to try to get better.

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Emotion affects cognition

I am still recovering from the setback I had following my dental appointment.   Its been a tough week, partially because this setback has been going on since June 2, so almost 6 weeks now, and that means that I am tired of being outside my routine, and those around me are also!   I was ready to be back to my baseline weeks ago.

Its also been a tough week because I have been feeling alot of grief because of two recent deaths.   What I did not know when I first had my injury, and what I was taught in rehab once I finally got it, is how much emotions affect one’s ability to think.  With an injured brain, I have learned many skills around feeling my emotions and understanding how they will impact my injury.   I have learned many coping strategies.

In my case, it is my grief this week (and last) that is making my brain functioning more difficult for me.  However, both depression and anxiety are secondary responses to brain injury in my case and I have been having to cope with these as part of my setback.   I have learned that these secondary emotions of depression and anxiety that go hand in hand with reduced cognition affect my ability to think and use my cognitive skills of attention, memory, planning and executive functioning.

On Sunday night, I learned that my high school friend’s Dad passed away and that his memorial service was on Monday.   I wanted to go and I was the only member of my family who could attend.   My family and my friend’s family spent alot of time together because of my friendship but also because my brother was the same age as my friends brother and our mom’s became close also.  When my mom became sick with cancer, my friend’s family was a vital part of our support network.   In addition, my friend’s Dad was a doctor and I had gone to see him for medical advice (and shots!) for traveling to Peru when I was younger, so I knew him not only as a Dad but also in his profession.

I have also been grieving for a young woman, Ann Zeis, who I have written about on my blog.   Sadly, she passed away over the 4th of July and her family and friends reached out to let me know.   Ann was helping me on my blog, and had inspired me tremendously as we had common interests.  I am going to write a special separate blog post on her inspiration in my life tomorrow.  Ann died in San Francisco where she lived, so I have been struggling with the profound loss of her life from afar.

I attended the memorial service for my friend’s father which was beautiful and reminded me of many times in my life that I spent with my friend’s family.   I went to talk with my friend afterwards.   I mistakenly thought that the handsome man standing next to her was her brother, who like I said, I knew well in high school.  We had about a 5 minute conversation the three of us.   I then said that I had a doctor in the same building where my friend’s brother works.   Since the person I was talking with wasn’t who my friend’s brother, and in fact lived in Houston not Austin, and was someone I went to high school, he retorted his surprise that I would have a doctor in his building in downtown Houston.  I realized at that point that I was confused.

I laughed at myself.   My friend later told me how well I dealt with the situation–that laughing was just a great way to deal with it.   It has taken years to learn to laugh at myself when my brain just isn’t quite there.  Its taken years to be flexible and give my brain space when it needs it.   This setback–and the increased confusion and cognitive deficits that it has brought–has really made me have to draw on these coping skills.  Its also made me appreciate that although I did not have these skills when I first needed them after my injury, I have them now.   And I need them to make this setback as short as possible and I have incorporated them in my everyday life so they help me in my daily life too.

Years ago when I spoke for Dr Paul Avarich’s class at Eastern Virginia Medical School in Norfolk, Virginia, it was my laugh that Dr Avarich wanted his medical students to appreciate.   Dr Avarich is a neuroscientist by training and he taught a first year class on neuroscience to his medical students.  I had met him when he did lectures about neuroplasticity at an annual conference at Williamsburg.  I wanted to know as much about neuroplasticity as possible because I wanted to keep getting better.  Years later, I traveled down to speak to his class.  And he pointed out to his students that being able to laugh when I made mistakes or when I did not know what to say (which was often following my brain injury) was a tremendous coping skill.   I now have a deep belly laugh and, as he pointed out, it really lightens up a situation.

I have counseled many after brain injury that letting go of situations where the brain isn’t working and allowing it to be okay that one’s brain is doing what it is doing, will help make life easier after injury.   I know now that my brain being confused or doing what it is doing is not “me”, its just my brain not feeling so well.  I also know that my brain (functioning) will get better the less feelings that I attach to my brain being confused.   It is what it is.   And that I will be able to think better the more that I take it “in stride”.

So that is the challenge of this week.  Dealing with my grief for the death of two lovely human beings who have contributed greatly to my life and allowing myself to feel my feelings of grief.

And at the same time deal with the effect that my grief is having on my ability to recover after my setback.

Its okay.  I need to feel my grief, and feeling my grief, although it may temporarily increase the difficulty of dealing with my setback, is what it is.  All that I can bring to this process is the awareness that I now have about what’s happening with my brain.  And at least I have that, now!

I need to get off the computer so I will publish this as is.  When I am better, I expect to come back to these posts and edit them, but for now, they will have to be as they are.

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Being gentle with myself

I am 70% back to my baseline before the setback that I had.

My Neurologist, Dr Thomas Hill, thinks that the symptoms and setback were caused from headaches causing sleep issues for me which in turn caused increased cognitive deficits.  Since I already compensate around cognitive deficits, I am trying to adjust as best I can to the, hopefully temporary, increased cognitive deficits.   What I have learned in my recovery is that sleep deprivation causes the same symptoms as brain injury.  So the good news about that is that solving the sleep issues will solve the temporarily increased cognitive deficits.   And, like Dr Hill said, because I have successfully resolved 70% of my symptoms, it is likely that I will be able to resolve the other 30% of my increased symptoms.   He is confident of that I will, so my job is to be hopeful and continue to do what I have been doing and believe in his confidence.

It has been 6 weeks though and realistically I know that recovery from these increased deficits will happen at their own pace.

I also know that this recovery may not happen in a linear fashion.   What that means is that each step may not get me better, it may be that each step will lead to getting better but not all steps will look like progress until I am actually fully back to my baseline.   That is important because I know that getting my head and my psyche on board with my continued recovery is essential.

In some ways, achieving this last 30% back to my previous baseline will be much harder than one would think.

Here are all the things that I am balancing.   I want to resume my life as it was.   Its been 6 weeks, so I have put a number of things that I had wanted to do, “on hold”.   And I want to get back to them, above all.  Doing the things that I enjoy and give my life meaning–being a mom, a wife and an advocate–are what keep me going in life.   So not being able to do them like I could before, as a result of my increased deficits, makes my life tougher.

Since my deficits are not as bad as they were 4 or 5 weeks ago, after the setback but before I was able to turn the corner on getting better, it is easy for me to think that they are all gone.  They are not, and I need to finish the recovery, else this period of not being completely back to my baseline will be prolonged.   And I know from experience that it is easy to think that I can “push past” this period.   I also know from experience, and from the wisdom of my health professionals, that ”pushing past” the deficits I still have, won’t shorten this period of increased deficits.

My real choice is to continue to heal or to prolong my increased deficits.

My real choice is to spend more time and energy focusing of recovery and hopefully recover quicker, or to spend less time and energy focusing on recovery and recover less quickly.

The uncertainty of whether I will recover the last 30%, is of course the thing that ultimately is bothersome.   I have to believe in my doctor and my experiences of recovery and I have to have faith.

I was thinking this weekend that given what I am going through now, thank goodness I have been through this recovery and rehabilitation before so that I can rely on the increased awareness and knowledge and compensatory strategies that I learned in rehabilitation.

As usual, when I sit down to write, I have way more to write about than what I have planned.

Since I am still observing increased cognitive rest (20 minutes on the computer at one time), I am going to post this and save the rest for the next post.

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Better but not completely back and Happy 4th

I am 70% better, but not all the way back to my baseline.

I had good news from talking to my Doctors.

My Neurologist says that if I have gotten 70% back, then the 30% will come.

He told me I am doing all the right things–cognitive rest and physical rest.

He was pleased that I had reached out to my support team and that what I am doing it working.

He did objective test to show me that although I have increased memory and cognitive problems, I can pass his simple cognitive tests.   They are still there!   When he was asking me questions, I remembered all the hard work I had done in rehab to get these back.   And I was thrilled they were still there.

More later.

Happy 4th.

I will continue to rest and get cognitive rest until the other 30% gets back.

 

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Staying afloat — Part 2

Last week I wrote about the difficulties that I have been having this past ten days with headaches, difficulty sleep and increased cognitive deficits.  I had gone to a health professional and these started happening after my appointment and when I tried to use the equipment that she/he made for me that was supposed to help me with a health problem.   Instead of helping me as I hoped, I am now working really hard to return to my baseline before my appointment with the health professional.

I loved the name of the strategy that was suggested– to “stay afloat”.   I had been using a strategy called “ride it through” that I had been taught in rehabilitation which I have used alot.   Stay afloat appealed to me because it acknowledged for me more validation of the difficulty I was facing.   The validation that it gave me was that I needed to be cautious of being sucked under.   What it made me see was that after a week of managing headaches and sleep issues and from not being able to be engaged in my life as was my normal, I was at a heightened risk of getting some situational depression.   Who wouldn’t get depressed when dealing with this, especially when I work so hard during my daily life to manage my life so that I don’t get headaches, and to manage life so that I get sufficient sleep and so that I don’t set off increased deficits.

Managing the increased health issues that I am having has reminded me that before getting all of the rehabilitation that I have now had, I did not know how to help myself around the symptoms (called sequalae) from my mild traumatic brain injury and that I have gone through much worse times than now.

So I wanted to point out the difference between trying to manage my life without the help of rehabilitation professionals versus now because as bad as what I am going through now, it was much worse dealing with all this when I not only had the sypmtoms but also had to find the doctors who could help me, and help them understand why I needed help at a time when I ha undiagnosed aphasia as well as other issues that compromised my abilities to get help.   Since I got some help, but did not get to appropriate resources for cognitive therapy and occupational therapy in the rehabilitation hospitals long after my concussion, I know the value of rehabilitation because I know what my life was like with out it.

I want to make two observations about my last post.   One, I purposely did not name the health professional I was working with since in truth during my recovery, I have had some similiar expericenes with all kinds of health professionals both those who purported to understand brain injury and health professionals who I needed to see who had not specifically studied brain injury.    Although I chose at that time to use the word health professional, I have decided it is useful to be more concrete in writing this blog post.   The health professional that I was working with was a dentist and so someone that I need to interact with at least twice yearly for checkups.    I selected my dentist carefully when I move to Austin (as I do all my doctors) and this dentist was not the first dentist that I visited which tells you something about the care I put into finding the right health professional.   I do hope that in using this example from my life, that my readers will understand that this experience often applies to health professionals, and is not specific to interacting with the dentist when one has persistent symptoms after brain injury.

The other thing I want to point out is a decision that I made in writing my blog midway through the post.   When I started writing my last post, I worked hard to edit it re-reading a paragraph after I wrote it.  So as I see it, the first part of the blog shows my editing of it.    While I was writing, I realized that my deficits were sufficiently increased (compared to my baseline before the dentist appointment)  by headaches my lack to sleep and that I was making mistakes such as omitting words, writing homonyms, spelling, and sentence structure issues, some of which I could see and others that don’t usually make and was not aware that I was making.

I made the conscious choice not to edit my words.

I will tell you why I made that decision.

Because 4 or 5 years in to my rehabiliation, I learned something about my brain injury that was eye opening to me. At the time,  I was working with the speech therapist who turned my life around, Liz Joiner.   I don’t recall just quite how this came about, but Liz saw something that I had written before I had time to go back and edit it.   Because I had done a lot of writing before my injury, it was my habit to edit my work.  Although I had a brain injury and was in rehabilitation for my brain injury, I still had my habits.   Until Liz recognized it and pointed it out to me, I was not aware that this habit of editing stood in the way of others seeing how my deficits were showing up in my writing.

So I wanted my readers to see the unedited version and the difference between my editing and my non-editing at a time where my deficits are increased.   “Show it, don’t say it” is the expression that a writer friend of mine has said over and over.

Since I am still recovering (although I have turned the corner from the risk of depression once I realized what was happening), I am going to stop writing for today.  I have already spent more time than I thought prudent before I started.

I went to review this on Sunday, and decided that I would post it as I wrote this yesterday and not edit it.

I am supposed to be resting so that I can get back to my baseline before all this happened.    Its a struggle not to (edit it), but I need to put my health first.

 

 

 

 

Read More - Staying afloat — Part 2

Staying Afloat

I have truly had a week from hell.

Mind you, I knew that my week would be more difficult and I prepared for that.

I knew it would be more difficult because this is the first week of summer camps for my son, and making the transition from no school, and a Memorial Day trip, and then a week of little structure to a week of camp is a big transition for him. His days go better when there is structure to them and when his days go better so do mine!   In addition, more structure is helpful for my days going well, regardless for him.   Less structure requires that I spend more energy getting through the day and it requires more emotional energy to be patient and to be able to tolerate what comes up.  It also requires more flexibility which is something I am trying to cultivate but is still, shall we say, “not my strong suit” after my injury.

So my Monday went more or less as I expected.

Tuesday, I went to see a health professional who I have worked with previously and whom I thought was helping me.

It was a horrible experience.    I am much worse off for seeking the health care I needed than I was before I went.

In short, I have pain, I couldn’t sleep, my cognition is worse because I am in pain and because I cannot sleep,

I cannot do my job as a mom and a wife this week.  Others — my husband, sitters and friends — have had to lean in.   I have reached out to my support network.  I have also tried to write about to help me try to process it and try to what happened.    I was aware in the health professional’s office that things were not making sense to me.

With my persistent cognitive disabilities, I could not take care of myself sufficiently although I tried.  The got out of there as soon as I could wish was not soon enough in retrospect.   I realize now that I stayed there as long as I did because I was over-committed in trying to get the health professional to help me.

On Thursday afternoon, I reached back out to Dr Wayne Gordon, an expert in unidentified traumatic brain injury and someone I have worked with on several occasions during my advocacy.   I had called him last Friday and had planned to return his call this week.

On Thursday I realized that the most I could make of this week was to start afresh next week.   I told him unforeseen events had come up that I was coping with as best I could had come up and that I would reach back out when I could.

He wrote back “Stay afloat!”

I cannot begin to describe how important his words and encouragement were.

He got it, and he got it  just right!

That is exactly the name for the compensation strategy that I was using without realizing it or naming it for myself.

What his words meant for me was that I realized was working hard to not be sucked down into a negative spiral.

Stay afloat was what my goal right now!

Once I realized that my goal was to stay afloat I realized that tomorrow would be a better day.

It has to be!

Do whatever I can to not get sucked down by the unfortunate circumstances that had befallen me in trying to get health care that I needed.

What strategies do you use to “stay afloat” ?

And dare I ask, what strategies do you use after you have seen a health professional who has done more harm than good?

Do you have a different name for this strategy?

 

 

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Compensatory strategies and Deadlines

One of the great things about writing my blog is that it is forcing me to identify what stands in the way of writing my blog posts.   I have learned in Rehabilitation that the first step to resolving a problem is to be able to identify the problem is that is challenging for me.  Then I can work to come up with compensatory strategies to resolve the issue (work around it) or I can ask others for help to figure out a compensatory strategy to help me get around the problem.

I want to point out that last week, I had to come up with a compensatory strategy sort of at the last moment and I did!   Looking back, I am pleased with myself about that.  I so wanted to finish the post I had planned and get it out. Instead I came up with a strategy when things did not work out as I planned.   I realized I just had to explain what I had tried to do and wish everyone a Happy Memorial Day and be satisfied with that.

Last week was a short week for us because we were leaving early for the Memorial Day Weekend and we were traveling (which, in short, means a lot of extra preparation and cognitive steps for me.)   I had looked ahead and made plans to get my blog post done early so that I could post it.   I had started writing my on Tuesday, as far as I recall anyway.   And I had scheduled time into my calendar on the Wednesday in order to finish my draft before we left on Thursday morning.  All was going well so far.

To explain this further, I am going to step back a moment and say that what I have learned in rehab is that planning and figuring out how to meet a deadline are all “executive-functioning” skills.   I have had to relearn executive functioning skills as part of my speech and language therapy and I was lucky to have some very good therapists who have helped me.   And before I could even begin working on executive functioning, I had to do a lot of work on attention and concentration with my speech and language therapists.   What I did not know before my rehabilitation was that attention and concentration  are important skills underlying executive functioning skills.   My vision therapy has also helped me with these skills.  While I still cannot describe how, I know that they have.

My executive functioning skills are much better then they were because of my rehabilitation.   Some of these skills are more automatic now.   When I say they are more automatic, it means I do not have to think about them and line them up consciously, they happen by themselves (again).   Like when I used to get in my car and drive before my accident, I didn’t have to think about the steps of driving my car.   I did not have to think first I put the keys in the ignition, then I put the car into gear, then I adjust the mirror, then I back out of the driveway.  I just did all of those without thinking.  That is what I mean when I say that they were “automatic” before my accident.

Suffice it to say that how my brain worked was not automatic after my accident.    I had to relearn many steps that most adults do without thinking.

Back to my last Wednesday and trying to meet my deadline of posting my blog with the skills I currently have.

It used to be that when I was not quite done with a deadline, my brain could figure out how to resolve a problem in a limited time and resolve it without me having to consciously think about it.   I still remember the brain that could do that.   Because of rehabilitation and a lot of practice since rehabilitation, I have to consciously remember that as much as I would like to be the person that could automatically resolve deadline issues, I am not that person anymore.   That means that I have to find a way to resolve the deadline issue that incorporates my current abilities around deadlines.

So I was pleased with myself last Wednesday when I realized that I needed to just wish everyone Happy Memorial Day! as a solution to not quite having the executive functioning skills I needed to finish my post and get the other things I needed to get done that day.

What compensatory strategies do you use with deadlines?

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Finding the Best Doctors

I have been trying to help a new friend who suspects that the symptoms she has struggled with for years, since age 16, are possibly the result of cumulative brain injuries during falls.

She found the article in the Washingtonian Magazine about my recovery and much of it seemed so familiar to her that she reached out to me. www.washingtonian.com/articles/health/i-wanted-my-brain-back/

Because of my own struggle finding appropriate rehabilitation, and my own health and functionality improvements when I did get to rehabilitation, her story touched me.

You see, many years ago, I remember reading Dr Claudia Osborn’s book  “Over my Head: A Doctor’s Own Story of Head Injury from the Inside Looking Out”.

Reading her book helped let me know I was not alone.  And I had felt very alone on the day I found the book at the Barnes and Noble on 18th and L  Streets in Washington, DC.

I was roughly two years out after my injury, and I had just gone to see my neurologist and was feeling depressed as I sorted through the appointment in my mind.   I don’t even remember what I felt depressed about but my guess was that I felt no one seemed to have the urgency that I felt was needed when it came to fixing my brain so that I could get back to work and get on with my life.  I was desperate for answers and hoped that there would be something on the bookshelf that could help me.

When I say that I remember “reading” Dr Osborne’s book that is not quite correct.  I remember the book, that part is correct.   I just wasn’t able to do what I would call “reading” at the time. So looking in a bookstore for a book about brain injury wasn’t something I thought to do — I avoided books.

I couldn’t really read, and whatever you’d call what I was doing–looking, skimming, taking in what I could–I could not do more than 2 pages at most at a time.

While I cannot say that I was aware of what was wrong with me after my injury, I was aware that I couldn’t absorb what I was reading.  I noticed that while trying to read Time Magazine in the waiting room for one of my doctors.

So looking at and taking in just a little of the text that Claudia Osborn had written made me sob.  Not just cry but sob.

I felt that Claudia Osborn was able to articulate all the things that I would say if I could tell my story.  I felt that she was telling my story even though her injury was different.  And she found access to doctors and resources after her injury.

From reading her book, I knew that Claudia “got” what the injury was like and that she could describe it.

That meant there was at least one other person in the world other than me, who got it.   And she could articulate in print what her experience was like.  Which I couldn’t at the time.

So when my new friend reached out after reading my story in The Washingtonian Magazine, I wanted to help her get to good medical care. I wanted to help her so that her journey would be a little shorter and perhaps a little more efficient and a little less of a struggle than mine.

And, if her problems weren’t from brain injury, I wanted her to get to doctors who were knowledgeable enough to know that persistent symptoms following brain injury was not her problem, and not a doctor who wasn’t knowledgeable enough to clear her appropriately.

You see, in my journey,  I have learned that some doctors really understand brain injury and patients are lucky to get to them.   However, many doctors were not sufficiently trained and hence are not sufficiently knowledgeable about concussion or about persistent effects following concussion.  Doctors who are not sufficiently knowledgeable cannot help a person who actually needs further medical care for their symptoms to get to the right place. Another frequent error that I have learned that some doctors can make is to tell the patient that their symptoms are definitely not a brain injury when they are not knowledgeable enough to make that determination.

How have I learned this?   I have learned this through my experience first and foremost. Although I desperately needed rehabilitation, I had quite a struggle getting to it and there were many barriers and pitfalls along the way.

Getting to appropriate specialists and getting to rehabilitation turned my life around.   So I am going to be brazen here and say that if I had gotten to that same rehabilitation earlier and in a more consistent and less piecemeal fashion, it would have been beneficial to me both in terms of my health, my productivity, my well being and my finances and my livelihood.    (It would also have been beneficial to my  health insurance company’s finances!).

I also know this from hearing countless stories from others who cannot find the health care they need, or worse, who are being told they are malingering, even as they seek care.

I also know this by talking to health professionals and from volunteering at the Brain Injury Association of America and talking with staff members at WETA/Brainline in Washington DC.  I know it from my work with the American College of Rehabilitation Medicine and from my work with the Ontario Neurotrauma Foundation.

The researcher in me also knows that there are several academic studies that provide more objective evidence about the pitfalls of getting to care. However, citing those studies right now on this blog is a little of a leap of faith for me because I don’t have the memory skills to find the studies and I am still struggling with learning what research I feel comfortable talking about and what I do not yet feel comfortable with talking about.  I am still not very organized, and even 2 1/2 years after my move finding and citing the research is still a task that I have not had the time to master. However, I am hoping that providing research citations is something that someone will help me learn soon.

What I will say from my experience is that many survivors, just like me, do not know that they are not getting to appropriate care after mild traumatic brain injury.   And it may well be the case that most survivors of mTBI do not get appropriate help.  As I said in my speech at the Congressional Briefing in 2011, the estimates of the annual number of people with brain injuries that are not identified in the US exceeds the number that are identified.   That is an astounding graphic!  (I just looked for the graphic on the Center for Disease Control and Prevention (CDC) website and cannot find it, else I would post it!)

Many, like me, are not even counted in the statistics on mTBI.   People with mTBI are not counted in the CDC statistics because we either were not treated in the emergency room or our injury was not identified in the emergency room.

Its impossible to study directly how well those who are not counted in the CDC statistics are treated, if at all, and how complete their recovery is or is not.   I think that is a fair statement.

 

Read More - Finding the Best Doctors

Listening to my body

Perhaps one of the biggest gifts of recovery from brain injury is learning how to listen to the very subtle clues of my body and changing my actions in response to that information.

This week, the clues from my body were not subtle at all.    I have had a lot on my plate for awhile this spring.   At the same time, I have felt that I did not need to observe the same limitations that I have learned to observe in the past.

Its a tricky balance to figure out — how much to take on and how much to observe what I have already learned about my limitations.    Since I want to allow for improvements in my ability to function, I want to be flexible when I feel that I can take on more.    At the same time, I have to feel my way into how much my restrictions/limitations are changing  or how restrictive my new limitations are.   This is a trial and error process.

Earlier in my recovery, I call the trial by error process “error by trial”.    With a brain injury–with parts of ones brain not working well–its hard to learn to stop doing things that are making you feel worse, especially when I could do so much more before my injury that I had no sense for–and no experience about– the limitations that my brain injury imposed on me.

Earlier in my recovery, I needed a doctor or health professional who was knowledgeable about brain injury to help me with the trial and error process and to teach me awareness.    Because I did not get to appropriate health care early on in my injury, this meant I had to learn alot about my limitations on my own (which was very frustrating and marginally successful to say the least!).    I am especially grateful that my eye doctor, Dr Francke, helped me learn some of the basics on this by observing me twice a week at my eye class and by reviewing my activities with me on a weekly basis.

And the devil is in the details!   Figuring out the balance of how much rest and how much exercise for optimal recovery and when to increase rest and when to increase exercise is not easy.   For me, the help of a health professional was tremendous.   While my eye doctors have been very helpful for me with this, so too have been the speech and language therapists, occupational therapists and physical therapists who eventually helped me with this as I was successful in getting more and more treatment.  Because they were observing me with regularity they could make seemingly suggestions or tweaks.  What I experienced  was that often small suggestions had large consequences towards improving my functioning.

As for this week, I had to stop everything that absolutely did not have to be done this week, until I felt better.   That meant resting horizontally as much as I could while my son was at school and getting increased sitters for the week.

It meant using all my compensatory strategies like:

–putting things that didn’t have to be done off,

–getting take out,

–limiting my driving,

–eating as healthy as I can;

–sitting down everywhere I went;

–getting a little exercise but not as much as I normally do;

–doing things that were inspiring or fun — like noticing the beauty of spring — that gave me some energy;

–and generally conserving my energy as much as possible.

I feel much better, but am still taking it easy to try to get back to my “normal”.

I didn’t think I was going to be able to write the blog this week.    I feel well enough to spend a little time on it but will spend less on it and come back to it if I need to next week when I hope to have more energy.

 

 

 

 

Read More - Listening to my body

Why Telling Our Stories Matters — Part 1

Earlier this week, I agreed to do an interview with a Journalism student named Eli Hillen.   He’s doing a photo journalism project on the topic of loss.

He reached out to the Brain Injury Association of America looking for someone to talk about memory loss after brain injury.   They reached out to me.

I am not exactly sure what motivated me to make some suggestions to him about resources and people who could talk with him about loss after brain injury.

I did want to make some suggestions to him to guide his search.   I  have seen some articles on the topic of loss after brain injury and I think there is so much more that needs to be written about it and done well.

I must say, though,  that I have never felt the urge to contribute about the issue of loss after brain injury before.

I had a packed week, so it wasn’t as if I really had any extra time to talk.   But I responded with some suggested resources that Eli should read.  And then Eli said he’d like to talk with me by phone.  And then someone cancelled an appointment, so there I found myself talking with Eli and answering questions about the topic of loss for Eli’s project.    What I thought would be a fifteen minute call was so engaging that it lasted over an hour.

And, as is true anytime I answer questions from a journalist or student, I find myself thinking about my injury and recovery in a way that I wouldn’t have done had I not spent the time and energy to do the interview.

To go a little deeper, I had to write and tell my story quite a bit to get to the point where I could process and remember and understand my story for myself.

I had to do a lot of work writing my story for myself before I could tell my story and before I could give interviews.

Writing and telling my story over and over has helped me to process many difficult emotions–like anger and grief and frustration–to name a few.

It’s also helped me come to terms with the reality of my injury and the difficulty of finding appropriate resources to recover.

Often I have written my heart out about whatever is in my head.

Then, when I have read what I have written, I have cried and cried.   There is something about seeing one’s words in black and white.

Writing has helped me see concretely the difficulties that I have had with just writing my thoughts and how my verbal expression has changed after my injury.

The starkness of my words on paper has helped me understand my deficits better and feel my feelings about the change in my abilities and my functioning after my accident.

And answering the questions of journalists and students has also helped me get to questions that I would never have thought to think about for myself.   Hence answering questions from others has allowed me to examine topics that my brain would not have gotten to on its own after my injury.

In examining the questions when asked by others, I have had to reach for considered answers.  Its almost like I can feel my neurons try to reach out to parts of my brain that aren’t yet so accessible to me because I haven’t gone there in my brain yet.

So I answer what is top of my mind, and then sometimes, I will find myself thinking about the question and a larger, fuller answer later.

When I first started talking to journalists and students, sometimes I wouldn’t be able to sleep that night, because my brain would still be working on an answer.  I learned how to get up at night and write things down so that I could get the thoughts out of me.  After I had done that,  I could sleep.

The next morning I would send off my written thoughts or corrections to the journalist or student (if they were interested in this information that my brain eventually wanted to express but couldn’t express on demand at the interview).

Over the years, I have been able to express more during the interview.  Thus, there was less information needing to come up out of my brain later to keep me up at night.

So the process of telling my story to others has improved and its much easier for me to answer questions in an interview than it used to be.

But, I am getting sidetracked.

Back to my interview with Eli.

There are two big gifts that Eli gave me with his two questions during the interview.

1) While I did not see it coming before the interview, I was surprised and pleased that Eli asked me gently to talk about the flip side of loss… which is gain in the long term after the loss.

2) And, the question that he asked that I found so interesting and hard to answer was:  “What motivated me to try to get back the things about my brain that I lost?”   I keep coming back to think about that.

So here is my more considered response to these questions:

I lost so many things with my injury… But over time, I have had had many gains also:

I lost my sense of self so I had to find myself again and I am a bigger person for doing that work,

I lost my ability to function independently so I had to learn to function dependently and independently when I could,

I lost my brain as I knew it (which means I lost what it meant to me to be me) and I had to find how to learn to live with my injured and recovering brain and eventually I found a bigger and more whole concept of what it means to be to be me),

I lost my ability to do economics which I loved, and which I had invested many years training to be, so I had to learn how to do the things I could still do that I loved and do other things I loved and relearn what I could,

I lost my income so I had to learn to meet my needs with less income and less abilities to to provide for myself,

I lost control of my life so I had to learn to live life differently until I regained some control of the direction of my life,

I lost my athleticism and had to learn to rebuild those abilities,

I lost many of my friends so I found new ones and had deeper relationships with those who remained,

I lost my ability to be understood so I had to learn improved ways to be understood,

I lost my ability to think and so I had to learn to use others thinking to help me think and learn to use more of my senses as well as my brain,

I lost my life as I knew it but became a wife to Michael and a mother to Daniel,

And I lost many other things as well and have worked to regain what I could and be comfortable with what I haven’t yet regained.

Wow, what an interesting way to look at my journey.  Thank you Eli!

And the question of what motivated me to want to get better was something I hadn’t really considered either.

The short answer, which is what I said to Eli, more or less, is that its painful and depressing to live with all the limitations to life that dealing with a brain injury brings and to be so dependent on others after one has experienced life and the freedoms and responsibilities of being an adult.

To be asked the question of motivation suggests that there was an alternative.

The alternative was to not get better.

And I must say, I never once considered not getting better to be an option.   There was a choice.

I was depressed at times.

I was down.    I felt suicidal at times.

I did not know how to get better often (sometimes on an hourly basis) and needed a lot of help learning how to get better.

But I never, ever considered the alternative of not trying to get better.  It was a choice not worth making.

I am not quite sure why that revelation is so meaningful for me right now.

It just is!

And telling my story, helps me see my journey differently.

Thank you Eli!

Telling our stories, when we can, helps us with new perspectives on our journeys.

What losses have you had after your injury?

Have there been abilities or functioning or meaningfulness that you have regained with time?

What motivates you to get better?

Have you tried telling your story?

 

 

 

Read More - Why Telling Our Stories Matters — Part 1