Managing TBI symptoms all around

Lots to work with

So, I’m headed back out on a business trip again next week, which means it’s probably going to be pretty quiet here for the next 10 days or so. I may get a chance to check in while I’m traveling, but I’m guessing things are going to be busy, so I might not get to check in.

One thing that’s been happening, which I’ve talked about before, is that I’ve been discussing my testing results with my neuropsych, comparing how I am now to how I was before. Back in 2008, when I had my first test, I was in pretty rough shape. I was struggling with a pretty constant sense of overwhelm, I had a pervasive sense that there was something terribly wrong with me, and my mental health was all over the map. I was borderline disabled… and headed in that direction, due — I’m sure — at least partly to the fact that almost all of my friends and associates were living disability-centric lives. By that I mean, they either considered themselves too broken to do much with their lives, or they devoted their lives to comforting and counseling the broken.

But in either case, their focus was on disability, wounding, victimization, and struggle. And in most cases, their perceptions of themselves and others was very similar — they not only helped wounded, damaged people, but to at least some extent, they also considered themselves wounded and damaged.

Sigh…

Anyway, the one exception to that has been my neuropsych, who has never let me get away with settling into a victim mindset, and who has really reminded me on a regular basis of what I really think about life — that it throws us some pretty intense curve-balls sometimes, and sometimes it really roughs us up, but in the end we do have the means and the ability to turn things around for ourselves and no matter how bad things may seem on the surface, we have the capacity to move on and do better.

And that’s been my experience. Truly, it has. They have helped me and offered me encouragement and information all along the way. Granted, I’ve only seen them for an hour a week — and sometimes not even that often. But they really have been a help. Because they’ve been the one person in my life who has not been sucked into the abysmal void of mistaken beliefs telling you that you have to settle for less, which I see all around me, each and every day.

I have been getting better. A lot better. My numbers are remarkably improved over last time. And we haven’t even gotten to the purely cognitive stuff yet.

What has been getting notably better is my overall functionality and my self-perception. The old depressiveness and the overwhelm is down — way down. Anxiety levels, impulsive acting on anger, social discomfort and avoidance, negative emotions, and my general sense of maladjustment are all significantly reduced — often to normal levels.  It’s literally like a light has turned on in my life. It’s like I am a completely different person on paper, and my life has gotten one of those major renovation makeovers you see on HGTV.

And yet, what all has changed? Seriously — what has actually changed in my life?

I don’t have the blindingly intense, constant headaches I once did, and the seizure-like behavior has subsided. I don’t go into anxiety/panic attacks the way I used to, and the anger and sense of confusion has subsided. But other than that, a lot of things have objectively stayed the same. I still have chronic physical issues — the pain, light-sensitivity, noise-sensitivity, balance issues, vertigo, headaches, insomnia, sleep issues, and I still find myself flying off the handle over things that “shouldn’t” get to me. I still get confused over things, I still lose track of where I am and what I’m doing, and I still actually have a lot of the 84 concussion/TBI issues that can make your life really interesting.

So, what’s changed? Basically, a few things have made a world of difference.

First, I am aware of the issues. I know I have these issues, I know that when I am not sleeping well, it affects my thinking and my sensory sensitivities, which makes life more of a pain in my ass. It’s not all this big mystery for me anymore — I’ve spent a lot of time observing my life and seeing what sets me off and what works, and after several years of serious study, I have a pretty good working understanding of what impacts me, and how.

Second, I have stopped fighting the issues. Sh*t happens. That’s just a fact. Especially with TBI. Instead of battling against the things that just are and fighting their existence, I use my energy for simply noticing that – yes, again – the sh*t has happened, and I need to respond to it, instead of wringing my hands and crying poor-me and cursing life for dealing me a crappy hand.

Third, I actively manage the issues. From my observations, I can clearly see that one thing leads to another, and I can tell when I need more sleep, or I need to wear my sunglasses when I go out. I generally know when I’m in rough shape (which is more often than I’d like, but oh well…), and I can then anticipate things going a certain way. For example, when I am very tired, I get clumsy. When I’m clumsy, I drop things. When I drop things, they often make loud noises, which startle me and set me off. So, when those things happen on days when I am tired, rather than getting completely bent over them, I just deal and move on. I take a deep breath, pick up the fork I’ve dropped and get a clean one from the drawer, and I eat my food. If I’m dizzy, I hold onto the side of the counter when I’m leaning over, so I don’t fall. And if I’m sick on my stomach because of fatigue and dizziness, I just move more slowly and eat my food at a more leisurely pace. And I get on with my day.

It might not sound like much — it might even sound very common-sense to a lot of folks — but for me, this is huge. It means the difference between

  • starting out in a really shitty frame of mind, thinking I’m damaged and wrecked and whatnot, and not feeling up to much of anything… which often becomes a self-fulfilling prophecy… and
  • starting out on a note that shows me that I can manage my situation just fine. It’s not ideal, but I can manage. And that certainly helps.

You know, it’s funny — while we were going over my test results, my neuropsych was saying how my physical problems had been really reduced almost to non-existence. Au contraire. Sure, they don’t ruin my life like before, but they are still very much there. They’ve been there for as long as I can remember. I’m just doing a hell of a lot better job of managing them, of dealing with them, of working them into my daily life, than ever before.

Again, being aware of them and realizing how they fit into the overall constellation of my life, how they shade my existence and contribute to things like anxiety and overwhelm and difficulties with thinking and processing information on the spot, has made a huge change. It’s not that I have this identity as a disabled person who cannot do anything much with their life. I have an identity as a human being who can do a lot with what they have, despite the issues that come up on a regular basis. I manage my TBI issues all around, and while it’s not my favorite way to live at times, it still gives my life a unique and very hopeful feel.

It pretty much sucks that I have these issues, and that they show no signs of going away permanently. But at the same time, I usually know how to handle them, so even though they’re there, they don’t have to ruin — and run — my life. They’re just there. Background noise. Oh, well. If nothing else, they are an opportunity to learn.

So, the bottom line is that things aren’t perfect. When are they ever? But I can manage. I do manage. Personally, if something has to be wrong (and part of me think there’s always gotta be something), I’d rather have it be this, than something more terrible that is insurmountably soul-sucking. There are plenty of folks who struggle in pain they cannot identify or address, and I’m not one of them. Not anymore. I struggle, sure, but after years or work, now I can identify the real source of the pain, and I can sure as hell do something about it.

So yeah — onward.

When things don’t go as planned

Sometimes there’s high seas ahead – oil painting by Joyce Ortner – click to see her gallery

I had my doctor’s appointment the other morning, and it went pretty well. I got some antibiotics for the infection that has been bothering my ears and making it hard for me to keep my balance, and I gave my doctor the holiday card my spouse told me I needed to give to them. It was a good call – and I picked out a good card, because it really touched my doctor a lot. They didn’t want to let on, but I could see it meant something. I mean, if you think about it, doctors spend their lives trying to help others. They have their limitations, like all of us, but in the end, their whole reason for doing what they do is to help people.

I have been taking my meds for the past few days, but I’m still having balance issues. I’m going to keep on doing it, and hope for the best. I really don’t want to go back, though. It’s just more opportunity to get put on more meds — which my doctor tried to do, when I told them about the balance issues. They tried to put me on meclozine / antivert, thinking that would fix what was wrong with me, but I told them no, because that stuff just makes me feel rotten and weird and dense, and it doesn’t do a thing for my vertigo. It’s supposed to fix the nausea thing and supposedly make me feel less dizzy, but it’s an antihistamine and the side effects whack me out.

Drowsiness and tiredness and that weird spacey feeling that antihistamines give me, is just not worth it. So, I told them not to prescribe it. Even if they had, I wouldn’t take that stuff. Like I need more crap in my system…Anyway, I can always take Dramamine if it comes to that. I’ve taken it for seasickness and it seemed to help me. At the same time, it still make me feel weird and “off” and the fishing trip I was on was a lot less fun because of it.

Anyway, I had been planning on “having the talk” with my doctor about not being a risk-taker, just having a hard time sorting through the myriad little “issues” I have on a daily basis. For any doctor who is reading this, please take note: TBI can introduce a whole host of physical issues, from noise sensitivity to light sensitivity to touch sensitivity to pain to ringing in the ears… a whole host of physical issues that can cloud the overall picture of one’s health. And that’s not even the mental health issues, like depression and anxiety, which can make everything seem 1000x worse than it really is… or it can make everything seem like it’s nothing at all. This obviously has implications for patients with TBI being able to accurately self-assess their level of well-being. And it’s helpful to address that aspect of our experience.

The only problem is — and I realized this when I was driving to my dr. appointment and was thinking about the best way to broach the subject. I thought about how I would approach it, how I would introduce the topic of my not being a risk-taker, but just a person who struggles with sorting through all the stimuli of each day… and I considered (based on past experience) what my doctor’s response would be.

I’m glad I did think it through, too, because it gradually dawned on me that if I talked about my issues the way I was, my doctor would try to prescribe me something. Or prescribe tests. Or try to DO something, instead of just understanding and thinking things through and letting that inform their approach with me. They tend to jump right into action! as though that will solve anything right off the bat. Sometimes it does. But in some cases, you don’t need a procedure, you need comprehension and understanding and a slightly different way of approaching things.

Knowing what I know about my doctor, after seeing them for a number of years, I really think that if I’d “had the talk” about my issues, I might have ended up fending off a slew of prescriptions and tests — they’ve already tried to get me CT-scanned and/or X-rayed over sinus issues. I mean, I’m sure they mean well, but I am not exposing myself to a bunch of radiation over a sinus infection. Seriously… It’s just not going to happen. Not unless I am in serious danger.

Likewise, I’m not going to raise a red flag that my doctor is going to treat like an invitation to charge. They’ve got a bit of a fight-flight predisposition, and the last thing I want is to have to try to explain and fend off their headlong charges and attacks against what might be vexing me, when all I really want is for them to temper their responses with a little more knowledge. I can easily see them ordering a bunch of tests and prescribing a bunch of meds, in the interest of helping me… and all the while, I just get sucked into the medical system with more crap on my chart to fuel the standard-issue medical responses that pathologize and (over)medicate my condition… when all I really need is some understanding and consideration. All I really need is for people to slow down… but knowing my doctor, that’s not going to happen anytime soon. At least not with them.

So, I didn’t have “the talk” with my doctor, and I’m a little disappointed in myself. At the same time, though, I’m glad I thought it through carefully ahead of time. In a way, I feel like I may have dodged a bullet from a weapon that I had trained at myself. I unloaded the weapon and put it down, and now I’m feeling a bit better. What I really need to do is speak up, in the course of conversations, when I feel that things are going too fast or my doctor says something that doesn’t sit right with me. Sometimes I can speak up and defend myself quickly, other times I can’t. I’m working on that. The times when I don’t speak up, I feel terrible afterwards, so that’s more impetus for me to practice speaking up.

That was something I did do on Friday — I spoke up about the meds and the tests and the assumptions my doc was making. They seemed a little peeved that I was questioning their judgment, but you know what? It’s my body, it’s my life, and I need to do what I need to do. Provided, of course, I’m not putting myself in danger.

Anyway, that’s one example of things not working out as planned, and it being okay.

Another example is last night, when I decided to go to bed early, then I got caught up in going on Facebook “one last time”. I swear, that thing is a massive time-sink, and I have to be careful. By the time I got to bed, it was over an hour later, which just sucks. Oh, well. I’ll just have to nap today. I had planned on doing some last-minute Christmas shopping, but the other thing that’s happening is that we have company from the party last night. Rather than driving home, we had someone stay over, which is fine. But now I need to be social and hang out, instead of running out to the mall. That’s annoying to me. But come to think of it, I actually knew that we might have company staying over, so I’m not sure why I was thinking that I was going to run out, first thing this morning, and take care of that. More annoyance — this time with myself.

Oh well — tomorrow is another day, and I can probably get all my shopping done early in the morning before the crowds hit the mall. I pretty much know what I want, and there’s not much of it, so it will keep things simple. Plus, having less time to spend on it really focuses me. Even if that doesn’t happen, and I get stuck in the crowds, and the lines are long, and I get trapped in the holiday crush, I can always check Facebook while I’m standing on line.

So, yeah – plans. I have them. We all have them. And when they don’t go the way we expect them to, then it’s up to us to decide how we’re going to handle them. I can get worked up and bent out of shape. Or I can roll with it and come up with another course of action. I can get annoyed at this, that, and the other thing, or I can just let it all go and see what happens. When I’m tired (like I am today), I am less able to just let it all go. When I am stressed (like I am over my job, even though I am off on vacation for a week and a half – the residual stress is ridiculous), it’s harder for me to just BE.

I’ve noticed an increasing level of intensity with me – I’m starting to lose my temper again (though inside my head, not out in the world around me so much). I’m starting to react really strongly to little things… like I used to, before I started exercising regularly and doing my breathing exercises. I’m noticing a change, and I’m not liking it much — especially the parts where I’m not rolling with changes as well as I would like to. Things are starting to sneak up on me again.

So, it’s back to using the tools I was working with  before. Despite my good progress, I had gotten away from the exercise and the breathing for a while, in part because I just got so uptight over doing it each and every day like clockwork, and also because I just needed to let it all sink in for a while. I was working really hard on my technique and also my regular practice, and it got to be just another chore that didn’t have much sense to it.  I just hit an impasse with it — maybe I had too many ideas and my head was spinning, maybe I had too much experience that I needed to just get used to… in any case, I needed a break.

So, I took a break. And I must admit it was a pretty big relief to not “have” to do the sitting and breathing every morning. All of a sudden, I had extra time, and ironically, I felt like I could breathe. I was still doing intermittent breathing throughout the day, when I felt my stress level increasing, but I didn’t have a daily practice.

Still, I do feel like I need to get back to a bit of that again. I’ve had my break. Now I need to try it again to see how it helps me… pick up where I need to — maybe where I left off, or maybe somewhere else… Just do what I need to do to get myself back on track and take the edge off this intensity, which has been building and is starting to drag me down.

Things change. Plans change. What we think we can do is often very different from what we can do, which is also different from what we DO do. Life has a way of changing directions on us when we least expect it, and the only constant is change. So, I need to work on my flexibility and chill-ness, so I don’t end up ship-wrecked over every little thing. Yeah… I need to work on that. And so I shall.

Now, to go for my morning walk in the woods.