After the Crash

RIP Sarah Burke (September 3, 1982 – January 19, 2012)

The Concussion Blog had a good post the other day – Action Sports an Issue Too — with a couple of videos that have really haunted me since I watched them.

I’ll show them again here:

There’s some mention at The Concussion Blog about high impact falls and the fencing response (which everyone who plays sports and is concerned about concussion should be aware of), which is good food for thought.

And it really did get me thinking. Because looking at Mr. Huston taking those falls, then lying there for a while and shaking himself off and jumping up to have another “go” at it is exactly the kind of behavior that gets so many of us into trouble.

I’m not sure if it’s the sudden release of glucose into the brain cells, or the whole rushing extended metabolic cascade of concussion that makes those neurons fire like crazy, but there’s something about getting hit on the head — and I hate to say it — that makes you want to go at things even harder. Perhaps it’s an evolutionary development from days of yore when warfare was largely hand-to-hand, and head trauma was just another part of the fight… and if you got hit, you couldn’t just lie there and wait for your opponent to make mincemeat of you. You had to jump back up and go at them even harder than before. Consider the eons of warfare humanity has been embroiled in, practically since the beginning of time. If darwinistic evolution has anything to do with how we’ve evolved as a species, and if the ones who could rebound after a blow to the head and keep fighting to the win, no matter about the dizziness, nausea, blurred vision, light sensitivity, cognitive deficits, poor risk assessment, etc…. and procreate along the way… and if the children inherited the qualities of their warfaring sires… then it makes sense that we would be in the situation we’re in.

‘Cause people have been running around, getting in fights, slugging each other over the head with sharp and blunt objects, and basically, wreaking havoc with the hidden grey matter since before recorded history. And if we as a species are conditioned to bounce back up and head back into the fray, well, then, it makes sense that Nyjah Huston is falling and hitting his head, apparently sustaining obvious concussions in the process (as indicated by the “unnatural position of [his] arms following a concussion. Immediately after moderate forces have been applied to the brainstem”), lying there for a moment or two to collect himself, then hopping up, grabbing his hat and board, and heading back up to the top of the stairs to try again, regardless of the “overt indicator of injury force magnitude and midbrain localization”.

Says Nyjah, “It normally takes that one fall in a trick like that to, thought, ride away and kinda like realize what you have to do to actually land it. And yeah then after that one that I rode away on, the next one was perfect, and it felt so good riding away from it after that battle.” (See the Berrics video at 2:19 to hear the roar of the crowd — which is really what so many of us want, right?) And all the while in the background, a band is playing “Well, you’re gone, you’re gone, you’re gone, you’re gone, you’re gone, you’re gone, you’re gone / But you went on and on and on and on and on and on and on and on…”

And so it goes. We fall, we get hurt — sometimes seriously (whether we know it or not) — but we get back up and run right back into the fray, regardless of possible consequences.

And the crowd cheers.

Because we value “resilient” athletes of all kinds, and we applaud them to no end when they actually succeed at the things they’ve practiced, over and over again. We value “resilient” employees and individuals who can “take a licking and keep on ticking”. We reward people who make sacrifice after sacrifice for the greater good, even when that “greater” isn’t so good. Even when it’s something as transitory and non-essential, like a Saturday afternoon ball game. Not that sports don’t matter – they certainly do. But is the temporary distraction of fans from the humdrum, sometimes uncomfortable facts of their lives as equally important as the long-term health and well-being of the athletes at play?

At what point does entertainment — and that’s what so much of it is for spectators — become more important than the health and safety of the entertainers.

Granted, entertainers and performers of all kinds have a long tradition of taking risks for the enjoyment of the crowds. Think high-wire acts, trapeze artists, bullfighters, bull riders, and people who play with fire to please an audience. In some ways, entertainment and distraction are as vital to human survival as food and air and water. We have to have them, or we wither amidst the constant rigors of the everyday. Something has to keep us going through it all. So, we have our sports and our games and our shows and YouTube and Twitter and so on.

And in watching those games and shows and performances, we learn lessons about what it means to be human, what it means to struggle to overcome adversity, be resilient, and keep on. We get reinforcement for our values, and we cheer on those people who support our values and demonstrate successful practice of the qualities we value most — the ability to take a hit, the ability to jump back up after a particularly hard fall, and get back in the game, not letting anything stop us.

Once upon a time, I was like that. I would get hurt, and I would jump right back into the fray. I wouldn’t take any time off, I would just push myself, no matter what. I would crash — and sometimes burn — but I’d be back eventually. Before anyone even really noticed I was down for the count. And I kept getting hurt. Like Nyjah Huston, I would lay low for a short while, then gather myself and plunge right back in. I kept recovering as best I could, then rush back into the action — in sports as well as in life. Knocked down and way woozy for a while? No problem. Just prop me up and turn me loose again. Smashed up in a car accident and unable to read with comprehension or understand what people were saying to me? No worries. Just give me a few days and a job change, and I’ll be right as rain before you know it. Went down a flight of stairs and smacked my head hard and can’t talk or think straight? Forget taking some time out. Let’s just get going — and move even faster than before.

That was pretty much the story of my life until 2007, when I started to notice that things were falling apart, and I didn’t understand why. Then it all caught up with me. And the rest is history. Here I am, working at rebuilding my life as best I can — and finding ways to do even better than rebuild — to actually build from the ground up, in so many ways.

In a way, what I’m doing now is a long, protracted rebound from the extended fall(s) I took over the course of my life. And this time I’m doing it a lot better than ever before.

Because I’m taking time off. Not 100% out-of-commission time off, but I’m stepping back from the crazy rush of everything, moving at a more sensible pace, and I’m not letting everyone else drive my action. It’s been an incredibly difficult change to make, but it totally makes sense for me. It’s a shift away from the reactive to the active, a move away from letting others define me and my life goals, and going with my gut — what I want and need, not what other people tell me I want and need. I’m not pushing to reach some brass ring that’s forever out of reach. I’m backing off… being more introspective about my approach… and giving myself time to come up with answers that make sense to me, not just the rest of the world.

It’s an entire life change, which hasn’t been easy. But it’s been necessary. And long overdue.

After the crash, when you take a hard hit, it can be a really good idea to step back, reassess, and only return to play after getting to a place where you’re truly good to go. If you got injured pretty badly, it may take some time to get back to that place, but you’ve got to resist the temptation to race right back into the fray without giving your body and mind some time to recover. If you take time off, you may actually figure out if you’re hurt, and how badly, and what you need to do to get back into decent working condition. But you’ve got to give yourself a chance to catch up with yourself. You’ve gotta be smart and self-defensive, not succumb to the pressure of the cheering crowds which can push you out into dangerous situations all over again.

Now, you can’t just sit out indefinitely, losing your conditioning and your abilities by being over-protective. And you can’t run away from the urgings of others, who may actually see things in you that you don’t see in yourself. That’s another danger that’s very real and present, and I’ve seen a lot of people pass up great opportunities in life because they were afraid they weren’t ready or up to it. At some point, you’ve got to find it in yourself to move on and act on opportunities as they arise, provided you’re up to it.

If you don’t, then brain injury has taken over your life, and you’re a hostage for as long as you let your fears dictate your future.

Now for the disclaimer: For brain injury survivors, self-assessment and accurately gauging the levels of your abilities can be extremely difficult, if not impossible. So, you may find yourself in “interesting times” as the Chinese phrase it, with all hell breaking loose, thanks to disconnects in your abilities vs. interests. It can be helpful to have the input of others who are realistic as well as supportive. Indeed, taking steps to get back in the game may in fact reveal that you’re better off not getting back in the particular game you want to rejoin. Self-reflection and objective observation of real feedback about your life and your abilities may show that you should find a different game — metaphorically choosing tennis or golf, instead of ice hockey or football. Whatever you find and whatever you choose, the important thing is to not get STUCK in one place, and to NOT GIVE UP trying to find a different way. The brain is a big place with tremendous plasticity. And history has shown that even significantly injured individuals have recovered and developed abilities that nobody expected or realized they had.

It’s a balance. And it’s a very hard balance to strike.  Especially after the crash, when your brain is telling you go-go-go… not necessarily for any particular reason, just to GO… and the rest of the world is cheering you on, urging you to get up, dust yourself off, and jump back in the action ASAP.

So, how DO I tell if I’m hurt?

I’ve been taking it easy, the past few days, trying to settle my nerves after that last fall. It was more like a slip-and-collapse than a fall, really. I think I did the right thing by just letting myself go down, instead of trying to break my fall. Still, I did hit my head, and I’ve been a little “off” ever since.

I really think it’s just nerves. Anxiety fiddling with my head. I’ve been a little uncoordinated, a bit edgy, and I haven’t felt quite like myself. But I’ve been working like a crazy person, lately, putting in super long hours, and that’s got to have an effect on me.

It couldn’t ALL be the fall.

Anyway, it’s been a challenge, figuring out whether the problems I’ve been having have been because I really got hurt, or I just got scared. The aches and pains and bruises on my arm are clearing up, but I still have this painful knot on the side of my head that bothers me when I touch it. I try not to touch it, but I also like to check in and see how it’s doing. I expected it to go down sooner, but it’s still bothering me, still feels tender.

I see my neuropsych tomorrow. They may be able to tell me something about that. Or not. They’re not a doctor, after all.

This is the big problem (for me, anyway) with head injuries — how do I tell which of my problems are neurological, and which are psychological, and which are physiological? I’ve definitely been “off” since the fall, and I think it may have plenty to do with anxiety, nerves, being worried about getting hurt. And also feeling stupid about falling in the first place.

Then there’s the physical problems — being off balance because I wrenched my shoulder and neck, and my muscles are not balance the way they usually are.

Then there’s the psychological stuff, the anxiety and nerves. The sick sinking feeling of helplessness as that slow-motion action happens and I can’t stop myself — or things happen so fast, I don’t have time to stop myself. Sense of helplessness. Loss of control.

Well, I’m tired. I need to go to bed. I try not to think about it too much, but what if I’m actually hurt?

Taking it easy… really

I’m still a little rattled after my fall. It’s a little bothersome, worrying about this, but I don’t want to make light of it, while at the same time not blowing it out of proportion. I had thought about calling my doctor, but for what — falling out of bed? How lame.

One of the things that makes it more difficult is this thought that I don’t really have the ability to self-assess. That my brain is going to tell me the wrong things about what’s going on, and I may either over-do the vigilance, or overlook something that’s important.

I don’t want to go to either extreme. So, I’m taking the middle ground, and I’m doing my utmost to just use common sense about things and not get all bent over stuff that happens.

I have been a little clumsier since my fall. But I think that can be chalked up to having been shaken up. I am also a little more off balance because I jammed my shoulder and my neck is sore and stiff in ways it isn’t usually sore and stiff. So, my balance is a little off. I’m also a little stressed – not only because of the fall, but because of work, as well. I’m coming down to the wire on this project, and there are a million little details to keep track of, some of which come up at the last minute and take everyone by surprise.

On top of that, my company is relocating 30 minutes farther from home in a new building with (possibly) new organizational structure. There’s lots of change going on, and I need to keep up.

I really need to keep up.

In a way, it’s helpful that so much is going on. I can’t imagine having a lot of time on my hands to sit around and fret about falling. I have to stay focused and steady, which is keeping my head from running away with me. It keeps me from thinking that my jangled nerves are a sign of neurological damage, that my balance issues are about my head, instead of my shoulders and indeed the whole muscular off-balance of my upper body. It keeps me from getting carried away and telling myself it’s all downhill from here.

Good thing… I just need to get on with it.

Me and my mini multi-trauma

Well, wouldn’t you know it, no sooner do I start writing about multi-trauma, than I fall, hit my head, and jam my arm and shoulder. I’ve spent the past few days trying to figure out which I should be more concerned with: my sore scalp, my tight and aching neck, or my banged up elbow.

It was stupid, really. One of those dumb things that can happen when you’re half-asleep and you lose your balance for one unfortunate moment. I didn’t gauge my distance from the table I was near, and when I lost my footing and went down, my temple bounced off the side/corner of the table, and down I went on my left elbow. Fortunately, it’s a small table, and the corner/edge I hit is not pointy. I also fell on top of some stuff that broke my fall, which was helpful, because the floor is all hardwood, and I could have seriously hurt myself, if I’d gone straight down with all my weight on my one arm.

As it was happening and I was falling down, it was like you see in movies – everything in slow motion, and me thinking “Oh, sh*t, this can’t be happening…” Then before I know it, I’m on the floor my head inside the tipped-over trash can (not sure if I hit that with my head — it was early in the wee morning hours, and I was out of it), and a pile of odds and ends underneath me.

I think I’m okay. The left side of my head, right in front of my ear, hurts like a bitch, and my neck and shoulders are sore and cracking. My elbow aches less than it did yesterday, which is good. But I don’t think I had any alteration of consciousness, and aside from being rattled by the experience, and getting things a little turned around now and then (nerves, I believe) I haven’t had any deficits that I’ve noticed.

And I would notice.

Because I’m on high alert. Knowing what I know about mild tbi, I’m admittedly a little hyper-vigilant about symptoms and signs of trouble. But I’ve been pretty clear, aside from being in pain and achey and still feeling foolish about the fall. And aside from a tension headache and the soreness on my head, I don’t think I’ve had any other problems worth mentioning.

I’m paying attention to myself, though. And I’m going out of my way to take it easy. Because the fall really threw me for the first day. I was pretty spooked. And I was distracted, too, by my concern. I hit my head… kept going through my head. Not fun. So, I have had to pay close attention to what I’m doing, because my distraction has made me clumsy and prone to doing absent-minded things. And that probably poses as much of a risk to me, as anything.

The last thing I need is to do something that really gets me hurt, when I’m just worried about being hurt.

Anyway, I’m tired and I need to sleep. I can’t let myself get all stressed out over this. It’s disconcerting, and it’s off-putting, but at least I didn’t do more damage.

That’s something.

How to fall properly

I recently came across this video, which features footage from one of Joseph Kittinger’s high-altitude jumps from the stratosphere. Yes, that’s outer space. He rode up on a balloon-lifted gondola, and then jumped from about 75,000 feet. (Planes fly at about 30,000 feet, just as a point of reference.) So, this guy is up in the stratosphere in a space suit, and he jumps off a platform, falls thousands of feet (the first attempt, his main chute didn’t open when it should have, and he almost died). He does it three times. And he lives to tell the tale. He’s now living in Florida, actually.

And then you have the parkour folks. The guys (and some gals) who have learned how to hurl their bodies over and under and around urban barriers (and some rural ones, too), to get from one place to the next as quickly as possible.

None of this should be possible, as far as I’m concerned. It’s sick, phat, whatever people call it these days. And people are doing it.

How?

Proper training. A lot of training. Proper equipment. Sometimes lots of it, too. In the case of parkour, the only equipment you have is your body and your environment (the more challenging, it seems, the better). In the case of high altitude jumps, you need a lot more equipment — and a military-grade budget — to get anywhere near a truly high altitude. Sure, you can skydive. Or you can basejump. But in both cases, you still need equipment.

Even in Kittinger’s case, you need a tremendous amount of expertise to do that sort of thing. You need equipment that’s been created by geniuses, training that’s provided by professionals, and a willingness to just do it — from 76,000 feet. You need to have the confidence in the systems around you as well as your own abilities — confidence in your preparation on all levels — and the opportunity to take a shot.

In terms of parkour, you need a physically hostile environment — filled with hard, fixed physical obstacles that make organic life impossible. You also need years of training, and a bit of luck. Years of training can, I imagine, produce concussions and other injuries. So, if you manage to get years of training under your belt without getting seriously injured (and that includes brain injured), you’ve gotten pretty luck, as far as I’m concerned. (As an aside, I understand that the parkour/freerunning community is fraught with dissent, infighting, rigidity, and feuds. Sounds like TBI-central, to me — yet another reason why it’s strictly off limits to me, except in a metaphorical sense.

Likewise, base jumping, skydiving, high altitude jumps, and extreme sports are off the docket for me (unless I become terminally and incurably ill, and the only alternative the doctors are offering is dulling my pain with morphine as I slowly slip away, haggard, jaundiced, and wasting… much to the horror and dismay of my family, and the destitution of what worldly wealth I have — in that case, I’m taking up extreme sports with a vengeance. I may even go to sea…)

But in a metaphorical sense, on a higher, more abstract level, they offer me a whole lot of inspiration. Because they show me what’s possible, if you properly train. If you properly prepare. If you focus all your attention on a single activity, and you acquire skill through practice. And when circumstances arise, you don’t hesitate. I’ve never been one for heights, and my balance issues preclude doing parkour-like things, so leaping from tall buildings and bouncing off moving cars doesn’t appeal to me. But the idea (and the physical evidence) that practice and preparation can help you overcome seemingly impossible odds — and get you places you could otherwise never go — does appeal to me. Very much so.

This applies quite well in my own life, and it’s been a great help to me. Seeing people do things they “should not” be able to do convinces me that many of the things which I consider “impossible” for me to achieve, might actually be within reach, if I just apply myself consistently and with single-minded focus. Overcoming my anger/rage issues is possible. Dealing with my fatigue issues isn’t impossible. Piecing back together my life after a series of traumatic brain injuries is within reach. I don’t have to stay bound to my old limitations. I don’t have to stay stuck in my ways. Even the ways that seem so fiercely entrenched, like dragons holed up in the side of a mountain I am trying to climb, don’t have to hold me back. I can find ways to go around them, over them, under them. And get where I’m going.

Granted, taming my tongue and keeping a grip on my temper are not nearly as aesthetically pleasing as the sight of a triple-twisting vault across a series of obstacles followed by a jump from one high rooftop to another in a gray industrial city, but they can be just as challenging to master. Plenty of religious and spiritual teachings point out that the tongue is the hardest beast to tame, and mastering your own mind is one of the most difficult challenges a person can take on.

Whatever the nature of the challenge or activity, the fact remains that people do impossible things every day. And many of the most “impossible” things are considered such mainly because nobody’s figured out how to do them, yet. But that’s not to say they’ll be impossible forever.

Or that they were impossible in the first place.

Which brings me to a quote I recently came across:

“My experience is what I agree to attend to. Only those items which I notice shape my mind.”

William James, American psychologist

The blog post where I found this talks about mindfulness and neuroplasticity… about how what we focus on shapes us, and shapes our mind. Given that I’ve seen with my own eyes how people can — and do — engage in seemingly superhuman activities, it’s easier for me to imagine that I myself can accomplish things that I never before dreamed possible. I’m not talking about physically perilous activities that invite death or permanent disability with one wrong step. I’m talking about things like managing my anger, getting a grip on my time management problems, and turning my life around against the odds (and contrary to the expectations of a lot of people around me). I’m talking about living the most life possible to me, despite all the messages I’ve ever been given about being a loser, being lazy, being a waste of time and energy. I’m talking about being as fully human as I can, even though many others are willing to give up — on themselves, on life, and on me. I’m talking about being able to participate in social events and cultivate relationships with people. I’m talking about being able to stay financially solvent, even when things are not looking good at all. I’m talking about overcoming multiple traumatic brain injuries that have brought different challenges at each stage of my life, and beating the odds when others have been so willing to assign me to a lesser place in life.

We all fall. How our falls affect us is largely a question of how we do it. If we’re prepared, it doesn’t need to maim us, it doesn’t need to finish us. If we are conditioned to roll… and then pick ourselves up and move on… a fall can be little more than a bump in the road. And even if we are taken off guard… even if we aren’t fully prepared and fall flat… as long as we don’t give up and keep trying, we can get back up and keep moving. We can get back.

I’m convinced of it. I’ve seen evidence of it in my own life. And I’ve seen evidence of it in others’ lives. I’ve also seen it on YouTube.

Brain has ability to adapt and change through life

Check out this Chicago Tribune story (courtesy of The Dallas Morning News)

By the time Scott Hayner of Highland Park, Texas, was 7, he had had one skull fracture and three major concussions from falling off horses.

Nobody connected those accidents to the difficulties he had in school as he acted out, stopped talking for three months and cried daily for two years. As an adult, he seemed to be a thriving, successful stockbroker, until traumatic brain injury from a 1999 soccer accident led to seizures and sidelined his ability to talk to people and stay on task, it seemed, for good.

Two realizations have turned his life around at 42. First, he realized that brain injuries were behind the troubles he had had all his life. And second, he read about brain plasticity — the concept that the brain can heal and learn at all ages.

“It was a relief,” says Hayner, who credits his 2008 training at the University of Texas at Dallas‘ Center for BrainHealth for helping to restore abilities that he thought were long gone. “It helped me regain my self-esteem and self-confidence. It gave me hope.”

Read the full story here

Actually, I’m not that way at all

Thinking, as I have been, about TBI and sense of self, I have realized something pretty important lately — namely, that I’ve formed a somewhat faulty perception of myself over the years. My sense of self has definitely suffered, and without correcting it, I’ve had my self-image re-shaped in ways that are not only harder on me than need be, but also incorrect.

For example: I tend to think I’m stupid. I’m not. I’m just not as brilliant as I’d like to be — but the thing is, I set my standards so high, noboby could meet them.

Another example: For the past six years, as I’ve had more and more money problems, I’ve had it in my head that I didn’t know how to manage money or make arrangements with insurance. I had it in my head that if I’d just had disability insurance when I fell, I could have possibly gotten help, and if I’d been smarter, I wouldn’t have parted with so much (as in, almost all) of my savings.

But the thing is, I did have insurance when I fell — short-term disability and long-term disability. I was also in a job that gave me 4 weeks paid vacation. I could have taken sick time, and I could have gotten help, had I understood what was going on with me. And as for my money  management… the fact of the matter is, I did have my act together before I fell. I had made smart choices about my mortgage, I had made smart choices about my use of debt. I had not gone overboard with refinancing my house to pay off other debts, and I had lived quite frugally for many years. Never, ever have I been extravagant. I’ve always had a very simple, modest lifestyle. It wasn’t me that screwed things up. It was the TBI’s.

Looking back now, I can see that I was just so turned around and messed up by the fall, that even if someone had offered me help, I would have pushed them away. I didn’t understand what was going on, I didn’t think I needed help, and I was slipping farther and farther into a hole that my brain told me I should be happy to slide into. Totally messed up. And very different from how I’d been prior to my fall.

It wasn’t ME that caused my life to go off the rails, it was my head injury. And all those concussions I’d had prior to that.

But I can turn things around now. I am… and I’ll continue to do so.

Enlightening Athletic Warriors

Xenith, makers of protective headgear for football, have published a great paper on the shift taking place in concussion awareness in sports, and the changes they believe are necessary to keep generations of athletes safe — and potentially healthier for the long-term, after they are finished with their student athletic careers.

From the paper:

Playing through an ankle sprain is understandable, but this mentality has been carried too far with regard to concussive episodes. Nerve cells do not heal the way other body tissues heal. In short, no one’s brain is “tough”. Players may come forward to reveal symptoms of a concussive episode, but it remains likely that players will work to stay on the field. It will be up to those around the players to recognize and report injuries.

Certified athletic trainers are often closest to players regarding physical injuries, and are therefore in a logical position to spot concussive episodes, or elicit honest information from players. Efforts to increase or mandate the presence of athletic trainers are certainly likely to result in better injury recognition.

In the absence of certified athletic trainers, coaches, officials, parents, and players still have a role. One concept, promoted by Dr. Gerry Gioia of Children’s National Medical Center, is called “Carry the Clipboard.” The Centers for Disease Control (CDC) offers free materials, designed to attach to a clipboard, providing a helpful checklist for awareness and management of concussive episodes. Carry the Clipboard suggests that one adult at each sporting event be assigned to carry the CDC information on a clipboard, designating that adult as responsible for recognizing players who appear to be debilitated, and for contacting a local expert.

Even though players may attempt to conceal their own symptoms, their teammates may be valuable partners in reporting a concussive episode. This unique form of honor code creates a team approach to risk reduction. Parents being attuned to their child’s behaviors may be the most critical element.

A major cultural shift is underway, which should lead to increased recognition of concussive episodes. As the veil is lifted on this injury, a significant short term increase in diagnoses may result. Over time, a corresponding decrease in actual injury risk and diagnoses should occur.

Read all of it here:

http://www.xenith.com/mission_control/assets/Uploads/BuildingtheEnlightenedWarrior.pdf

Understanding the trauma in traumatic brain injury

I’ve been reading Robert Scaer, M.D.’s book The Body Bears the Burden, thinking a good deal about the role of trauma in traumatic brain injury.

Trauma in TBI, I believe (from personal experience and observation of others’ lives) happens both during the injury and afterwards.

It’s not just the injury itself that brings on the terrible sense of threat to your very existence — it’s the life afterwards that emerges, when you are forced to face up to changes in your life and your personality and your capabilities that require a whole new way of working.

The repeated shocks and hurts and surprises and disappointments and the overwhelming sense that you’re not who you are anymore — and your whole existence is in question — threatens us on such a deep level, that the trauma of the initial injury can sometimes be dwarfed by the after-effects of the changes.

Suddenly, you’re angry all the time — for no apparent reason.

Suddenly, you can’t read things and understand — and you don’t find out till after your job (which depends on your reading comprehension) is in danger.

Suddenly, your balance is off, you can’t tolerate light and sound, and you’re breaking down in tears over nothing.

Who IS this person? Where did you go? And who has taken your place?

This change and the questions that arise can be abrupt and alarming — and the worst part is, it’s an internal storm that rages, almost (but not quite) in plain view, vague enough to elude explanation, but pervasive enough to disrupt much about your life — and throw you into a tailspin about the rest of your life which hasn’t been impacted, but might be.

If this doesn’t constitute a threat to your existence — one of the chief requirements for the classification of trauma — I don’t know what is.

So, as we approach traumatic brain injury, let’s not just focus on the brain. Let’s focus on the trauma, as well. Let’s help the countless folks out there — including our returning wounded warriors bearing the signature wounds of the Iraq and Afghanistan wars — who are struggling with both TBI and PTSD, and watching their symptoms get worse for no apparent reason.

Let’s stop dividing up the treatments into “disciplinary territories” and discounting the importance of body and mind and heart and spirit and how they interconnect to create the whole of us.

Traumatic brain injury has been getting a lot of press, lately, with regard to the brain. But unless we seek to understand trauma as diligently, I fear we are a far cry from a comprehensive solution for this widespread issue.

Fourteen Years Later, Someone Finally Got It…

 

Pat LaFontaine shares about his experience at BrainLine

 

I’ve been watching the video on BrainLine – NHL Hockey Hall of Famer Pat LaFontaine Shares His Story

Hear hockey great Pat LaFontaine recount his story and the steps he took during his recovery after several brain injuries.

It’s a great retelling of a story about how he sustained multiple concussions and could never get answers from anyone… until he was so impacted, it was obvious to everyone that something wasn’t right. It’s also a very telling look into an often hidden world of athletes who know something is wrong, but are told time and time again by doctors and trainers and other expert folks, that they just have a psychological issue and if they just suck it up, they can get back in there and get back to regular play.

Around 19:10 in the video, LaFontaine talks about how he had to keep calling his doctor (the new one who actually had a clue what was going on) to reassure him that the source of his emotions and depression and headaches and not feeling right was physiological. He thought that the doctor was just being nice, because he felt like he was losing his mind.

How true it is.

When you’re going through the disruption of a TBI, you can genuinely feel like you’re going crazy. Things are strange, you don’t feel like yourself, your emotions may be off the charts or completely changed, and nothing seems to be clicking. And trying to get help can be next to impossible, if the doctors you see are not familiar with brain injury/concussion.

This is so important — I wish more doctors and trainers and coaches of student athletes would pay attention to this and keep up to date with the most current research and best practices, so they can not only help people  understand what’s happened to them, but they can also take steps to prevent repeat injuries before healing is complete. Concussions among student athletes is much higher than most guess (and former studies showed), and second subsequent injuries before the brain has healed can be devastating. Second impact can complicate concussion symptoms, and if doctors and coaches and trainers are all pressuring the players to get back in the game and/or telling them that they’re really fine, they can get hurt again — and have even worse problems to deal with after the fact.

I was one of those student athletes who went back in the game after the concussions I sustained, but I’m different from many, in that my coaches and trainers had an eye out for me and kept me out of play (against my will). I was very luck. Lots of student athletes don’t have that same level of vigilance and care.

The one problem was that I’m also one of those folks who never got proper medical care until about three years ago. This was long after the period in which I could file for any sort of assistance or get accurate medical records documenting my injuries — so the chance of me getting any help from any organized sources is slim to none.

I’m on my own.  And even though I have doctors who know about my TBI history, I’m still on my own when it comes to advocating for my own care and well-being. They mean well, I’m sure, but when they tell me that I don’t need to worry about how much sleep I’m getting, because I may not need at least 8 hours a night, it’s not particularly helpful. And when they look you over, plying you with questions about your mood in search of clues about psychologically based depression, completely ignoring the physiological aspects of mood and emotion, well, that’s even more depressing.

I can tell you from personal experience that dealing with post-concussion syndrome is a real bitch, when you have no idea what it is, you think you’re losing your mind, everyone around you is telling you to just “shake it off” — or they have no idea you have anything to shake off, and all they can do is give you a hard time about struggling the way you do. And then you go to the doctor, and they tell you to take a meditation class or relax more or go on vacation to get your mood back in order… this is not helpful, in the case of TBI.

According to the medical/mental health system, without proper medical documentation of my injuries, in the eyes of others, I’m probably mentally ill. All that emotional volatility, the perseveration, the rumination, the difficulties getting started and stopping what I’m doing, the extreme swings in energy levels… Even some of my friends who are psychotherapists have written me off as mentally ill and refusing treatment. These are the same people who have flatly discounted the effect of TBI in my life and claim that all I need is to deal with my difficult childhood to get on with my life.

They’re wrong on so many different levels. Especially about me  refusing treatment — I’m not. I’m actually getting treatment at the level I need — on the neurological level, not on their preferred level. I know that I’m not mentally ill, and so does my neuropsych. And so does every other person who is intimately familiar with TBI and understands the nature of the issues I face on a daily basis. To say it’s maddening to watch the mental health field have a heyday with folks who have been neurologically impacted, would be an understatement. And hearing stories of doctors playing psychotherapist is equally irritating. But at the same time, I can’t let the shortcomings of our “modern” mental health industry impact my own peace of mind and my own mental health.

There’s no sense in that.

So, I seek out answers for myself.  And I share what I find, in hopes that others like me may realize that someone out there actually gets it. They’re are not alone, and there is hope.

Where there is good information and good communication, there is a chance for change.