So far, so good. I’m about to start Day Four, and I’m feeling really strong and positive about the whole thing. My current cubicle is down in another part of the building, and the floors are pretty “interesting”. The building used to be a manufacturing facility, so there are huge areas that are full of equipment, and then there are other levels that were built in, that house cubicles.
The walls of the cubicles are all high – which is amazing. You can actually have a conversation with people without disrupting everyone else. People appear to get it, when it comes to creating spaces where people can actually get work done. What a relief.
And there’s a gym… which is a whole lot better outfitted than my own home workout space. And there are mirrors at the free weights area, so I can make sure of my form. That’s important. This means I can get a heck of a lot more fit than I am, right now. I worked out yesterday morning before work. Amazing. Even better, I’m really feeling it today.
So, this is good. And I’ve figured out how to do some work in the gym. I have pages and pages of data I need to review, and it’s actually easier to review them on paper than on a computer screen. So, I’m printing out my numbers and taking them to the gym with me, where I can ride the bike and listen to music while I work.
Not a bad way to live, at all.
So… yes. Onward.
I wrote this early this morning.
Checked my calendar, put my necessary paperwork in a folder to take with me, got my numbers to call, once I’m all set, got directions to the place where I’ll have orientation. And I’m running pretty much on time. And yes, I do have clean socks.
So far, so good.
It’s a new chapter to a new day.
Then my computer froze. G*dd@mn Google was trying to update Chrome in the background again. I *&)#$(%* hate when they take liberties like that. Just sail right on in and take over my system, like it friggin’ belongs to them. Makes me want to uninstall Chrome, actually.
Bad things come to mind, when Google hijacks my system. I think very uncharitable thoughts about that pack of 20-something ignoramus nincompoops in Palo Alto.
No, I didn’t get to post that note.
My first day went really, really well. The one thing that went wrong, was that I ducked out of the room to empty my bladder at the time they were wrapping up and doing a group photo. So, I didn’t get in the group picture. But that’s okay, I guess. I hate getting my picture taken. Still, it would have been nice to be involved… Bad timing, but not the sort of thing that should ruin my day.
My head is full — so full — of a lot of stuff. I’ve got to get to bed early tonight. I’m incredibly excited about this new job. I’m being introduced as the new “resident expert”, which is phenomenal. I’ve worked for this. I’ve earned it. I’ve saved my past — and my future — from being permanently ruined by TBI. I have another chance. It’s taken me 10 years to get to this place… no, 40-some years, considering all I have been through.
And I’m owning this. Because no doubt about it, I have earned my place.
I have earned this, for sure.
Here’s your memory training image for the day (sorry I have forgotten to include these in the past days)
So, I’m starting my new job tomorrow, taking it easy today, catching up on my rest, and not going too crazy with everything. I had some errands I intended to run, but I went to bed, instead.
Just as well. Those errands can wait.
I’m pretty excited about my new role, and I can’t wait to find out how it’s going to go.
I got myself some really nice, fresh food for dinner, and I’ll start cooking that up in a little bit. I need to get my things together — make sure I have clean socks, as well as a formal suit to wear. It’s my first day. I want to look my best. I’m sure it will prove to be a lot less formal than I’m dressing for, but I’ll just take off my jacket. Roll up my sleeves.
I’m trying to drink a lot of water, so I’m clear for tomorrow. The last few weeks were pretty action-packed, and I need to settle my system. Yesterday I ended up being pretty busy and active, which wasn’t my ideal. I really wanted to have yesterday off, but that’s not what happened. Oh, well. That’s what Sunday’s for, right?
I spent a lot of time, this afternoon, relaxing and stretching and breathing. I did that after my nap, while I was lying in my warm bed, feeling comfortable and easy. I am having more trouble with my upper back, shoulders, neck, and trapezius muscle. I’m really stiff and sore, and not feeling great. All that lifting and moving yesterday didn’t help. Oh, well. I stretched, rolled on a tennis ball to work out the knots, and I “breathed into it ” as my chiropractor tells me to do. In the end, I felt better than when I started, but it’s still tight and painful to move at times.
The main thing for me is to work on clearing out the stress sludge from my last job. Let by-gones be by-gones, and also help my body clear out the biochemical leftovers from all the ridiculous dramas and conflicts that people seemed to dream up to keep themselves entertained. It’s not a small thing, clearing out the sludge. We have to do it, in today’s world, because nobody else will do it for us. We live in very stressful times (especially as the new political season picks up), and our systems are deluged with all kinds of conflict and strife and perceived threats.
If we allow it to build up and stay there, it takes a toll. It puts additional stress on our systems, and it drags us down. I dunno about you, but I don’t need anything else dragging me down. Especially if I know how to clear it out.
So, I’m breathing – steady as she goes – count of 5 in… count of 5 out… nice and even, relaxing all the while. It balances my autonomic nervous system and gets me out of fight-flight mode. It backs down the stress response and makes it possible for me to clear my head, so I can think properly.
This is important. This is critical. I know how to do this, and I must do it. It’s no longer optional for me. Not just some interesting thing to try out, here and there, but a discipline I need to regularly do.
Like the image memory exercises.
Both help. In different ways. They really help.
And now, get your pencil and paper and draw the image you just looked at above. No peeking. It’s important to see where you come up short. If you succeed each and every time, you’ve learned nothing. Good luck.
I’ve been thinking a lot, this morning, about how people get derailed by neuropsychological exams. In the past few days, other folks whose blogs I follow have talked about their difficulties coming to terms with test results that “show” they are more impaired than they would like to be — or even that they think they are.
It’s a tough one, for sure. One of the hallmarks of TBI is that brain injury survivors are unaware of how impaired they really are. Take, for example, Charlie Elsmore, from the documentary Me And My New Brain (click here to watch it), who adamantly insists that she no longer has any issues from the TBI that nearly killed her only four years before. Just watching her in action, it’s clear (to someone familiar with TBI) that she continues to be affected. It’s not terrible. It’s just there.
On the one hand, you want people to be realistic about where they are. You want them to make good decisions and not put themselves in danger.
But you don’t want to kill their hope.
In the category of keeping hope alive, I keep coming across stories about people who have either functioned throughout life with significant brain impairments (or pieces just being missing). Take, for example, the Chinese woman who was born without a cerebellum. She went in for testing to deal with some dizziness, and she found out through imaging that he has no cerebellum, which
“is estimated to contain half the neurons of the entire brain. Experts used to think its function was purely to do with coordination, balance and controlling the body, but in the last decade or so they’ve realised that its role is far more varied and includes language, emotion, memory and attention.”
So, she’s literally walking around without a very important part of her brain.
Although this woman with no cerebellum apparently started walking late (at age 7), walks unsteadily as an adult and has slurred speech, it’s amazing that she is able to walk and talk at all. The authors of the case study say she has mild intellectual impairment, but they also note that she is married with a daughter, had normal word comprehension and was “fully orientated” by which they presumably mean she had a normal sense of time and place.
So, yeah… It actually is possible to live out your life without everything being perfectly in place — or even, apparently, having a cerebellum.
So, for a fun Sunday mental romp, take a gander at this:
According to British biochemist Donald R. Forsdyke in a new paper in Biological Theory, the existence of people who seem to be missing most of their brain tissue calls into question some of the “cherished assumptions” of neuroscience.
I’m not so sure.
Forsdyke discusses the disease called hydrocephalus (‘water on the brain’). Some people who suffer from this condition as children are cured thanks to prompt treatment. Remarkably, in some cases, these post-hydrocephalics turn out to have grossly abnormal brain structure: huge swathes of their brain tissue are missing, replaced by fluid. Even more remarkably, in some cases, these people have normal intelligence and display no obvious symptoms, despite their brains being mostly water.
Here’s Forsdyke’s illustration: a normal adult brain on the left, alongside two striking adult post-hydrocephalic ones. The black spaces are nothing but fluid:
This phenomenon was first noted by a British pediatrician called John Lorber. Lorber never published his observations in a scientific journal, although a documentary was made about it. However, his work was famously discussed in Science in 1980 by Lewin in an article called “Is Your Brain Really Necessary?“. There have been a number of other more recent published cases.
Forsdyke argues that such cases pose a problem for mainstream neuroscience. If a post-hydrocephalic brain can store the same amount of information as a normal brain, he says, then “brain size does not scale with information quantity”, therefore, “it would seem timely to look anew at possible ways our brains might store their information.”
Whereas the orthodox view is that “information relating to long-term memory is held within the brain in some chemical or physical form”, Forsdyke says that we need to consider the possibility that memory is stored “in some extremely minute, subatomic, form, as yet unknown to biochemists and physiologists” or, maybe, that it is stored “outside the body—extracorporeal!”
Forsdyke refers to this latter possibility as ‘cloud storage’, suggesting that perhaps “The brain [is] as a receptor/transmitter of some form of electromagnetic wave/particle… of course, when speaking of extracorporeal memory we enter the domain of “mind” or “spirit” with corresponding metaphysical implications.”
Who knows what else the world has to teach us?
If we want decent medical care, we need to take care of our caregivers. This article is from the UK, but the principles are universal.
Originally posted on "Sweat the small stuff....":
Today a short post as I have just finished a night shift as a resident ED consultant and am bleary eyed. However this is an issue I feel, like many others in the UK, particularly strongly about.
“A patient has a 15% higher chance of dying if they are admitted to a hospital on a Sunday than on a Wednesday, implying that the inflexibility of consultants leads to unnecessary deaths.”
For those reading this not in the UK, here’s a link to a newspaper article on it.
“Around 6,000 people lose their lives every year because we do not have a proper seven-day service in hospitals. No one could possibly say that this was a system built around the needs of patients and yet when I pointed this out to the BMA they told me to ‘get real.’ I simply say to the doctors’ union that I can give them…
View original 509 more words
My new “vice” is following tweets being sent from brain injury conferences.
Yesterday I was following the American Academy of Neurology Sports Concussion Conference (check out the link to see more details), seeing things here and there as they unfolded, complements of some of the attendees. Unfortunately, I did not have the time or opportunity to really get into it or see if there might be a live feed. I was helping my spouse with an event they were attending, yesterday, so I only got to check it out in bits and pieces.
The Kent Surrey Sussex Air Ambulance Trust Brain Conference is the latest I’ve found – with all the tweets shown at https://storify.com/jeffdoran/2015-brain-injury-conference-brighton
It’s really phenomenal, how many people are presenting and talking about these brain injury issues – and it’s really heart-warming to see how much they care and really respond to the real people behind the injuries.
It’s also absolutely amazing, how possible it is to find out what they’re talking about, either in real-time or not long after. Or even later on, as all the tweets are stored on Twitter, and if you know the hashtag, you can find everything… as well as the people who tweeted, who are people who genuinely care.
For those who are doing the tweeting – thank you! And for those who are organizing the conferences to connect people and better educate them – thank you as well.
This is an extension of the piece I wrote years ago (January, 2011), called “After concussion – you’re not stupid, it just feels that way“. I’m writing this after seeing a physiatrist for a follow-up appointment regarding neck & shoulder pain/stiffness and tingling and weakness in my left hand and arm. They had given me a prescription for a physical therapist to get some help, but I never got PT help, because:
- Carving time out of my schedule is a challenge. I already have two standing appointments after work, each week, and a third (and sometimes a fourth) usually shows up, which doesn’t leave me enough time to rest.
- The one PT who I am interested in seeing has an office a good hour from my home, which not only makes it tough to find the time, but it also threatens to wipe out any benefits I get from them, while I’m driving home.
- It’s hard for me to explain what’s going on with me, because I get turned around – especially when I’m tired, and my symptoms shift and change. It’s hard for me to A) remember from one day to the next how I’ve been feeling, B) track how I’m feeling without it being disruptive, and C) put into words the impact of my issues. Not being able to explain — especially to people who do not know me, and who do not know how to parse out all the information in a meaningful way… it’s just a waste of time.
- The PTs I’ve worked with in the past have had no clue (I mean, NO CLUE) what to do with me, when they found out about my head and neck injuries. They either treated me like I was mentally deficient, or they got so in a tizzy about my different injuries and whole host of aches and pains and issues, that they were no use to me at all. They were so obsessed with being careful, that they achieved nothing at all.And what they showed me was stuff I already knew how to do.
So, no, I didn’t follow up with a PT, and I told the doctor a few of the points above. I should have written it down, but I didn’t get to it.
The doc was a little taken aback, probably because I had seemed so compliant and cooperative when we’d met. I explained to them that I hadn’t had good experiences with PTs, and anyway, I thought I’d try to fix the issue myself with some light exercises… which has worked. Strengthening my trapezius muscles in a specific way and also stretching my neck has resolved my issues. That, and being determined to not get hooked into a healthcare system that is A) clueless about me, and B) too impatient to be of much help to me.
In the end, we parted ways with them telling me that I was going to be fine and I guess trying to be encouraging. That’s fine, but it was also a bit infuriating, because (cover your ears and/or close your eyes) Jesus Fucking Christ They Treated Me Like A Goddamned Simple-Minded Idiot. They talked slowly and said “Good job!” a lot, like I was a goddamned puppy learning a new trick. They were complementary towards me for taking things into my own hands and being pro-active, but the way they did it seemed forced, like they were making an extra effort to accommodate my “disability”.
I do not have a disability. I have a history of injuries that have changed the ways I process information, and just because I’m struggling to find the right words — “X-ray”… “arthritis”… “traps” — doesn’t mean I’m not parsing all the information as well as the next person. My brain works differently — not worse. But every time I stopped to find a word or I had to work at putting thoughts into a sentence, they got a little more “accommodating” and remedial with the way they interacted with me. The worst thing was when I started to tear up over explaining why it’s hard for me to get help.When I get angry or frustrated, I tend to cry. And you’re right, if you’re thinking “How inconvenient… How infuriating.” It is. And that makes me even more prone to tears. Arrrrgggghhhh!!!!! &(*$^%#*!!!!
I’m sure they were trying to be compassionate and empathetic and whatever, but their total affect came across like they had to talk more slowly and put ideas into small words and lower their communication level for the simpleton in the room (that would be me). It seemed like they thought that I was less intelligent and less capable of processing information due to my history of TBI, so they had to talk to me like a 5th grader. Plus, they kept saying that everything that’s happening to me, is just because of my getting older. They said that a lot, last time I saw them. And they kept saying it with this air of “professional resignation”, like that’s just how it is, and I was a mentally deficient person who was getting all paranoid with bad thought habits, thanks to my history of head injury.
The thing is, my 50 years on the planet might be a factor, but my family members regularly live well into their 90s and past 100, so I’ve got another 50 years ahead of me. At least. It’s medically possible now to live till 120, so we’re probably looking at 150 being possible, by the time I near that. That’s my plan, and all this talk about “well, that’s just what happens when you get old” is not helpful to my plan. It’s just a bit resigned. Pessimistic. Cynical. None of the things that actually help me… or are consistent with my own attitude towards life and living it to its fullest.
Now, if I were going to see this doctor regularly for an extended period of time, I could do something about this. They would get to know me. They would change their mind about what “has” to happen as we grow older. They would realize that they don’t have to give me me special treatment – they just need to have a little patience while my brain coughs up the right word. And I’d be able to educate them about the ways in which I am strong – so strong – instead of just what they see with the verbal issues.
But I’m never going to see them again. I can deal with my issues on my own. I don’t need to be constantly told to adjust my expectations down, thanks to the inevitable march of time. And call me crazy, but adding an hour of driving, breaking up my work day, and spending $40 a pop to go see someone who is just going to talk down to me, no matter how helpful they’re trying to be… seems like a waste of time. It was a great lesson to learn — next time I’m not going to bother going back again, if I’m actually not having any more issues. Consider the lesson learned.
It’s best that I just steer clear.
And while I’ll never have to deal with them again, most likely, this is the thing that makes me NUTS about people and their cognitive prejudices. If you’ve got difficulties putting words together verbally, people assume you’re less intelligent or are “slow”. If you have little tics or fidgets, they think there’s something wrong with you. If you don’t answer them immediately with a definitive reply, they take you for weak-minded and indecisive, and they sometimes get angry to boot. If you get tired and distracted and lose track of what they’re talking about, they think you’re not interested in what they’re saying, and they get angry. If you can’t remember things that happened only a few minutes ago, they think you’ve got Alzheimer’s or some other degenerative condition that’s making you lose your mind, and they start “helping” you remember things.
Doctors are just as susceptible. They are human, after all, and medical education doesn’t always impart insight or interpersonal clue-fulness. Maybe this physiatrist has seen other folks with concussion / TBI, and they needed the extra help. But it’s really demeaning to treat people in that way — like children, or developmentally delayed “dearies” who just need love and understanding – not cold, hard facts.
For as long as I can remember, my parents have treated me like I was “special”. Like my inability to remember things marked me as less-than. Like my losing track of things and getting lost with directions meant I was functionally impaired.
I am not an idiot. I am not simple-minded. I am not intellectually impaired.
I have a handful of issues that get a lot worse when I am tired, in unfamiliar conditions, or under pressure. I have a handful of issues that I have learned to work around. I don’t need anyone’s condescension or “help”. I just need people to cut me a break, be polite, and treat me professionally. I need them to treat me like the adult I am, and with the respect I deserve.
Is that so much to ask?
Mounting evidence suggests that concussions in football are caused by the sudden rotation of the skull. David Camarillo’s lab at Stanford has evidence that suggests current football helmet tests don’t account for these movements.
When modern football helmets were introduced, they all but eliminated traumatic skull fractures caused by blunt force impacts. Mounting evidence, however, suggests that concussions are caused by a different type of head motion, namely brain and skull rotation.
Now, a group of Stanford engineers has produced a collection of results that suggest that current helmet-testing equipment and techniques are not optimized for evaluating these additional injury-causing elements.
The ideal way to test any protective gear is to gain a sense of what causes the trauma, set up a system that replicates the way the trauma occurs, and then evaluate the gear against the injury-causing criteria. For the past several years, David Camarillo, an assistant professor of bioengineering and, by courtesy, of mechanical engineering at Stanford, and his students have been collecting and analyzing data in hopes of identifying the signature skull motions that cause concussions.