Putting Anxiety to Good Use

river winding through green landscape

I had a really good weekend. I made a lot of progress, and I got a lot of plans in place that I think are really going to help me get stuff done. I didn’t clean my gutters, which I really needed to do. And there were a few other things I need to do this morning, to catch up. But all in all, it was a good and satisfying weekend.

My top achievement was getting rid of some serious distractions that have been pulling my attention in all different ways. Those are old projects I was very fond of… and that I was very fond of thinking I’d ever finish. As it turns out, because I had too many things going at the same time, I never advanced down the path I was hoping to, which resulted in me getting nothing done.

So, that’s stopped.

And that’s a big deal for me. Because distraction and dissipate have been regular themes in my life, for as long as I can remember. I’m not sure what’s changed with me, but suddenly I don’t feel drawn to spread myself so thin.

Part of it might be getting a hold of my anxiety. Or just using it for something productive, instead of trying to get rid of it entirely. For quite some time, I’ve tried to manage my anxiety by calming myself down. But at the end of last week, I realized that anxiety is actually a really potent source of energy for me. And it’s constant. It never really goes away.

So, I can use up all my time and energy and attention trying to control / manage something that’s always there, anyway. Or I can redirect the energy into something productive. And really kick it.

That’s what I’ve been doing for the past several days. Kicking it, using my anxiety. Not trying to calm myself down, but directing my energy into something useful. Making plans. Creating a new pace for myself. Letting that old companion anxiety propel me forward…  Turning that often-unwelcome companion into a friend.

And it’s working out pretty well, I have to say. After years and years of being so dissipated and distracted by, well, just about everything, I feel like I have a much better understanding of how my system works — and how it can work for me.

Of course, none of this would have been possible, if I hadn’t worked at my TBI recovery intentionally and with a lot of trial-and-error. I can tell my brain is behaving more, these days, because I’m actually able to focus. I used to be able to do it, at will. Then I fell in 2004, and that went away. I couldn’t manage much of anything, concentration-wise. That’s something that’s come back over time, with lots and lots of practice and (again) trial-and-error. I’ve let myself make mistakes. That’s how I learn. And I gave up worrying about “failure” in the process, which always helps.

So, yes. This is good. I’ve got my mandate for the next year — maybe two. I’m only focusing on one major project, for 2019, funneling my anxious energy into taking steps to do something about each hurdle I come up against — which are many. I will keep this blog going, because it helps me keep my head on straight and also keep focused on what’s most important to me. But I’m not working on a bunch of other side projects that I had going, lo those many years.

And, ironically, that tames my anxiety. Using it for something good not only lets it just be without judgment or blockage, but it also gives it somewhere to go. Like a rushing river, when I let it just flow and direct it in a certain direction, it takes me on some really interesting turns. Instead of damming it up and trying to control it, I just let it flow… and I ride that wave.

Which is good.

And overdue.

Onward.

Taking it easy… sort of

work sign showing person shoveling a pile of dirtI’m doing my version of “taking it easy” today.

Basically, I’m working on my projects that have been on the back burner for weeks and weeks. Five weeks, pretty much. Count them – five. Ouch. Especially considering how psyched I was about finally getting back into them, about a month ago.

Then I had to travel.

Then I got tired.

Then I had to travel some more.

Then I was exhausted.

I’ve spent the past week swamped at work – two very late-night working sessions, and both nights not getting much sleep at all.

It was really demoralizing and depleting.

But — ha! — now I’m back.

I’ve had the whole day to myself today, to do as I pleased. And it’s been good. I didn’t do the errands I typically have to do on Saturday mornings, because, well, they’ll keep. Those errands aren’t going anywhere, and I needed the down time… the time to just sink into my passion projects and not be governed by someone else’s timeframes, deadlines, limitations.

Even though I worked really hard, this morning, it was very much a vacation from all the intense work at the office, as well as the care-taking for my spouse. Oh, also, my spouse has been ill, so I’ve been doing even more care-taking this week, than I did when we were traveling. And that’s a lot. Nearly constant attention paid. Lots of interruptions. And a trip to the doctor, as well as wrangling with the pharmacist who didn’t understand why I was asking all those questions about the type of medication that was prescribed. My spouse is extremely sensitive to meds, and the pills given before made them violently ill.

So, yeah. I’m going to ask questions. Too bad. At least I kept my wits about me and didn’t yell at anyone. That’s helpful.

Anyway, I spent a great deal of time this morning (and early afternoon) mapping out specific steps I can follow to make the most of my time and not make myself crazy in the process. Now that I have it figured out (mostly), I can move forward.

I hate not knowing what direction to take. It stops me. It blocks me. I’m not a fan.

Anyway, duty calls. I’ve got some things I must take care of this evening, so I’ll sign off for now. I am very much looking forward to this next week, when I’ll have five days off work… to continue to make progress.

 

Now you can help me to help others with TBI

group of hands holding onto each other in a circle
Reaching out to others is what brings us back to ourselves

After some very helpful feedback yesterday, I decided to go ahead and put a “Donate” button on my blog. You can see it in the right-hand column of the page. I’ve been thinking about doing this for a long time, but I never got around to it. I’m a firm believer that, of all people, brain injury survivors need access to information and connections that’s comprehensive, accessible — and free.

Experiencing a brain injury, or sharing your life with someone who’s had a TBI is taxing enough, as it is. And I think there’s a special place in hell for people who prey on TBI survivors and their families. I’ve had the mixed blessing of getting clunked on the head a bunch of times, along with a love and passion for writing. So, the two of them have combined to produce this blog. I’m committed to carrying the message that

Brain Injury Recovery is Possible.
I should know. I’m doing it.

and spreading that word as far as I can. I’ve been doing it on my own, since ’round about 2008, and as unlike me as it is, I’m actually reaching out to ask for help in doing that. Ideally, I would love to support myself through my writing and this work, but that’s not going to happen overnight. I have a number of writing projects in the works, which I very much want to get done and get out there. It’s just one step at a time with this plan of mine. And if I just keep at it, I believe I can get there — and learn a whole lot in the process.

Putting up a “Donate” button is a first step in that direction. Eventually, I may get to where I can focus on this work full-time. But for now, I’ll simply live my life as it is, share my experiences and lessons, and give others the chance to pitch in, if they like.

Ultimately, though, this is not about me. It’s about you. It’s about the readers. It’s about reaching out to others in a frank and hopeful manner, to offer insights into how brain injury recovery progresses — or regresses — and what can possibly be done to help the process along. It’s a complicated thing. It’s a very, very human thing. And more needs to be written and shared about it on a regular basis.

Whether or not money comes in, I will continue this work. It’s needed. I wish to high heaven I’d had access to this, when I had my last “mild” TBI in 2004 and everything started to fall apart in my life. But I didn’t. I had to learn from too many costly mistakes — which are still dragging me down, to this day. I would hate for that to happen to anyone else, but I know it does. And many people have it much, much worse than I. It’s heartbreaking, really. Absolutely crushing, to think of the level of human suffering — much of which happens because of lack of access to the right information at the right time.

We do know this from multiple studies:

Early intervention with the right information can help to reduce the impact of mild TBI / concussion.

It can help people with recent brain injuries understand their injury and make better choices about how to manage their lives. It can help keep recovery times to several months (sometimes weeks), instead of the years and years that some people experience.

And that’s part of my mission — to get brain injury recovery information to recently concussed individuals quickly, before the desperation sets in and/or they start making the kinds of decisions that will either further endanger them or prolong their recovery.

Beyond the initial “acute” period, I want to provide support and encouragement to individuals who are recovering from mild TBI and are confused about what they can expect, and why it’s taking so long for them to heal.

In the long run, for those of us who have prolonged periods of difficulty, struggle, and various levels of catastrophe, I want to provide an insider’s view into what it’s like to piece your life back together, after others have given up on you, or flatly refused to help you anymore. That happens all too often. I’ve lived it. I’m still living it. And it breaks my heart to think that others have to go through this… “experience” (that’s my nice, polite way of putting it).

So there it is — why I do this, and what my mission is.

I realized today that I’ve been feeling depressed and defeated over my old neuropsych moving away. I really did enjoy working with them, and they gave me so much good, encouraging information to work with. They gave me a weekly shot of hope, like no one else ever had. Losing them was a pretty big loss for me, and five months later, I think I’m nearing the end of my grieving period for that loss. I think it takes about six months to regain your footing after a significant loss. And yes, it was a significant loss for me. I’m just now realizing that.

But I’m ready to get back to work. And getting clear (again) about what this blog is really for, is a good place to start from. It’s a very good place, indeed.

So, if you also believe in this mission, and you’d like to help me get the word out, you can donate below. You can make a one-time contribution, or contribute monthly. Any amount is welcome. Thanks!

 

Onward! … Together

 

A good night – about to get better

Had a very pleasant evening with a bunch of friends tonight. Ate good food, talked about old memories and shared stories that we had somehow never told each other before.

Good times.

Now I’m home – my spouse stayed behind to catch up some more, while I came home to rest. We’ve been driving separate cars to common events for some time now, because there are times when I . Just . Run . Out . Of . Steam.

Tonight is one of those nights. While everyone was still going strong, I said my good-byes and ducked out. Got a few miles down the road before I realized that I’d forgotten something, turned around and went back, chatted a bit more, then finally made it home.

I had a really nice ride home. The night was clear and cold, and for some reason tonight just looked so beautiful. Maybe it’s all the Christmas lights. Maybe it’s because I don’t have to go to work for another week and a half. Maybe it’s because I gave myself time to get going, so I don’t have to bump up against the rough edge of my limits later on. For whatever reason, it was a beautiful drive, and I took my time coming home.

Now I’m having some hot lemon water to help with my cough, and I’m winding down … getting ready to hit the hay. This is good – much better than being crazy rushed and forcing myself to hang around and be the life of the party. I really like my friends. I also like getting a good night’s sleep.

The wind is up tonight. It sounds like a wild animal prowling around the house.That’s fine. It can prowl. I’m taking a shower and going to bed.

The hurt of the hidden wound

Got a tip about this article today. Good reading – check it out.

It was July 4, 2009 when Lieutenant Colonel Stewart Hill had his independence taken away from him. But he doesn’t remember much of what happened on that hot, dusty Saturday, and has no recollection at all of the moment the lights went out on his former life for ever.

His last memory was of a Chinook helicopter rising from a ploughed Afghan field. It carried the lifeless body of 18-year-old Private Robert Laws and other injured men of the Light Dragoons and 2 Mercian, victims of an attack with rocket-propelled grenades by the Taliban. After that, the gaps have to be filled in by others.

Read the rest here >>

concussion now i’m stupid

Someone visited this blog yesterday with the search “concussion now i’m stupid” and it seems like it’s in the air.

I had a great day Saturday — I had a very social day, and I was out and about in town, which rarely happens with me. I either don’t have the time, or I don’t make the time, or I find a hundred other things to do that are more interesting than interacting with other people in a city.

But Saturday, I took a bunch of chances, and I had a ton of interactions that were really positive and encouraging.

Sunday, on the other hand, was a huge challenge. I wasn’t able to rest as much as I had wanted/planned, and I was really feeling the effects of all the exertion on Saturday. Even if the exertion was good and positive, it was still exertion, and I didn’t remember to rest.

One of my big problems is, when I get over-tired, I often forget to self-monitor. That happened to my yesterday. So, I ran into trouble.

With a Capital T. Had a huge meltdown yesterday. As in — rage and tears and being stuck in a loop of anger and shame and frustration and resentment. I hate when that happens. I could feel it coming on, and I thought I could stop it, but I couldn’t. It was like a repeat tsunami of unwanted overwrought emotion. Waters pulling out, then washing in and wrecking everything in its path. Emotion pulling out, then rushing back in and leveling everything in its way.  It came and went for about three hours, and it totally screwed me up — and my spouse. Not pretty at all. And I’m still “hungover” from it this morning.

Ugh.

Looking back on things with a less emotional eye, one of the things that complicated my situation yesterday was that insidious little voice in the back of my head that managed to find everything I’d done “wrong” on Saturday, amplified it about a thousand times, and then commenced to tell me You’re So Brain-Damaged and Stupid. Who would ever love or care about you? You’re such an idiot – you had a concussion — no, wait, you had a bunch of concussions – and now you’re stupid. You’re so stupid you don’t even know how stupid you are.

Stupid.

Well, you get the idea. And sure enough, as always happens when that voice gets going, before long, I was at war with the world, at war with myself, at war with my spouse, at war with my job, at war with everything and everyone who came anywhere near me.

concussion now i’m stupid…

My thinking is too slow, I’m not sharp and quick like I used to be, I’m not even funny anymore (and I used to be a laugh and a half all the time), and who would want to bother with me?

Geez.

It’s bad enough that I have to contend with the physical and logistical issues, but when that voice gets going… well, the only thing to do is go to bed.

I managed to do that eventually, but not on my own steam. I had to be guided to bed and put away like a cholicky baby. I friggin’ hate when I’m reduced to that. But when I’m in the midst of that storm/tsunami, I cannot for the life of me pull myself out.

For future reference, I need to keep the image of the tsunami in my mind, when I feel it coming up. So I can get to higher ground. Tell my spouse I need to take a break, and remove myself to my bedroom or study, to simmer down. Just get myself out of the way of the wave. Maybe go out for a walk in the woods. I did that yesterday at the end of the day,  and it helped tremendously. Yes, the walk in the woods — climbing up to the top of the nearest big hill — helps me a whole lot.

I also have to have a talk with my spouse about this TBI business – it’s not okay for them to talk to me like I’m an idiot, which is what they’ve been doing more and more over the past year. Apparently, they seem to think that because my memory is a bit spotty at times, and my processing speed has slowed, I’ve lost my innate intelligence. Either that, or they have always acted this way, and I’ve just recently stopped allowing myself to be intimidated into hiding my issues from them. That’s always a possibility.

So, there are three main issues I am contending with — the wave of emotion that cannot and will not be stopped and can only be avoided until it calms down… the voice in my head that tells me I’m stupid… and the voice I live with that tells me I’m impaired. The first one, I just have to be mindful of and learn to avoid being swept away. The second one, I have to either ignore or actively argue with. The third I have to have a serious talk with — and possibly involve my neuropsych to explain to my spouse that my relative weaknesses are manageable and don’t mean I’m reduced to a simpleminded shadow of my old self. Some days it feels like that — like yesterday — but it’s not the truth of the matter.

But ultimately, the bottom line is, here’s the #1 Lesson I (re)learned over the weekend:

I have to pace myself. If I have a big day, even if it is a really good big day, I need to take the next day OFF and SLEEP. Rest. For real. Nothing else matters. No distracting entertainment is worth the price I’ll pay for exhaustion.

Achieving more by doing less

I am really resisting writing this post, but I have to put it out there for the sake of honesty — and also to get it into my head that this is the way things are now.

It’s not that what I’m thinking about is a bad thing, or even an unpleasant thing. It’s a new thing — a true thing — that I’ve been resisting for as long as I can remember, much to the dismay of my family, my coworkers, and my neuropsych.

I hate having to admit that I have been wrong, and they have been right… but in this case at least, I have to admit it:

I get more accomplished, when I do less.

Now, it might not seem like that big of a deal, to admit it. What’s the big deal?

Well, people have been “on” me for years, that I do too much. I take on too much. I have too much on my plate. I’m spread too thin. My spouse has been lecturing me for years, that I don’t relax enough and I have too many projects going on. We’ve actually had some pretty bad fights about it. I defended my hyper-busy-ness with every fiber of my being, till the bitter end, and it’s not helped our marriage at all. But I was convinced that I was right, in having twelve balls in the air. I felt so energized. Like I could do anything. And it never seemed like there was a problem. If I didn’t finish things, so what? They were boring, I told myself. And I needed a fresh start.

Well, that outlook has modified somewhat over the past couple of years that I’ve been working with my neuropsych.  Taking a long, hard look at my patterns on a regular basis, I’ve realized that being super-busy is often a direct result of anxiety. It’s not about positive exuberance. It’s not about having a vision of a future I can eagerly step into fully and with all confidence. It’s about existential angst that is welling up and driving me ahead of it, like a wild stagecoach driver whipping the team of horses into a mad gallop… in the meantime not holding the reins or guiding them in any particular direction.

This mad gallop is plain to everyone else’s discernment. It’s obviously a ploy on my part to avoid life, rather than engage with it. But it is disguised from my view by something in my perception that interprets a mad dash towards whatever comes to mind as a positive and life-affirming thing ;}

Over the years, countless people have tried to get me to stop and look at what I was doing, but I resisted — and resented — their “interference” with my grand plans. I wasn’t planning, of course. I was just flying willy-nilly in every and all directions, for the sake of flying willy-nilly. Nothing more. And when I got to a point where I couldn’t continue with what I was doing, I’d drop it… and then wonder, sometimes years later, why I ever quit what I was doing, if I was so devoted to it.

Crazy.

Well, as I mentioned, that’s been changing over the past year or so. Once I started logging all my activities and tracking them — for real, not in some quasi-reflective journal entry that rambled on about this and that for pages on end — I started seeing what was really going on in my life, and I wasn’t pleased. I looked back on all the projects I’d started — each one seeming like the thing that was going to catapult me to greatness and/or solve all my personal problems through professional success. What I saw was not greatness, but whatever-ness. Oh, man… what a wakeup call.

And I started to admit that maybe I was spending an awful lot of time on things for the wrong reasons. Maybe I was spreading myself too thin. No… obviously I was spreading myself  too thin. Judging by what little I was getting done versus what lots I was putting into my efforts, my approach was not effective. It was downright disastrous.

So, I decided to change things up. I swept a whole bunch of projects off my plate. I trimmed the fat off my docket considerably, tabling projects I thought would be cool, but obviously demanded a lot more time and energy and manpower than I could muster. I decided to do without a lot of the lists I made for myself. I also quit imagining I was going to have these multiple career paths, and be able to pick and choose between the cream of the crop, on down the line, whenever I chose to switch my path.

And it was working out pretty well. Suddenly, I had a lot more time to devote to my pet projects — the really pet ones, that is. I could focus more on the details that had slipped by me before. And I had a lot more bandwidth to do the things I enjoyed during my free time. Sleep hasn’t appealed to me much over the past months, because I was still totally into the idea that I could continue to keep up a blistering pace on a select few things — for the fun of it. Literally. I felt really “on” at work — I felt like I was really making headway and was taking the tiger by the tail.  Woo hoo – right?

Um… not so much. Now, months on down the line, I find myself worn out, all turned around by myriad details that once seemed so clear to me, and not delivering at the rate my boss wants me to. My thinking is not clear, my relationships at work are suffering, I feel like I’m slipping into a hole of my own digging, and I’m battling to get myself out. I find myself taxed and tapped, angry and raging and resentful and antagonistic and defensive and increasingly volatile… saying things I wish I hadn’t… and my marriage and work situation are both suffering as a result.

Here, I’d thought I was supporting my family and my coworkers better by driving myself like a crazyperson, taking on all sorts of tasks, when all I was doing was driving myself — and my spouse and my coworkers — crazy.

Which brings me to what I’ve been learning — the hard way — over the past couple of weeks.

I actually perform better, and I accomplish more, when I do less.

… As in, when I work in intervals — planning and thinking things through ahead of time, then mustering my energy and tackling tasks with full attention and focus.

… As in, when I spend less time on busy-work, and I devote the bulk of my attention to strategic and tactical planning and implementation, saving my logistical energy for select tasks — no more than two or three a day.

Indeed, I do better, when I tackle less of the little niggling details work that’s just filler for my time and is more about my brain thinking such-and-such is important, when it’s not really.

And I accomplish more when I don’t insist on taking on this mountain of everything by myself, as I’ve always been prone to do.

Truly, the practice of only doing 2-3 significant things a day, when I used to tackle at least five-to-ten times that amount, is a huge change for me. It’s a difficult change… An unsettling turn of events. It makes me nervous — incredibly anxious. I feel like I should be doing something. But during those stretches when I’m “doing something” to the tune of 20 deliverables a day, and I look back on my notes about what I actually accomplished, well, the results are a lot less impressive, than my fantastical plans.

But if I break it all down and pick and choose from the things I need to get done and don’t worry about the other things, till I get the most immediate couple of things done, it’s friggin’ magic, man.  I get waaaaaay more accomplished if I take things 2 and 3 tasks at a time and do them in an extremely focused and intense fashion, than if I “pace myself” and take on 20-3o items (no joke) at a “reasonable pace”.

They say timing is everything. It’s true. It’s even more true that the right timing in the right way for the person in question is more-than-everything. Some people can go slow and steady through a mountain of small details. I, on the other hand, drown in those details. Just like there are slow-twitch muscles that long-distance runners use, and fast-twitch muscles that sprinters use, I’m more of a fast-twitch kind of person. And if I slow down to go at a “reasonable” pace, I’m toast.

So, there we have it. I’ve had my helping of crow for the day. I have to admit, it feels good to say/write it out loud, but it’s been a long time coming. And I have a lot of work to do, to reverse the damage that’s come from ignoring and denying the truth about how I work best — and worst. But reverse this, I will. I’m the comeback kid. I’m not going to quit till I get where I need to be.

Even though I know it’s good for me and it’s the only way I can really work effectively, the idea of only doing a few things  a day still makes me intensely anxious. I don’t expect to get used to it overnight.

But you know what? Doing a little bit at a time in a very focused, intentional way gets me there. And since actually getting there is what matters to me (and my spouse and my coworkers and my boss) — even more than the “journey” on the way — that’s what I’ve got to focus on. Results. For real. Not plans and methodologies. Results. What works. What works for me.

Onward.

How Can I Recognize a Possible Concussion?

One of the nice things about being a blogger is that I can add my information to the general wealth of data about subjects of interest to me – in this case, mild traumatic brain injury. This blog is about more than telling my side of the story — it’s about fleshing out info that other trusted sources provide, in ways that are personal and individual… and hopefully contributing to the general understanding about traumatic brain injury, and sports-related concussion in particular.

The CDC has a wealth of information on concussion in youth sports over at their Heads-Up site.

What’s missing is a bit of in-depth explanation about the different points they make.

Since this month is Brain Injury Awareness Month, I hope to contribute to the awareness piece with further info and examples from my own concussion experiences.

From the CDC site about recognizing concussions:

To help recognize a concussion, you should watch for the following two things among your athletes:

  • A forceful bump, blow, or jolt to the head or body that results in rapid movement of the head.

AND

  • Any change in the athlete’s behavior, thinking, or physical functioning.

Athletes who experience any of the signs and symptoms listed below after a bump, blow, or jolt to the head or body should be kept out of play the day of the injury and until a health care professional, experienced in evaluating for concussion, says they are symptom-free and it’s OK to return to play.

Signs Observed by Coaching Staff

  • Appears dazed or stunned
  • Is confused about assignment or position
  • Forgets an instruction
  • Is unsure of game, score, or opponent
  • Moves clumsily
  • Answers questions slowly
  • Loses consciousness (even briefly)
  • Shows mood, behavior, or personality changes
  • Can’t recall events prior to hit or fall
  • Can’t recall events after hit or fall

Symptoms Reported by Athlete

  • Headache or “pressure” in head
  • Nausea or vomiting
  • Balance problems or dizziness
  • Double or blurry vision
  • Sensitivity to light
  • Sensitivity to noise
  • Feeling sluggish, hazy, foggy, or groggy
  • Concentration or memory problems
  • Confusion
  • Does not “feel right” or is “feeling down”

Remember, you can’t see a concussion and some athletes may not experience and/or report symptoms until hours or days after the injury. Most people with a concussion will recover quickly and fully. But for some people, signs and symptoms of concussion can last for days, weeks, or longer.

Now, for some explanation to fill in the blanks…

To help recognize a concussion, you should watch for the following two things among your athletes:

  • A forceful bump, blow, or jolt to the head or body that results in rapid movement of the head.

The head, atop the neck, holds our precious brain — which has the consistency of pudding, and is surrounded by fluid which protects it from the bony inside of our skulls. Unfortunately, the bony insides of our skulls can have rough/sharp edges which can rake across the surface of the brain and cause damage that way, should the head/bodybe knocked so hard that the brain pushes past the protective fluid and scrapes against the inside of the skull.

You can see a video of different types of brain injury at YouTube. It’s very informative, and I recommend it.

When the body or head is hit hard enough, the brain can hit against the front inside part of the skull, be injured there — and then fly back against the rear of the skull (called coup-contracoup — which means head-back0fhead — injury), causing damage to the rear part of the brain as well. Under ideal conditions, the protective fluid provides an ample buffer to shelter the brain, and the inside of the skull is not really sharp and uneven. Unfortunately, there are no guarantees that that’s the case.

Forceful bumps or blows or jolts to the head can be things like:

  • being hit on the head by a ball, such as in soccer or baseball
  • colliding with another player and bumping heads
  • being elbowed or kicked in the head
  • colliding with the catcher and slamming your head against his/hers when you’re trying to steal homebase
  • falling and hitting your head on the basketball court floor

Another way the brain can be injured by a hard hit to the body, is a whiplash effect — where the connections that are located at the base of the skull and neck are twisted and torn by the head snapping forward and backwards really hard. You don’t need to be knocked out, and you don’t even need to have your head hit, to sustain a concussion in sports.

Forceful bumps or blows or jolts to the body can be things like:

  • being tackled hard in football
  • being fouled hard and knocked to the floor in basketball
  • falling during a soccer game
  • colliding with another player when going after the same ball
  • landing hard after any kind of fall, even if your head doesn’t hit the ground
  • running into the wall when you’re eplaying squash/raquetball

It’s important to remember that these very common collision/impact occurrences (which are part and parcel of just about any sport) will NOT necessarily lead to concussion. If everyone who was tackled hard, or fell, or was fouled hard and ended up on the floor/ground sustained a concussion, there would be a whole lot of impaired people walking around.

Being hit or tackled or falling during a game or practice is NOT a guarantee of a concussion. This is where the next criteria comes in… the “and” part.

AND

This AND is important. The first set of criteria — the bump, blow, or jolt to the head or body are no guarantee that a brain injury has occurred, but they can serve as a trigger to watch out for the following. The next point is what acts as an alert that a concussive event has occurred.

  • Any change in the athlete’s behavior, thinking, or physical functioning.

Signs Observed by Coaching Staff

  • Appears dazed or stunned
  • Is confused about assignment or position
  • Forgets an instruction
  • Is unsure of game, score, or opponent
  • Moves clumsily
  • Answers questions slowly
  • Loses consciousness (even briefly)
  • Shows mood, behavior, or personality changes
  • Can’t recall events prior to hit or fall
  • Can’t recall events after hit or fall

Symptoms Reported by Athlete

  • Headache or “pressure” in head
  • Nausea or vomiting
  • Balance problems or dizziness
  • Double or blurry vision
  • Sensitivity to light
  • Sensitivity to noise
  • Feeling sluggish, hazy, foggy, or groggy
  • Concentration or memory problems
  • Confusion
  • Does not “feel right” or is “feeling down”

Here are some examples from my own experience:

When I sustained a concussion from a hard tackle during a football game in high school, there was an immediate change in my thinking and physical functioning.

  • First of all, I was not thinking as quickly as I was before the hit. Even I could tell I was slower — I wasn’t following the calls by the quarterback very well, and I was clearly a little dimmer than I had been before the hit. I had trouble understanding what was said in the huddles before the following plays, and I had trouble following the instructions I was given. For example (I can’t remember the exact details, but this is how it was), when I was told to go long and then cut left at a certain point, I went long, but I didn’t cut left.
  • Secondly, I was not as coordinated as I had been before the hit. I ran clumsily — like I was drunk — and I couldn’t catch the ball when it was thrown right to me. I also stumbled a lot, and I fell a few more times. For all I know, I did more damage to myself, but I was so totally focused on continuing the game and not letting my teammates down, I refused to take myself out of the game. They had to stop the whole game, completely, to get me to quit playing. I was that stubborn.

When I sustained another concussion from a fall during a soccer game a year or two later  in high school, there was yet another immediate change in my physical functioning and behavior.

  • First of all, I was a lot less coordinated than I had been before I fell. I couldn’t control the ball as well as I had before, and it felt like I was moving in slow motion. I stumbled and fumbled, and there was obviously something different about how I was playing.
  • Second, I was not the same player I’d been before my fall. Before, I had been aggressive and confident on the field. Afterwards, I was hesitant, confused, and I hesitated before shooting on the goal (or just plain failed to shoot). I had a number of opportunities to score, but I didn’t, because I was uncertain and confused. I was also less able to be a team player. I didn’t pass the ball to my open teammates as frequently as I should have. I also became more withdrawn and was not communicating with the coaching staff on the sidelines. It was like I was in my own little concussed world, suspended in a foggy soup that slowed down all the input and output.

Athletes who experience any of the signs and symptoms listed below after a bump, blow, or jolt to the head or body should be kept out of play the day of the injury and until a health care professional, experienced in evaluating for concussion, says they are symptom-free and it’s OK to return to play.

Absolutely, positively. This must be done. Unfortunately, I myself never received any medical evaluation or treatment for my injuries. But on the bright side, I was removed from play in both instances. Nobody watched me afterwards to make sure I was symptom-free and it was OK for me to return to play. Then again, by the time I got to those games, I’d had a number of TBIs already, so I already showed symptoms of impairment. Still, the changes I did experience, on those two separate instances, were clear indicators that I’d undergone a concussive event. I only wish someone had known what to look for, and helped me out.

Another important piece of the CDC info is:

Remember, you can’t see a concussion and some athletes may not experience and/or report symptoms until hours or days after the injury. Most people with a concussion will recover quickly and fully. But for some people, signs and symptoms of concussion can last for days, weeks, or longer.

This cannot be overstated. Concussion, hidden as it is inside the skull, can also be hidden by time. It can take hours or days for symptoms to show up, which is why it is so important that not only coaches, but also teachers and parents and teammates are all familiar with the danger signs and informed about how to respond appropriately.

One of the things that can show up later, are behavioral issues. Indeed, behavioral issues are the bugaboo of mild traumatic brain injury, because on the surface everything looks fine, and the brain may have recovered from its initial trauma, but there are microscopic changes under the surface that can have long-lasting effects. If you know someone who plays sports, whose behavior has suddenly started to change for the worst – suddenly they have a lot of anger, rage, irritability, distractability, sensory issues, fatigue, insomnia —  it could be they had a concussion during a game or some other event — and nobody realized it, including them.

Concussion doesn’t just affect the student athletes — it affects everyone who interacts with them, everyone who loves and cares about them. It’s in all our best interests to learn about it, learn what to watch for. And to report it to someone who can help.

As the CDC says, most people recover quickly and fully, and it doesn’t need to wreck their lives. But if you don’t pay attention to the first warning signs, it is all too easy to re-injure yourself (having a concussion increases your chances of experiencing another one from 2-6 times). So, paying attention, right from the get-go can help prevent other problems from happening.

In retrospect, I wonder what might have happened, if I’d stuck with track and field and cross country exclusively, and not played any team sports that involved tackling or the danger of falling/collisions. I wonder if I would have been so susceptible to drugs and alcohol, if my behavior would have been so problematic. Thinking back, I had a ton of problems when I was a kid that actually resolved as a result of organized sports. Unfortunately, the thing that helped me most, also introduced more problems to my mix.

Well, I can’t worry about it. What’s done is done, in my case. I’m just happy I’m as functional and well-off as I am, today.

I also hope that coaches and trainers and teachers and teammates are learning enough, today, to help avoid the kinds of situations I got myself into… and help address the after-effects of the kinds of injuries that I — and hundreds of thousands of others young athletes — experienced. The CDC material is really helpful, and they have lots of free information and additional materials available.

Check ’em out. It’s worth the trip.

Once we’re aware of brain injury… what then?

One of the things I hope happens during this month — March is Brain Injury Awareness Month — is that TBI awareness doesn’t “dead end”.

What I mean by that is, I hope that in learning about brain injury, tbi, head injury, concussion… whatever you choose to call it… people don’t reach the conclusion that a brain injury is The End of the Line for people who sustain one.

Proof that this can’t possibly be true, all across the board, is the fact that Every 21 Seconds, someone in the U.S. suffers a traumatic brain injury.

1.5 Million Americans suffer a traumatic brain injury each year.

And those are just the ones we know about.

There are very likely many, many more individuals who sustain head injuries (or concussions) and either never fully realize it, or who say nothing about it, don’t report it, don’t seek medical assistance, etc.

Now, I don’t know about you, but that sounds like an awful lot of people. Which means, there are a whole lot of folks walking around with a history of head injury. And it means that this “silent epidemic” as some folks are calling it, has a substantial presence in our lives, whether we like it or not.

And although this silent epidemic is a serious one, from where I’m sitting, it’s not catastrophic. It doesn’t need to signal The End of Productive Life for survivors. And it certainly doesn’t necessarily mean that we TBI survivors are all disabled or incapable of getting on with our lives.

Now, I’m playing devil’s advocate here — and it may seem out of character, because I’ve devoted a fair amount of time and energy to raising awareness about the difficulties that come with TBI (especially “mild” traumatic brain injury, or mTBI). I’ve spent a lot of time talking about my difficulties and challenges and things that hold me back and get in my way. I’ve really wanted folks to get a sense for what it’s like to deal with TBI on a daily basis, not sugar-coating it, and not hiding the warts and bumps and foibles and screw-ups that beset me along the way.

I’ve taken the liberty of saying things here and voicing opinions that are clearly the results of my issues — temper tantrums and tirades and poor-me bitching and moaning. I’ve been as honest as I can be — on purpose — because that’s a side of this condition that needs to be acknowledged and reckoned with.

At the same time, though, I also want this blog to show how, despite these challenges and problems, it is possible to overcome them. With the right strategies and the right outlook and the right tools — and the right self-awareness — you can overcome mild TBI’s challenges and get on with your life. You can even overcome a more severe TBI — I may have had a more severe one that I originally thought, when I was knocked out by that rock when I was 8 years old (but I don’t remember how long I was knocked out, and I didn’t get medical assistance that could identify what the real story was with me, back then, so I’ll never know for sure just how severe that injury was — for all I know, my brain might have swelled or I had a bleed, or something like that, but 35 years after the fact, any evidence of that didn’t show up on the MRI or EEG).

TBI doesn’t have to be the end of the line. Concussion, either (and let’s use those terms interchangeably this month). A head injury may sideline you for a time, but it does NOT need to become a permanent, life-threatening condition that plunges you into chaos and desperation. For some people it may be that, but there is no rule written in stone that says that TBI is the end of the road. While the organizations and research facilities which are seeking funding and want to get the public’s attention around TBI may resort to dramatic accounts to get people’s attention and get them to take this national health issue (note, I am not saying “crisis”) seriously, as an individual I am saying that TBI can be survivable. And it does NOT need to permanently derail your life.

Now, I know the dangers of giving people false hope. Sometimes an injury is a permanently disabling one. Sometimes there’s just no chance of getting back certain functions and abilities. Sometimes the brain is just “done”  in places, and the things it used to do, are things of the past. For people in that situation, I feel a great deal of compassion. Not pity. Compassion. They are in serious need of help — especially when their injuries have come as a result of serving their country, and their TBIs have left their spouses and kids and other family members with a huge gaping hole where their personality and presence used to be.

That’s a terrible, awful situation, and those folks need all the help our nation can offer.

But when it comes to Brain Injury, there is no set-in-stone rule that says a certain outcome is 100% predictable. There is no 100% certainty that a certain type of injury will result in a certain type of effect. Everyone is different. Every brain is different. We’ve got our genetics, our physical fitness, our personal expectations, even our individual character, to factor in. We’ve got past training and conditioning — physical, mental, spiritual — to consider, as well as the amount of support we receive. And then there’s plain old grit and mettle…

What happens to one person and results in certain after effects, can happen to another person and result in something completely different. It’s not an exact science, and there are as many unpleasant surprises along the way, as there are pleasant ones. There are no guarantees, and there are no unassailable absolute rules about TBI that say if such-and-such happens, you can expect such-and-such to occur.

Each head trauma survivor, and their family and friends, have to find out for themselves what is truly possible for them.

But while we’re learning about the issues and problems and difficulties and challenges, let’s also keep in mind the possibility that there is much, much more we have to learn about how much recovery is truly possible. For all we know about brain injury, right now, there’s a ton we don’t know. That goes for the brain, itself. And in this day of medical and scientific expertise, where trained professionals with “qualified” backgrounds are doing their utmost to help us feel more secure by being their expert selves, it would do us all some good to keep in mind that their demeanor and their outlooks are parts of roles they play — as experts, they must necessarily appear strong and confident and authoritative. Which opens the door to following them blindly down roads where the surface is not paved nearly as well as they would have us think.

And it can also close the door to other possibilities — the possibility that they might be wrong about how the brain works and how it heals. The possibility that they may be wrong about what the human spirit is capable of doing. The possibility that they may be looking in the wrong places for some of their answers, and that they might be discounting valuable information and experience that others can use, because it’s not part of a double-blind peer-reviewed controlled experiment conducted under tightly monitored conditions.

March is Brain Injury Awareness Month, and my own personal contribution to the collective awareness is this: Just because you sustain a brain injury doesn’t mean your goose is cooked for all time. There may be some things you have to let go of — like that go-go-go lifestyle that kept you from paying attention to your whole life. There may be some changes you need to make — like exercising regularly, or taking some meds to keep yourself cognitively engaged. There may be some challenges you cannot shake — like constant headaches and all-over general aches. But everybody has something they have to overcome. It comes with the human territory. And for every one thing that we have to let go of or adjust away from, there are about a million other things we can do or pursue, to take its place. Just because you can’t do ___________, doesn’t mean you can’t do _____________.

The world is bigger than that. And so are we.

Awareness of Brain Injury is just the first step. And it doesn’t have to be the last. There are millions of people who are dealing with the after-effects of TBI, years after the fact, and not all of them have been rendered incapable of living their lives. How well they recover and move on with their lives depends on myriad factors, not least of which is character and the strength of the human spirit. It’s not all about the brain. It’s about the mind. The body. The heart. The soul. The brain is one piece of the equation — it’s an important piece that cannot be disregarded. But it’s not the only piece.

This is important information. It’s critical. And it’s vital that we not lose sight of the whole person, when we look at TBI survivors. Each person has their own personal “constellation” of abilities and limitations. And each person has a choice in how they approach them. We TBI survivors may not have the same faculties as we had before our injuries, and we may not have the same faculties as others, but we are still very human and we are still very much alive, and that in itself should count for something.

That being said, during Brain Injury Awareness Month, I am really hoping that more of a conversation can emerge about the nature of brain injury, and we can hear more stories of recovery. There’s always the danger, I suppose, of successful recovery stories convincing people that brain injury is not that big of a deal, and that all you need is time and rest, for things to get back to normal. That’s not how it works. I’m not sure it works that way for anyone, brain-injured or not. Likewise, there’s the danger that showing the lives of people who were brain-injured who never fully recovered will tell people that once your brain is damaged, it’s the end of the line for you. That’s not how things have to work, either.

It’s more complicated that that. More complex. Perhaps more than can be handled and addressed and discussed in March.

Well, at least this is a start. The month is just beginning, and there are 30 more days in which to talk about all this.

Onward…

Anger, anger, and more anger

temper strikeOne of the things that can make TBI particularly difficult, in the ensuing weeks, months, even years, is anger issues. Rage issues. Flying off the handle and attacking others for no good reason that they can see.

There are a lot of reasons this happens. Some of them are:

  • Fatigue – your system is compromised by too little sleep and/or too much activity (with me, the two go hand-in-hand), and you don’t have the energy/wherewithall to stop yourself from going off
  • Fear – there’s nothing like a sharp spike of adrenaline, combined with anxiety and fear to set you off. Fear has a way of clouding your judgment, so you not only under-think situations (from fatigue) but you also overreact to the circumstances (which may or may not be true).
  • Frustration – when you’re trying to get something done/said/understood, and it’s just not happening, no matter how hard you try, patience wears thin — especially with yourself. My frustration tends to be directed inwards, though it also gets directed outwards. But the inward-turning kind is actually a lot worse for me. It makes me mean and aggressive. The worse I feel about myself, the angrier I get with life in general, and the more I tend to blow up.

It certainly doesn’t help that my brain gets into an uproar and starts getting into a biochemical soup drama, so that even if I wanted to think straight, I can’t.  The constant restlessness of my brain, coupled with the toll that agitation and fatigue take, can combine for a pretty potent mix of explosives.

So, what can I do about it?

  • At a very minimum, be aware that I’m angry. It often feels like something completely different — it feels like I’m just revved, and I don’t recognize the emotional piece of it. It may sound simple, but realizing that I am actually angry is a big challenge for me.
  • Realize that my anger does not necessarily make sense to others. What I’m thinking and feeling may be entirely unique to me.
  • Realize that my brain may be sending me wrong signals, and the surge of emotion that’s coming up may be simply a biochemical response by a physical system that is WAY overloaded and highly sensitive.
  • Remember that the long-term effects of a blow-up are probably not worth the satisfaction I get from venting. No matter how justified I feel about my anger, it can do much more harm than good. I have to think about whether I want to spend the next days/weeks/months patching up the damage I do to myself and my relationships with others, thanks to uncontrolled anger.
  • Keep myself in check. No matter how justified I feel, the more revved I get, the more I need to step away. I need to do whatever I can to remove myself from that situation, before it escalates and turns really nasty.

It’s not a perfect process, but it’s something. It’s an ongoing thing, and I’m far from perfect. But ultimately, life has a way of teaching me the lessons I need to learn, so if I just keep at it, eventually I do make some progress.