Head injury – the gift that keeps on giving

I’m on my way home from visiting my family for the funeral. All in all, it was a good visit, and I learned a few things I had not known before.

The main thing I learned is that my nephew, who has had multiple concussions thanks to falls and collisions in his sports of choice – BMX (bicycle moto-cross), skateboarding and action sports, is having huge problems in his life after graduating from high school last spring. He’s not living independently, and he’s having terrible headaches and sleeping through alarms.

I’ve suspected this might happen to him, and now it’s a reality.

I had a chance to talk to his mom, and she is understandably worried.

I promised to send her some information, and so I shall, when I get home and have access to all my “goodies” on my hard drive. I talked with her a bit, sharing some of my own insights, without saying much about my own experience… I wish I could have said more, but there wasn’t a lot of time and I didn’t know how much to say.

One of the big issues that comes front and center with this situation, is the issue of sense of self. No surprises there. My nephew is very invested in being a BMX racer / stunt rider as well as a skateboarder. So any change to that status is going to mess with his head in a bad way – especially because he’s just now going out in the world.

He is a really great kid, and I have been concerned about him for some time.

Now perhaps I can help.

Gotta try.

Onward.

What our denial is costing us

It’s not like we can’t see the signs

I’ve been thinking a lot about The Crash Reel, lately, especially thinking about the parents of Kevin Pearce and how they handled his accident and brain injury and recovery. One of the things that stands out in sharp relief for me is how silent his mother is, as she watches her son suffer and struggle. When he’s sitting with the doctor, telling him about how he thinks he should just go out and start snowboarding again… when he announces at a family dinner that he’s looking forward to getting back on the snow… his mother is silent. Sitting quietly in pain, having aged a great deal over the past year, and not speaking up on camera to set him straight.

I know it’s heresy to be critical of parents — especially those who have children who are struggling with a disability or recovery of some kind. It is a parent’s worst nightmare to see their beloved child injured so horribly, even killed. At the same time, parents are one of the most available lines of defense against action sports TBI, and when they don’t step in to stop dangerous behavior, I really feel for the kids who end up suffering as a result.

The kids literally do not know better. Their brains have not properly developed enough to be able to make good decisions. And parents who just leave all the decisions up to them may actually be inviting danger and disaster into their families.

On the other hand, no parent can own or control their child forever, and accidents do happen, no matter what sport you play. Even if you’re not playing a sport, accidents happen. TBI happens. No amount of good parenting will erase that chance 100%.

There are many other pieces to the TBI puzzle, especially when action sports are considered. There’s the X-Games atmosphere of daredevil stunts, the constant push to exceed your (and others’) limits, the steady pump of adrenaline that makes us feel alive — and makes some of us feel like we’re human again.

That adrenaline pump, the flow of dopamine when you accomplish something fantastic, the numbing of pain that all the fight-flight stress hormones make possible… it’s not just an addiction, which people simply dismiss. For some of us, it’s a non-negotiable part of who we are, and without it we are just shells of who we know ourselves to be.

I spent the last week deliberately resting, and man, at some times it was hell. Boring. Dull. Dampened. Blah. Booooorrrrinnnngggg.  I knew I needed to rest. I knew I needed to catch up on my sleep, and it was all good, when I finally got to a place where I actually felt rested. But that persistent sense of being so dull and dim and low-level was extremely difficult to take. And I’m not even an extreme sports athlete.

Imagine how it must feel for someone to go from the thrill and elation of successfully completing a difficult ride down the slopes… to being laid up, forced to rest and recuperate and “take it easy”. Yeah, sheer hell.

It’s the denial of this part of our lives that is the most dangerous, I think. Because we deny that we need that rush, the challenges that test our limits in real life, we don’t get the stimulation we genuinely need, and we live lives that are far less … alive … than they should be. We try to reduce danger at every turn, avoiding uncomfortable situations and everyday challenges, in hopes of having some sense of security. But in the process, we starve our systems of the important challenges and tests that make us more of who we are. We stunt our growth, and we know it harms us. But we are still so convinced that somehow, some way, we can be safe and secure.

In a way, our hunger for safety and security is the worst thing we could possibly indulge. It makes us less than who we could be, and it denies us the necessary genuine risk that fine-tunes our systems and makes us better at being who we are.

But we can’t be deprived forever. As I said, part of us knows the constant risk avoidance is not doing us any favors. So, we seek out artificial challenges that we think we can control ourselves — like extreme sports, velocity sports, collision sports. The worst is when we ask others to vicariously seek out those challenges for us — NFL football players, extreme athletes, and all sorts of danger-seekers we reward with adulation and praise for doing things we could never do ourselves — and which might actually permanently maim or kill them, right before our voyeuristic eyes.

We need action. We need excitement. We need risk. There’s no point in denying it. Our brains and bodies are finely tuned to handle risk and excitement, and if we can’t get it in a healthy way, we will get it in an unhealthy way.

So why not exercise and develop that part of ourselves — safely?

When I say “safely”, I mean without putting our lives and limbs in direct danger — within the context of our everyday lives, taking on challenges that others so frequently flee. Countless “dangerous” situations present themselves to us each day, which we could pursue, and make our lives better in the process. Things like

  • Speaking up and telling the truth about what’s going on around us.
  • Refusing to play along when a bully shows up and demands that you join in their “game” of ridiculing or bullying others.
  • Taking a long, hard look at yourself and admitting what’s really there — and taking steps to address the things you’re not so happy about.
  • Following your dreams, once and for all, and damn the torpedoes or what anyone else has to say about it.

Those are just a few examples of the real risks in life, and those are the ones that get lost in the shuffle. I’ve been seeing a lot of trailers for the “Secret Life of Walter Mitty” movie, lately, and just from what I’ve seen, it seems like old Walter is doing just what I’ve described — replacing the challenges and dangers and risks of everyday life with extreme situations that give him that necessary pump of adrenaline and dopamine that makes him fully human. Fortunately or unfortunately, I suspect the movie concludes with him coming out safe and sound, with no TBIs or other disasters ripping his life apart. Yet more denial? {sigh}

The Walter Mitty story seems not so far removed from the story of sheltered kids taking up extreme sports to supply their brains and bodies with the biochemical pump they need to develop properly. Of course — full disclosure — I haven’t seen the movie yet, so it may turn out to be a good one. I do know the original story behind the movie, so I can speak to it a bit. I’ll have to check out the movie for sure — but on DVD later. I’m not going into a movie theater filled with people who are talking and texting and coughing all over me.

Anyway, that’s my little discourse on denial and its role in producing one TBI after another. We are all culpable, when it comes to cases like Kevin Pearce

  • those who let him take up extreme sports,
  • those who encouraged him,
  • those who rewarded him,
  • those who profited from him,
  • those who continue to urge him back on the slopes to do yet more dangerous stunts,
  • and those who sit by quietly not speaking up when the danger is so apparent, so obvious.

The crazy thing is, this keeps happening every single day, and yet we sit by silently and say and do nothing about it.

Makes no sense. I think we all need to get our heads examined.

For skiing and snowboarding, helmets are not saving lives

There is a great article over at the New York Times (http://www.nytimes.com/2014/01/01/sports/on-slopes-rise-in-helmet-use-but-no-decline-in-brain-injuries.html) about how helmet use is not lowering brain injuries or fatalities:

Ski Helmet Use Isn’t Reducing Brain Injuries

Michael Schumacher in 2005. Schumacher was wearing a helmet when he was injured recently.

By KELLEY McMILLAN

Published: December 31, 2013

BEAVER CREEK, Colo. — The fact that Michael Schumacher was wearing a helmet when he sustained a life-threatening head injury while skiing in France on Sunday probably did not come as a surprise to experts who have charted the increasing presence of helmets on slopes and halfpipes in recent years. The fact that the helmet did not prevent Schumacher’s injury probably did not surprise them, either.

Schumacher, the most successful Formula One driver in history, sustained a traumatic brain injury when he fell and hit his head on a rock while navigating an off-piste, or ungroomed, area at a resort in Méribel, France. Although he was wearing a helmet, he sustained injuries that have left him fighting for his life in a hospital in Grenoble, France.

Schumacher’s injury also focused attention on an unsettling trend. Although skiers and snowboarders in the United States are wearing helmets more than ever — 70 percent of all participants, nearly triple the number from 2003 — there has been no reduction in the number of snow-sports-related fatalities or brain injuries in the country, according to the National Ski Areas Association.

Experts ascribe that seemingly implausible correlation to the inability of helmets to prevent serious head injuries like Schumacher’s and to the fact that more skiers and snowboarders are engaging in risky behaviors: skiing faster, jumping higher and going out of bounds.

“The equipment we have now allows us to do things we really couldn’t do before, and people’s pushing limits has sort of surpassed people’s ability to control themselves,” said Chris Davenport, a professional big-mountain skier.

Read the rest of the article here

And again, we come across examples of how risk-taking behavior takes over and trumps reason. With better equipment, people take more risks — like football players who treat their protective gear like armor to protect them as they turn their bodies — including their heads — into weapons.

Additionally, the article says:

In fact, some studies indicate that the number of snow-sports-related head injuries has increased. A 2012 study at the Western Michigan University School of Medicine on head injuries among skiers and snowboarders in the United States found that the number of head injuries increased 60 percent in a seven-year period, from 9,308 in 2004 to 14,947 in 2010, even as helmet use increased by an almost identical percentage over the same period. A March 2013 study by the University of Washington concluded that the number of snow-sports-related head injuries among youths and adolescents increased 250 percent from 1996 to 2010.

So, dangerous sports continue to be dangerous, and may become even moreso, when the participants are “assured” that they will be protected from injury by a helmet.

But a helmet won’t protect your brain from smashing against the inside of your skull, and that’s where the real injury takes place. It’s inside – where the sharp bone impacts the soft brain… as well as deep within the brain where axons are twisted and sheared and torn, like roads being torn up by a twister or a flash flood.

The Crash Reel has a lot of people talking about TBI and snowboarding. Whether people are listening — and changing their behavior — is anyone’s guess.

Even more questionable, is whether people are actually asking the right questions about what makes this kind of risk-taking seem so attractive to people. They’re not always taking seriously the real need for a reward in life — and the rewards that dopamine and the adrenaline rush offer, can be “just what the doctor ordered” for someone who struggles with attentional issues, low dopamine levels, confusion, alienation, and a general sense of not really fitting into a larger community.

As long as risk-taking that can get you seriously injured is the only option offered to folks who need those neurotransmitters to feel whole and alive, you’re going to continue to see this sort of thing.

And helmets aren’t going to make a whole hell of a lot of difference. If anything, they can make things worse.

Death Wish? Not even close

Note the missing helmet

When it comes to living on the edge — extreme sports, extreme living, leading the way in innovation and exploration — there’s usually an element of risk, even life-threatening danger involved. People like to say folks who push the limit have a death wish. They may be right at times, but on a deeper level, I think they’re wrong.

It’s more like a Life Wish – an intense desire to live life to the absolute utmost and take the human experience to places it’s never been before. Plenty of us live on the edge – out on the front lines of human experience where the everyday is simply not enough to keep us going. There must be more. Surely, there must be more.

And it’s not just us. Our whole society is in love with that kind of mindset – the ones who push the envelope, who take human experience places it has never been before, who show others what is possible and how it can be done. Indeed, when was the last time you heard anyone celebrated for doing the same thing everyone else is doing — just more reliably and predictably and with less variation than anyone else?

People want to be woken up — all across the board. And those of us who live on the edge probably need it more than most.

So, why do we need it?

I have my theories. I believe that some of us have more  of a need for the edge, because life has thrown us a bunch of curve-balls over the course of our lives — maybe our lives are a living, breathing curve-ball. And dealing with it all can be overwhelming and defeating. Day after day of confusion and frustration and being treated like you’re less-than, because you are different, and having but faint and fleeting moments of clarity in a world that will not stop and wait for you… it takes a toll. Whether you’re dealing with dyslexia or ADD or ADHD or some other neurological or medical issue… TBI after-effects, PTSD, old wounds from trauma that just won’t go away… it takes a toll.

The one way you can get relief is sometimes to take up an activity that forces you into the moment with such urgency, that you cannot spare a moment’s attention on anything else except for Here And Now. You can block out the static. You can shut out the noises. You can silence the voices in your head that tell you you’re wrong, you’re bad, you’re worthless, you’re lazy, you’re pathetic, you’re a waste of breath, you’re a disappointment, you’re a good-for-nothing whatever.  And you can just BE. Right then and there. As you are. As things are. As you wish they always were.

And whether you’re riding a snowboard or skiing or paddling or running or flying or driving or working like a mad person, you’re not in the midst of the crazies. You’re not stuck with that herd of nay-sayers who never cut you a break. You’re either alone with your own mind and body, living what’s in front of you — and ONLY what’s in front of you. Or you’re with your friends who find the same solace as you in that kind of activity.

People who say extreme/action sports athletes have a death wish, simply don’t understand. Maybe they don’t want to. Maybe they don’t care. Whatever. I guess the reason I’m thinking about this, is that the label “risk-taker” dehumanizes people who live on the edge and puts us in a category — a category that makes us seem like we’re not worth saving. It’s a category that makes our eagerness to push the limits look like blind foolhardiness, rather than a real love of life — and a very real need to relieve the pain of our everyday lives.

Not only does it devalue this basic human need, but it also misses the point – and I don’t know how many lives have been ruined or lost, because people don’t “get” the nature of extreme risk-taking, when they’re helping someone who’s been injured. This is the point that gets me the most – and how many lives have been trashed needlessly because of it? People try to reform risk-takers and danger-seekers, by treating them like they’re self-destructive individuals who are addicted to the adrenaline rush.They dismiss the need for speed, or they talk about it in psychological terms — when it’s really a physiological and soul-level issue.

Now, it very well may be a self-destructive addiction in some cases, but look beneath, and see what the larger need is — relief from the pain, activation of certain circuits in the brain, analgesic stress to numb the anguish of living every day in a world that does not make room for you. Why not look at that need as a valid thing? Everyone needs to ease the pain of their existence, in one way or another. Risk-taking and extreme danger-seeking are just variations on what everyone does, to some extent or another.

And what it brings… well, that’s pure sweetness on a whole different level. When it works out, of course. When it doesn’t work out, that’s a completely different ball of wax. That’s when you get hurt. That’s when you get really, really hurt. Seriously injured. Sometimes permanently. Sometimes dead.

And then loved-ones and caregivers gather around the survivors of the crashes, hoping to wean them off their “addiction” to the adrenaline rush, and convince them they have something else to live for.

In the process, a valuable opportunity is lost — a chance to see what’s really going on, and find another way to address it. The real work is not to find a way to do away with the rewards of speed and danger, but to replace them with similar rewards that do the same thing for your brain and your body that danger-seeking does. Asking someone who is in serious pain and confusion on a daily basis to get rid of the very thing that gives them a sense of actually being alive makes them believe they are human… well, that’s a little unkind. It’s well-intentioned, most likely, but it misses the point.

The point is not to get rid of extreme experiences and stop that kind of behavior entirely. The point is to recognize the important role that extreme sports and danger-seeking plays in stabilizing someone who’s “all over the map”… and then find another way to achieve those same effects and experience those same rewards, without putting yourself in unavoidable harm’s way. It’s not about decrying and getting rid of extreme sports. It’s about listening to the messages that risk-taking send out — and no, it’s NOT self-destruction and addiction — and then doing something with that information to find a way that doesn’t end up in a mangled pile of flesh and splintered bone at the bottom of a mountain gorge… or splattering your brains all over the bottom of a half-pipe.

This is important. I really believe lives depend on recognizing the true nature of risk-taking and extreme sports. And the longer we take to understand this, the more peril we’ll stay in.

 

The secret about risk-taking

So, I searched Kevin Pearce on YouTube, and I came across this video of him in a video hangout promoting the release of The Crash Reel.

There are a bunch of folks on the video chat, including veterans, some other folks advocating for brain injured folks, and a fellow who’s been in the TBI rehab line of work for over 30 years. I only watched it for a little while, partly because I had a bunch of things to do yesterday. But the bigger reason I quit watching was  one thing in the video that kind of freaked me out:

Kevin Pearce is snowboarding again.

Now, I don’t know if he was cleared by his doctors, or how much snowboarding he’s doing — if he’s trying any of his old tricks, or if he’s just happy to be back on the snow and is taking it easy. I do know this — if I were in his shoes, I wouldn’t be able to NOT do the tricks, flips, spins, and all the acrobatic stuff for very long. Because doing those tricks has been a part of snowboarding for almost as long as it’s been around. And if you can’t do them, then what kind of snowboarder are you?

It made me a little sick, to be honest. Because I get the distinct impression that if he keeps it up, Kevin Pearce is not long for this world. He’s brain-injured. His brain has been permanently altered, and even though it is possible to build back a ton of functionality, and he’s looking worlds better than he did 3-1/2 years ago, there’s still got to be deficits in the areas of the brain that rule executive functioning and decision-making. That stuff can be rebuilt to some extent, I believe, but there will always be something different about how things used to be.

And when you get caught up in the moment, feeling great about yourself and where you’re at, not paying attention, maybe pushing the envelope a little bit, that’s when it becomes really easy to hurt yourself badly. Even a little fall — after a series of falls, including a major one that put you in a coma and forced you to learn to walk and talk again — can prove fatal.

The problem is, there’s no guarantee it will. The problem isn’t that there’s a chance it might not kill you. The problem is, you have no reason to believe with 100% certainty that it’s going to end your life. And when you’re caught up in the moment, feeling fine, feeling — let’s face it — invincible… that’s when things start to get interesting dangerous… even life-threatening. You have no reason to feel like you need to be careful. You have no reason to believe that anything bad is going to happen. You have no reason to believe that you can’t make that jump, that spin, that flip, and you have no reason to believe that you won’t land fine and be fine.

When you’re “in the zone” where you’re feeling really great, invincible, on top of your game, that’s when things can get the most dangerous with a TBI. And I feel pretty terrible for Kevin’s family, considering how elated he is to be on the snow again in the video chat, while not acknowledging that there’s any inherent danger in what he’s doing. He seems so happy just to be back… who would want to kill his buzz? Then again, who wants to see him kill himself?

Not to be a nervous nelly or anything. I just know what it’s like to be fed up with limitations, to want to push the envelope, and feel like yourself again… and end up getting set back, hurt, or worse.

I know what it’s like to crave those risks — not because I’m addicted to the high of doing it, but because it makes me feel like myself again. It makes me feel centered, whole, complete, totally in the moment, really alive. It makes all the static and the confusion and the frustration fade away into the background… none of that exists anymore, when I’m in a tight situation, and it’s such a relief to not have to THINK about anything, if even for just a few moments.

Taking risks is not necessarily about addiction to adrenaline. It’s not necessarily about having a death wish. It’s not necessarily about wanting to tempt fate and rebel against a tyrannical order. Taking risks can be more about just wanting to feel like yourself again, needing a break from all the difficulties of thinking things through, every single moment of every single day, and being physically hungry for the experience of just BEing part of something that’s bigger than you and gets you out of yourself and your head.

In a way, risk-taking could be seen as a sign of mental health — a needed pause from the pressures of EVERYTHING that gets you back into a sense of purpose and belonging and meaning in your life. People who don’t struggle daily with cognitive challenges like attention issues, dyslexia, and other neurological issues, cannot begin to imagine just how overwhelming and exhausting it is to have to THINK . THROUGH . EVERY . LITTLE . THING . EVERY . SINGLE . MOMENT . OF . EVERY . DAY. Unless you’re in it, you just can’t imagine how much it takes out of you and what a number it does to your sense of self.

Given that Kevin Pearce has struggled with dyslexia (according to The Crash Reel) and had difficulties in school, I can totally see how he’d end up where he is. And given how rough society is on people who can’t read and write and cogitate like the “norm” and isolates people who don’t function that way… and considering what a social guy he is, and how important his friends frends are, and how much snowboarding is a part of the world where he belongs, I’m not surprised he’s out there again.

He doesn’t have to have a death wish. He doesn’t have to need to take risks. He doesn’t have to be self-destructive. On the contrary, him getting out there is just him doing the thing that he feels will help him most — which could turn out to be the thing that does him in.

I just hope he stays safe, and that he’s got people around him who can help him dial it back, when everything in him is screaming to crank it way up… I hope he can find another way to feel like Kevin Pearce again.

Getting back up again

I got online access to full-length The Crash Reel, and I’ve been trying to watch it, for the past three days. Here’s the official trailer:

My time has been limited, and my internet connection hasn’t been that great, so I’ve had to start over a couple of times, and re-watch parts that I can’t quite remember. The thing with my memory is, I lose out on the later parts in movies sometimes, because I can’t remember exactly what happened before. When I’m watching with another person, I can “cue” off their reactions to get my bearings. But watching a movie by myself is another experience entirely.

If nothing else, watching this over the course of several days has given me time to think about what I’ve seen, which is good. Watching Kevin Pearce’s life before, during, and after his traumatic brain injury, reminds me a lot of my own situation — albeit on a much smaller scale. I think a lot of us who get injured in the course of “doing what we do” (versus people who get brain injured because of what someone else does – like a car accident or an assault) have similar qualities.

Watching footage of Kevin’s life before his injury, there’s that focus and determination and drive to really push the limits… to be better… to get better… to take calculated risks, and then to revel in the success when it goes well. There’s that heady euphoria that comes from being IN IT and feeling that rush, that adrenaline, that focus. There’s that clarity that comes from being so completely in the moment that’s second to none – and it’s such a welcome relief from the confusion and contradiction that can rule the day, when there’s not that intensity of focus.

Whether it’s snowboarding or a profession or some other activity that brings us to life and rewards us, we push it. We test our limits. We constantly push past what we (and others) think we can do and take risks in the process. The risks Kevin Pearce took were in the snow, riding a board. The risks I take have to do with the limits of my energy and amount that I can do. In both cases, they can — and did — result in near-catastrophic traumatic brain injuries.

There might be a big difference in the types of activity that got us here and the severity of the results, but the end result — whether the brain injury is “mild” or “severe” — can be devastating, when we lose the things that mean the most to us… namely, our ability to push limits and throw ourselves whole-heartedly into what we do, without concern for risk or complications.

That’s probably the hardest thing for me to deal with after TBI — the loss of the ability to just act without thinking, to immerse myself in what I’m doing and really leave myself behind.  I want to be able to just drive and drive and push and push, and not have to stop and think about every little thing. I want that fluidity back. I need that carefree immersion back.

But I’m not sure if it’s ever coming back. It may never. And that’s pretty tough to take.

I suppose it goes along with getting older, whether you’ve had a TBI or not — growing up and looking beyond my own immediate need for gratification and learning how to block out the “static” of my life without risking life and limb. We all have to make adjustments, over time, to keep ourselves safe and get to grow old… learning to deal with a TBI is like getting a lot older almost overnight, in my experience.

But knowing that doesn’t make it easier. It makes the process seem inevitable and inescapable and like a monstrous burden… which makes me even more inclined to push myself, to block out the pain and confusion and static and sensory overload and all the things that have been part of my life for so long, that I just have to get away from.

I need to get up again — get my spirits up to the place they once were. I need to really invest myself in my life, and I need to have a fulness in my life that a lot of people (maybe most?) don’t need. I think that’s one thing that makes folks with action-activity-based TBI a slightly different breed than passive-TBI folks — that we have this passion and love for life, this burning desire that propels us forward. I still have it, I still need it — but the ways I express it have had to change.

That’s the hardest thing for me — to figure out how to do all that living without putting myself in harm’s way. How do I block the static interference and soul-sucking things out in a way that doesn’t endanger me? How can I find that sweet spot of focus, without hurting myself even worse the next time? How can I get myself back in the game — in one way, shape, or form — without running the risk of screwing myself up, yet again? I’ve come close to re-injuring myself a number of times since 2004 — the most recent, this past Thanksgiving, on the 9th anniversary of my last and most serious TBI, no less. That’s the ultimate question, and I’ve found a few answers. But I have yet to find a comprehensive solution for this — finding that elusive something that gives me the same sense of completion, satisfaction, and my Self, as the life I had before my TBI in 2004.

I’m still working on it. And speaking of working, I need to get out of my head and go forth into this new day, get some chores done before everything closes down for the day. Find some absorption in what I do, and get myself on the good foot.

Getting back up again

The Crash Reel is in theaters as of yesterday, and I’m going to see if I can find it near where I live. I really want to see it all in one go.

Onward.