Another way to measure TBI impact

Here’s another Memory Training Image. Study this for a few minutes, then read the story below. After you’re done with the story, grab a piece of scrap paper and a pencil and draw this image from memory.

memory training image - memorize it and then draw it later
It’s a simple design, but it can be a challenge

From Brain Injury Blog Toronto comes this great piece of news:

Interconnected brain regions – an end to the GCS?

BY: SOPHIA VOUMVAKIS

Traumatic Brain Injury (TBI) can often lead to problems with a person’s cognitive control, affecting their attention, memory, thought, behaviour and emotion. Cognitive control is our ability to modify our behaviour and actions to adapt to the situation we are in. It provides the basis for planning, problem solving and adaptive behaviour (our ability to be self sufficient and independant, based on our age group).

person in MRI machine
photo credit: P4250960 via photopin (license)

Accumulating neuroscience evidence suggests that cognitive control functions are carried out within a network of highly interconnected brain regions. These networks allow for
communication across long distances within the brain and enable us to direct attention to important information in our internal and external environments, to plan and to problem solve. Three such networks have been identified: the salience network, the default-mode network (DMN) and the central-executive network (CEN).

Traumatic brain injury often leads to deficits in cognitive control. The salience network plays a vital role in controlling our emotions and our awareness to the physiological state of our body. Damage to the salience network produces deficits in awareness, such as difficulty with focusing and attention span.

The DMN allows for an internal focus of attention during self-reflective cognitive activity, and is responsible for our autobiographical memory (recalling events that happened to us, as well as facts about the time and place where the event occured), and social cognition (how people process social information). Damage to the DMN results in difficulties with remembering our personal histories, problems understanding time and space, and imagining the perspective of others.

The CEN supports an external focus of attention during goal directed, cognitively demanding tasks. Damage to this network results in impairment to flexibility of thought, working memory, and problem solving.

The different brain areas which comprise these networks communicate with each other via axons, the part of the cell which allows neurons to send electrical impulses to each other. Recent advances in neuroimaging techniques have shown that TBI results in damage to axons, and depending on where in the brain the damaged axons lie, damage to one of these networks, which, in turn, will result in specific deficits.

photo credit: Brain Animation via photopin (license)
photo credit: Brain Animation via photopin (license)
A New Approach to Diagnosing TBI

Since the mid-1970’s the severity of TBI has been diagnosed using The Glasgow Coma Scale (GCS). The GCS measures eye opening, verbal response, and motor response. The test is objective and correlates well with outcomes following severe TBI. It does not, however, predict the specific deficits that will develop in a brain injury survivor. In one recent study, researchers  propose moving away from using the GCS to indentifying the structural and functional integrity of each of the interconnected brain region. If damage is seen in a specific integrated brain region, then treatment can be better targeted and started earlier to deal with the specific deficits that will arise because of the location of the damage.

In a future post we will discuss new neuroscience research on interconnected brain regions and how this can be translated into effective interventions for TBI.

Since acquiring her traumatic brain injury in 2011, Sophia has educated herself about TBI. She is interested in making research accessible to other survivors.

 

Okay… now draw the image you saw at the top of this page. No peeking (till you’re done).

 

My mission for this blog – and our veterans

Well, Veternan’s Day came and went without my blogging about it, and I regret that.

In truth, I was all caught up in my own pity-pot, feeling sorry for myself and all the difficulties I’ve been having, lately. I’ve been dealing with some unexpected health issues, and I’ve been tired, so I let that get the best of me.

To all the brave wounded warrriors and able-bodied veterans and active soldiers of our great nation, the United States of America, I offer my most sincere apologies.

And I offer you my thanks and deepest gratitude. There are no words to express how much I value your commitment and valor and tireless sense of duty.

I must  — we must all — never forget that no matter what our difficulties in this amazing country of ours, countless committed, courageous individuals have made tremendous sacrifices of life and limb and mind and body and heart and soul to let us all have those difficulties in the protection and safety of a country where we can actually turn things around — both for ourselves and others.

This is America. There is no end to our story.

That being said, I am renewing my commitment to this blog, especially for the sake of our soldiers. In the course of my life, those who have been kindest and most courteous and most helpful to me, have been either active or former members of the armed services. The co-workers who most quickly went to bat for me, when I was down, were former soldiers. The colleagues who held their own the best and worked with me most closely as vital team members, were often from a military background. The most open-hearted and dignified and courteous and considerate co-workers I’ve had, hailed from the Service.

My life has been personally enriched by these individuals, whom I’ve been honored to work with.

Now, as so many return to this civilian life and struggle with the aftermath of blasts and head injuries and other neurological issues that are all too seldom recognized, diagnosed, and properly treated, I must do something. As a long-term multiple TBI survivor. As someone who knows what it’s like to not have anyone understand why you’re having such a hard time at such “simple” things. As someone who knows from personal experience that it is possible to survive hidden injuries, it is possible to live a good life even if your brain doesn’t work right, and it is possible to give and receive love and support in the world and have a future… even if the rest of the world doesn’t believe you do. What do they know, anyway?

I can’t do nearly as much as I’d like, but I can do this thing called, talk about my life. And so I shall. Because the men and women who make the ultimate sacrifice for us, deserve far more than they’re receiving — and that includes information.

So, if you’re an active duty soldier or a veteran or you live with or love someone who is, I offer this blog to you in hopes that you can see past the darkness that may surround you and see there is light ahead. It may be a ways off, and it may not be very visible right now, but it is there.

I wouldn’t be here, if it weren’t.

I have started an art gallery to explain my tbi experiences

In the course of working through my tbi issues over the past year, I’ve realized that words alone aren’t always the best way to communicate what’s going on with me. I grew up in a very verbal household — both of my parents are avid readers, and I was often found with my nose in book. I never thought of myself as an artist — my younger siblings were the “artistic” ones. I wrote stories and I focused more on words (perhaps because the act of hand-writing uses parts of the brain that are related to impulse control, and I instinctively new I needed to develop that part of my brain).

What I didn’t realize (till my mother told me within the last year) was that as a child, I had a very advanced visual “intelligence”. I drew pictures as a young kid that incorporated elements that weren’t usually seen until later in one’s development. In some ways I was a prodigy… but I think that changed, when I started to have head injuries… so that my skills and abilities were hidden behind the difficulties I had, and they were not actively developed.

In the past year, I’ve found myself drawing and painting A LOT. And I’ve found that when I draw and paint, I am actually better able to think about certain things, than if I just use words. I’ve also found myself remembering events from my life that had escaped me for many years. There’s something about the color and shapes that triggers my memories. And it also brings up a lot of emotion.

I’ve started an Imagekind Gallery (tbi-survivor.imagekind.com/art/) where my artworks can be found. I only have one piece up there, right now, and it shows how I see my back yard. But there will be more coming.

I’m pretty excited about this new development — both as a way for me to express myself and show the world I live in, and to help educate people about what it’s like to live with the after-effects of mild traumatic brain injuries.

Imagekind offers prints of my work on paper and on canvas. I hope you’ll pay a visit.

TBI Symptom of the Day: Auditory (Hyper) Sensitivity

I’m not sure what’s going on with me, these days, but I have been hearing just about everything around me much more acutely and loudly and with a lot more detail, than I recall in the past. Listening to the radio, I hear all these different aspects of the music that I normally don’t… I hear the individual instruments in the background, all of them in distinct detail… to the point where it doesn’t even sound like a single song, anymore, but a group of instruments each playing their own part.

It’s very trippy. I keep thinking I’m hearing my cell phone go off, but it’s electronic background melodies and harmonies of the songs I’m listening to.

I’ve been hearing my cubicle neighbors really clearly, too, which is fine, except that they’re driving me nuts with their conversations about their trivia calendars. I try to listen to music with headphones on, but somehow their conversations bleed through. I like the people I work with. A lot. And it irritates me that I’m so irritated by them.

I haven’t been much fun, lately.

I’m coming up on my 4-year anniversary of my most recent tbi (I fell down a flight of stairs a few days after Thanksgiving in 2004), and I haven’t been sleeping very well. I try to relax, I try to chill out, I try all sorts of things. But I haven’t been able to really REST, which is a problem.

When I’m tired, everything gets amplified around me. My vision, too. All the colors look brighter. The sounds are louder. The tastes of things I rarely notice are now very noticeable — like the candy bar I was eating the other day — I could taste every major ingredient, and it occurred to me that the chocolate wasn’t the highest quality.

Which is weird. Because I’m not a real candy connoisseur. But I noticed the relative quality of the chocolate.

If I drank, now would be a good time to impress people with my palate for fine wines. But I don’t drink, so I guess that leaves me with candy. Oh, well. The price we have to pay 😉

People seem to think I’m depressed. And the other day someone hinted at whether I might be thinking about ending it all. That really bothered me. WTF? Of course not! Just because I’m low, these days, doesn’t mean I’m planning to check out! Don’t get me wrong… the thought has crossed my mind in the past… especially at times when I realized that the net worth of my life insurance policy was greater than my living worth, and I was feeling like I was letting my family down by not being a better provider. But those thoughts pass. Seriously. I’m not a danger to myself. Am I protesting too much? Perhaps, but no, I don’t want to kill myself.

Not when I’m finally figuring out what’s going on with me and I’m getting help! Fer Chrissakes, it’s taken me 40-some years to get to this place, and I’m not about to just check out because I’m feeling low.

Besides, I feel as though I’ve really been divinely spared a lot of terrible things in my life. Things that went badly for me could have gone a whole lot worse, but they didn’t. And I hung in there, and they got better. When all is said and done, that’s really my whole life philosophy/strategy — just hang in there. Things change. They either get better or they get worse, or they go both ways at the same time. But you never know when things are going to go in your favor, so why not stick around and find out what happens…?

It’s not the most sophisticated or complex philosophy, but it works for me.

Now, if only my hearing would change. Seriously, it’s driving me nuts, hearing every little thing. The sound of the keys clicking as I type is not just the usual clicking. I can hear my fingers making contact with the plastic of the keys, I can hear my thumb brushing along the space bar, I can hear the keys depressing and then clicking against the keyboard base… and the wiggling of the keys has a weird clicky plastic sound that’s very “reedy” and faint. But it’s there.

I just heard my furnace kick in, which is good. It’s getting cold, these days, and heat is good. I hear cars driving on the road near my house, whooshing down the hill as they head into the woods… I hear the baseboard heat kicking in… and the distant sound of a radio  playing. And of course there’s the ringing in my ears. Tinnitus they call it. I call it constant.

“Ringing” is the wrong word for it. It’s not ringing. It’s a constant high-pitched whine that has an almost metallic quality to it. Beneath the high-pitched whine — like a huge honkin’ mosquito always hovering beside my ears — there’s another tone… lower, fuller… again, always there. I’ve had this since I was a kid — when I was a teenager, it used to drive me NUTS!!! I couldn’t stand it!!! But oddly, I got used to it.

It’s really never gone. It just varies in intensity. And when I’m tired and my allergies are acting up, it gets way out of control. The weird thing is, it doesn’t keep me from hearing everything else. It’s like it’s in a different “space” that I hear in… always in the background, but never keeping me from hearing every other sound on God’s good earth.

Good grief!

Well, I know I’m tired, and it’s been a long day, and I have a doctor’s appointment in the a.m., when I’m going to discuss some of my concerns with my pcp, who I actually really like. My doc has got a good manner, and I feel comfortable talking things through with them. I need to do a reality check about some things I’ve been noticing… to make sure I’m not in imminent danger. It sounds serious(?) and it might be. But I won’t know, till I check in.

And it’s definitely tbi-related, so I’m actually looking forward, in a way, to getting to the bottom of the mystery.

I’m being cryptic, I know. I’ll write more later, when I know more. Later

Yes, I’m tired. And overtaxed. I really need to chill for the evening. Eat my supper. Go to bed.

Then go to the doctor and get on with my day.

Onward…

Catching up with myself

It’s been a while since I last posted… there’s been a lot going on with me, actually. I have been seeing a doctor regularly for neuropsychological testing, as well as other physicians like neurologists and my general practitioner, to follow up on other health issues. I have more appointments scheduled to check out some issues that I’ve been having for a long time — and I believe are tbi-related — but I never realized were part of a larger pattern, till the past year or so.

It’s been very frustrating for me, because

  1. I’ve had a lot of trouble identifying the true issues, starting with even realizing that I had them to begin with.
  2. It’s hard for me to talk out loud about things I can conceptualize in the privacy and quiet and safety of my own mind — somehow the words don’t do justice to my thoughts.
  3. Talking with doctors and interacting in that power relationship is very stressful for me, which makes it even harder for me to express myself.
  4. People don’t like to think there’s something wrong with me — they don’t want to believe that someone with my intelligence and insight and humor and kind manner and talent and abilities might actually have something wrong with them. Even doctors get scared by that prospect, I’ve found.
  5. I don’t have medical records of my injuries. I’m one of those tbi survivors who people thought would just get over the falls, the accidents, the blows to my head, when I was a kid. And even when I was in charge of my own health and well-being, I never put two and two together to get myself to the doctor and seek help. Now, my doctors are faced with a lot of unknowns and a lot of guesswork — which they hate! — about what’s going on with me.
  6. I don’t know how to ask for help. My parents and teachers and authority figures when I was growing up never got me help for my problems, I don’t think they ever realized that my injuries might be the cause of my bad behavior (no, I wasn’t just being bad all the time! I wasn’t just bad seed, the “bad apple” in their barrel of kids — I had neurological problems that needed to be addressed!) And since I was raised in an environment that relied on discipline and force to keep me in line, I never was able to see that my issues were due to actual physical injuries, rather than some character defect. I thought it was me that was defective, rather than the processes in my brain. So, I’ve tried like crazy over the years to avoid any sort of detection and avoid drawing attention to my needs and limitations.

But while I can’t do much about most of the points above, I can do something about the last one. I’m actually learning to ask for help! I’m learning to figure out where I’m falling down (using my self-assessment sheet and other check-in approaches), and I’m learning how to express to others what my needs are, getting past the shame and horrible feeling of being so friggin’ deficient.

Yes, I’m learning to ask for help. And I’m learning to talk to doctors. Which is a big change for me. All my life, I’ve avoided them like the plague — in large part because of my communication issues. And because I never wanted anyone to know I was in the level of trouble I was in.

A little progress at a time. It’s slow going. But at least my various doctors and I have all agreed that I do have issues… which is a big step, compared to where I have been in the past, when my issues were not as pronounced, and I frankly didn’t have a clue why I was doing the things I was doing — like being unable to get going with things I needed to do… being unable to follow conversations… being emotionally volatile and tired all the time… I could go on, but I get tired just thinking about it 😉 I really need to finish this post…

The view of my back yard has changed…

my back yard

You can buy a copy of this piece at my gallery at Imagekind – click here for prints on paper and canvas

One of the things I’ve noticed, this fall, is how much my relationship with my home has changed. When I first moved into my house in 2002, I was rarin’ to go… really pro-active with everything. I worked at a pretty intense pace, getting the place in order each season. I seeded the lawn, mowed it every other week in the summer, fertilized it, put down lime, mulched the shrubbery, kept things neatly trimmed… I split a lot of firewood and really went hog-wild with cutting up fallen trees and stacking the winter wood supply… I tidied up the flowers and plantings… I fixed things around the house… I constructed different fixtures I needed… I was quite handy and used my carpentry tools regularly. And I used my workshop in the basement a lot. I kept on top of all the repairs that needed to be done, and I called workmen to do work I couldn’t handle.

Since my fall down the stairs in 2004, however, a lot of that has changed. One of my 2-1/2 baths is completely out of commission — falling apart, literally — and I haven’t used it in almost a year. The electrical wiring in my dining room is funky and I’ve stopped using the overhead light. The outside light to the back stairs is not working, and hasn’t been for some time. The trees need to be trimmed and cabled, but I haven’t made the call. I haven’t been keeping up the outside of the house, doing the same level of upkeep. I haven’t been chopping wood. I have even forgotten to cover piles of perfectly good firewood, time and time again, to the point where much of it is unusable now — a total waste. My yard is suffering, the plantings are just running wild, the ticks in the grass are out of control, and frankly I’m lucky to have gotten any leaves up last year, at all.

It’s quite dismaying, when I think about it. It’s just not like me. And I feel that loss of my old self quite keenly.

But there’s a big part of me that just doesn’t care. That part of me looks out at the yard (which isn’t horrible looking, by any stretch, but still needs help) and just notices that it needs help. It doesn’t actually want to do anything about it. I work around the lighting issues in the dining room and the back stairs, using lamps and lanterns instead of the light switches.  All the repairs that need to be done just have to wait, as the part of me that’s usually motivated to do something about these things just tries to get through the day.

Truly, even the most basic things — like getting up and out into the day — are so much of a challenge, I just haven’t got the energy to tend to other things. It’s such a challenge to just get to work, do my job, and then come home, that the extra stuff like raking and calling contractors and fixing and patching and hammering and what-not, just tend to fall by the wayside.

But as I’m increasingly aware of these things, I find myself better able to deal with them. Like when I do my self-assessment sheets, and I check in about how I’m really doing… if I’m angry, if I’m anxious, if I’m distracted, if I’m tired, what kind of headache I have today… when I take a look at myself and my life and it sinks in about what I need to do, then I can start taking some action.

I just need to be aware. i just need to watch my energy. I just need to sleep when I need to sleep, and not worry about it. And I need to ask for help, when I need it.

Because I do need help. And there’s no shame in that.

How I figured out something was REALLY wrong

Yes, I picture’s worth a thousand words… Here’s a graph of what happened to my financial situation, after my fall down the stairs (I hit the back of my head on the top 3-4 stairs) in 2004:

The interesting thing about this is that I never fully realized that there was something really really wrong with me, till I looked at my finances in 2007. Prior to that, I had thought that the problems I was having with my moods, my temper, my attention, my sleeping patterns, my pain… welll, everything… were due to things outside myself.

I literally thought that it was other people who had the problem. Or, it was just job stress. Or it was an unhappy childhood. Or I didn’t realize there was something wrong at all.

But then, in 2007, I looked at my finances and I realized that something was very, very wrong. I, who had been in the financial services industry for a decade or so, who was studying to become a financial advisor, who had been all about money for years and years and years… who knew about all sorts of common sense investment and savings vehicles… I had literally forgotten to keep track of my finances. And I had forgotten to stash a large lump sum I’d received in a secure interest-bearing savings account.

People, that’s just common sense. It’s the bare minimum you do with a lump sum of money, let alone all the other things you can do with it.

But I hadn’t. Even knowing what I knew, even having the positive orientation that I had to money, even having all this domain experience in savings and investments… something had broken down. And it forced me to take a long, hard look at all the other factors that had been plaguing me in my life.

Suddenly, a pattern emerged. And I started to remember things i hadn’t thought about in years…

My second neuro visit OR If only they could walk in my shoes…

Here are details from my most recent neuro visit, I believe back in August. As you can see, it was a less than stellar experience, and I’m still recovering a bit from it. It’s hard to believe that someone who specializes in neurological disorders can be so callous, but here we have it…

I had a 9:30 appointment scheduled with Dr. X to discuss headaches I’ve been having. I had been to see another neurologist about my series of mTBI’s some time back, but the results had not been conclusive, and I felt I’d just been shoved off. I didn’t mention this past visit to this new neuro — In retrospect, that was probably a tactical error, but I wasn’t sure how to explain what had happened, so I decided it was better to say nothing. When in doubt, I tend to do/say nothing, rather than initiating and seeing things blow up in my face. Plus, I wanted to start with a clean slate and get this doctor’s opinion without input from anyone else.

I had been to see this neuro on other occasions with a friend of mine who has some issues of their own. I thought it would be a good idea to work with someone who already knew me in a different capacity. I thought it would be easier for me to work with someone with whom I was already familiar. So, I had high hopes for this meeting. Hopes that didn’t pan out.

Here’s what I recall happening:

I arrived early at 9:20 and finished filling out my paperwork.

The receptionist was unpacking boxes at the time. I settled up with her for the co-pay and gave her my license and insurance card. I thought that the co-pay was $15, and when she corrected me that it was $25, I felt as though she thought I was trying to “get one over on them” and get out of paying the $10. I felt as though she was treating me like I was hostile. It was an innocent mistake on my part, and not intentional.

Around 9:30, the receptionist  had me go in to Dr. X’s office. I wasn’t sure about which door to go in, and she said “You know which one it is.” I honestly didn’t. I couldn’t remember which one was his, but when she pointed me to the door, I walked in and took a seat.

Dr. X greeted me cordially, shook my hand, and we chatted a little while.

He asked me why I was there, and I said I’d been having constant headaches.

He looked over my papers and told me that I had forgotten to fill in my employer and my occupation. He seemed miffed that I’d forgotten. It wasn’t intentional on my part. I gave him the information then, and he filled it in. We chatted a little about my work.

He asked me how old I was, and I hesitated when I answered. I don’t tend to think of myself as any certain age, and I will usually have to calculate how old I am, based in the year it is, less 1965, and then figuring out where in the calendar year I am. Dr. X commented that it took me a while to answer, as though there were something wrong with that, and I told him I usually have to do math to figure that out.

He then started to look over my information sheet, which I’d taken great pains to complete as thoroughly as possible. He flipped through the pages, and then started to work his way down through.

I pulled out my notebook with my family medical history, my history of injuries, my symptoms, and other information I’d collected which I thought might be important to know. I also had many pages of a headache journal I’d been keeping for a number of months, which showed exactly where and with what intensity I’d been having headaches. I had compiled this information over a period of more than 6 months, and it contained my most complete understanding of my cognitive situation. I also brought the notes with me to consult, so I could be accurate in my accounts. I tend to get turned around and unintentionally confabulate when I try to recount things (more when I’m under stress, but even under regular conditions, I have had a lifelong issue with unintentional confabulation), and I had hoped that I could rely on my notes to help me be as accurate as possible.

Dr. X told me to put away the notes. He didn’t want to see them. He also didn’t allow me to refer to them.

He proceeded to ask me questions about my headaches, the intensity, the frequency, the nature, the duration, and when I took a while to answer him, he became very impatient and told me I was over-thinking things.

He told me not to over-think my answers, but just to answer off the top of my head, which is very difficult for me to do.

I had to pause a lot to think, and my answers were not instantaneous. I could not verbalize my answers as quickly as he wanted me to, apparently, because he kept telling me to just answer with averages.

It’s very difficult for me to answer that simply, because nothing is that simple to me. I do not think in terms of a “bottom line” and I have a very precise and logical thinking process that sometimes takes longer than “normal” to complete. Being accurate and truthful is very important to me, and when I cannot be accurate, I become anxious. He really pressed me for quicker answers. “Just off the top of your head,” he said. “Just on average.”

It felt as though he were intentionally trying to trip me up and make me contradict myself, or find some “hole” in my “alibi”. I felt like I was being grilled, and I had done something wrong.

I had to stop and think a lot — I could see the answers to his questoins right in front of me — when he asked me about timeframes and durations of my headaches, I saaw images of calendars with days marked, and the severity of my headaches marked on the calendar (some were in colors). I could also see the pages of the calendars flipping by, and I tried to see what information was where. It was very hard for me, though, because he was moving faster than I could go, and I kept losing my place with the images. I had to close my eyes a lot to think, and I had to look down at the ground. I couldn’t look him in the eye AND figure things out, because looking at him distracted me from my thinking — and I started trying to “clue in” to him, instead of the answers to my questions.

At one point, he appeared to be very frustrated and said I needed to speed things up, or “We would be here till next Tuesday” before we got all the answers to the questions. I agreed with him, but I told him that I had to translate my visuals into words, and I am not a primarily verbal person. I tried to explain that I see the answers as images, and then I need to translate them into words, but I’m not sure it sank in with him. I was getting very frustrated, and I was tearing up, which seemed to annoy him.

He also asked me about any addiction background, and I told him I had quit drinking in 1989. It had been 19 years since my last drink, and I had not touched a single drop since. He asked if I’d taken drugs, and I told him a little bit — speed in high school, but only a few times a week, as it made me too speedy and upset my stomach. I told him had smoked marijuana while I was drinking during high school and college.

I may have left the addiction piece of information off my form, but it was not intentional. It was an oversight. He didn’t seem to see it that way.

He asked about any medication I was on, and I told him that I didn’t take any, and I was not a big medication person. I told him that I took Advil, now and then, and I had once taken it for headaches, but it had since stopped working at all.

We talked about my head injury experiences, and I gave him details from what I knew and could remember. It was very difficult for me to think on my feet, and I was becoming increasingly anxious. He was moving very fast, so I’m not sure I answered everything completely. I had my notes, but he would not allow me to consult them. When I tried to pull them out, he told me to put them away.

Dr. X seemed to become increasingly impatient with me, and he said we were just going to focus on my headaches.

He asked about the nature of them, if anything helped, if I exercised regularly, if I was under stress.

I told him that I’ve had a lot of stress, and that my headaches have gotten worse over the past 6 months. He asked if I’d been under more stress, and I told him I’d been in a very stressful job for 3 months.

He said he’s not a big “pill person”, and I said I was not, either. I prefer to deal with my aches and pains in other ways, and sometimes I’d rather just live with pain, instead of taking medications that gave me side effects.

He asked about the vertigo, and I told him it was worse when I had allergies. I told him that it was very intense and I had to hold onto things to keep from falling over at times.

He asked about my history with other injuries or conditions, and I told him about a diagnosis of lupus diagnosis in the late 1980’s, early 1990’s. He asked if it was discoid or systemic, and I believed it was systemic, but when I told him about the skin rash, he said that sounded like discoid, not systemic, and I became confused and said it may have been discoid, but not tests were ever conclusive. Also, the medications I’d been on had not helped.

After a while, we went into the examination room, and he conducted a physical neurological exam. It was standard, and he seemed to go very quickly — more quickly than I’d seen him go with a friend of mine. He seemed to be in a rush, and it was painful when he checked the reflexes on the bottoms of my feet. It was hard for me to answer quickly, when he pricked me with the pin, and sometimes it took a little while for me to verbalize I’d had the sensation. He seemed to think that I was “fixing” my answer to fit what he wanted to hear. I was getting confused and felt like the room was pulling away from me, and my reaction time was slowing.

During the exam, he asked me again if I had taken drugs recently. I told him no, I had not taken any drugs since stopping drinking in 1989. I believe he repeated the question, and I answered him again in the negative. I couldn’t figure out why he was asking me if I’d taken any drugs. It didn’t seem like the kind of thing he’d be asking me while he was checking my reflexes.

He told me that my exam was normal, and everything looked good.

We went back into his office, and he said that my exam looks clear – no indication of a tumor or vascular issues. He said he believed my headaches are tension headaches and he wrote some notes on a piece of paper. He gave it to me, and he said that my headaches are probably muscular in nature, related to stress. He also said that he thinks the vertigo is probably BPPV (Benign Paroxysmal Positional Vertigo) or Meniere’s Syndrome, and I could check with an Ear-Nose-Throat (ENT) specialist if I chose to. He didn’t seem to think I needed to see someone, but my ears have been hurting me a lot, and I said I would like to talk to an ENT specialist. He referred me to a doctor he knew and believed was good. He wrote that down on a piece of paper (his prescription pad?), as well, and gave me that.

He said that he didn’t think that medication would necessarily help, as it may cause side effects, and I agreed with him. He also said he didn’t think an MRI or EEG would show anything, which was really disappointing. I mean, I have a whole lot of issues, and I have trouble sorting them out, and the one way I can think of reducing some of the mystery, is to have an MRI or an EEG or something like that. I really didn’t know what to say at that point. All I could manage, was to agree with him, which irritated me when I did it, but I was helpless to do anything else. My thinking process had slowed considerably by that time, and I was feeling very overwhelmed and confused by everything. I wasn’t sure if he was being congenial or if he was upset with me. He seemed distant. But I couldn’t really tell for sure how he was being with me.

He asked if I exercise, and I didn’t know what to say. I lead a pretty active life, and I move a lot through the course of each day. I could see myself walking and moving a lot at work, walking across parking lots, and making extra effort to incorporate exercise into my daily life, but I couldn’t just come up with a simple “yes” or “no”. I had to think about whether or not I was going for walks. I eventually answered “Not regularly,” and he said, “No” and wrote that down. He said he wanted to see me exercising on a regular basis, nothing really heavy, just maybe going for a brisk walk with a friend several times a week. I saw a friend of mine and me walking along a road near my home, but I didn’t know when that would or could happen, as I work such long hours during the week. Dr. X appeared a little exasperated with me, as though he thought I wasn’t being fully cooperative.

He asked me if there was anything I do that relaxes me, but I was having a hard time processing at that point. I couldn’t think of anything — I was drawing a blank. I told him I draw and I write, and he recommended I draw 15 minutes a day. I couldn’t figure out how to explain that when I draw, I get very absorbed in my work, and I lose track of time, but there was no time for me to figure out how to say that. He also recommended that I exercise regularly, go for a brisk walk with a friend on a regular basis. Again, there was no time for me to respond in a way I felt was adequate.

I told him I was going to see another doctor for a neuropsychological exam, and he said he would like to know the results of that. I told him I would keep him apprised.

He said he wanted to see me again in 7 weeks, to see how I was doing.

I made an appointment with his receptionist. I had a hard time thinking through my schedule at the end of August, beginning of September, and she was not very patient with me. She acted like I was pretending to be “slow”.

Basically, I felt completely humiliated and treated like I was a liar who was seeing him under false pretenses — as though I had been an addict showing drug-seeking behavior. I left in a daze, and I went to the nearest bathroom, locked the door tightly, crouched down in a fetal position, and cried… and cried again in the car before I drove to run an errand. And felt like crap for the rest of the day. I did collect myself and manage to get on with my day, but the flow of my day was completely disrupted, as was my weekend. It was too disruptive for words, and I in retrospect, I really resent the implications that I think were in play.

Sometimes, it just sucks when nobody can tell you’ve got issues… and they treat you like a criminal, just because you’re trying to get some answers (and they apparently can’t help you, but don’t want to say so).

It also sucks to have processing difficulties that might be making things look worse — or better — than they are, and that keep you from being able to ask for help.