No sooner do I say I need more movement, than my day fills up with meetings

brain with arms and legs walking on a treadmillToday there is not one minute of my day that is not scheduled for a meeting. Non-stop. Eight hours. No fun.

But that’s the deal, today, so that’s that.

Fortunately, I’ll be working from home today, so I can walk around the house while I talk on the phone. I can’t do that at the office… at least, not on the scale I can do it here. I can’t walk around the halls, talking on the phone. I can reserve a conference room and then walk around it, while I’m listening. I could even project the meeting proceedings on the big screen, so I can watch what’s happening as I pace. But it’s not the same as being able to walk around my house.

So, at least there’s that.

And man, do I need that today. Yesterday I was stuck in an all-day workshop where we just sat… and sat… and sat. It started early, so I didn’t have time to exercise in the  morning before I went. But it ended earlier than my normal days typically do, so I was able to get to the pool and go for a swim. That was productive. And much needed. So, it’s all good.

I noticed that I was getting really tired towards the end of the day, and I was starting to get cranky and a little confrontational. But I managed to pull up and not blurt whatever came to mind. There was this module we were working through that just seemed like such B.S., and I wanted to say so. But I held my tongue and said nothing. Mission accomplished. I got out of it without wrecking my reputation, which is what I often do at those kinds of things, towards the end of the day when I’m tired. I blurt out crap that makes me look belligerent and confrontational, when I’m just tired.

And then all the work I put into cultivating rapport with others goes out the window. Fly away, little reputation. Fly away.

But yesterday, I held my tongue, and that was good. It was very, very good.

And today… Well, I’m looking at another day of non-stop paying attention to important stuff, and potentially being virtually motionless the whole time. I can’t let that happen. Not two days in a row. I just have to get creative and think outside the box. Find ways to keep myself moving. Heck, maybe I’ll even ride my exercise bike while I’m on a call — except that I get out of breath, and speaking up when I sound like I’m in the middle of an exercise routine is not the most professional thing to do.

So, scrap that. No riding the bike while I’m on a conference call.

I’ll just pace in my living room, walk around the downstairs. Do some movement… knee bends… stretching… anything to keep my body awake. ‘Cause if my body isn’t awake, neither is my brain.

And not-so-great things happen when my brain is foggy and asleep.

Onward.

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Gotta watch what goes into my head…

So, I’ve had a rough days, lately, with some conflicts at home and at work. This is over the past week and a half, and it’s similar to how things were back a few years ago, but not in the recent past.

The one thing I have been doing the same now, as I was several years ago, is listening to heavy metal music. I started listening to it again, about a week ago, when I was in a car that didn’t have a way to play my own music on my smartphone. And while it felt cathartic to listen to it, that was not in a positive or gentle way.

It really did feel good to listen to it, I have to say. It was like, all the songs were reinforcing how bad I felt and how angry I was over so much. I have had a lot of pressure at work, and I have been handling it pretty well.

But I have been on a tear, the past week or so — very short-tempered and not doing well at handling conflicts. Yelling, shouting, fighting, intellectually brawling, picking nits, and getting all bet out of shape over this and that and the other thing. It’s just like it was, back a few years ago, when I was still listening to hard rock and heavy/death metal while I was driving to and from work. Those were some days when I was pretty regularly tied up in aggressive, divisive behavior that did not help me or those around me.

I just wasn’t happy, and it didn’t occur to me that my music choices had anything to do with it. But when I started listening to more electronic music that lifts my spirits, instead of dragging me down into depression, I realized that music did make a difference to my mental health.

Now I feel very similar to how I felt then. It’s different from how I’ve felt in recent memory, when I was listening to much more positive music that soothed me, instead of getting me bent out of shape with righteous anger.

And the heavy metal songs keep playing in the back of my head.

So, it’s off the hard rock, heavy/death metal tunes for me, and back to my soothing music. This state of mind and spirit is no good. I feel like crap, and I cannot seem to get myself righted. Mind you, music choice is the ONE change I’ve made in my daily routine. And it’s turning out to be not a good one.

Now I have to work through a bunch of problems I caused for myself over the past week.. and get this ship righted again.

So, it’s back to the soothing music. Heavy metal is just not worth the cost to me.

Just updated – BI Recovery Tools for Behavioral Issues

Few things will make your post-brain-injury life more difficult than Behavioral Issues.

I just updated the BI Recovery Tools page for Behavioral Issues 

I’ve added info for how to deal with Impulsiveness, Aggression, and Raging Behavior.

Good-bye Facebook app, hello sanity

What a relief

Well, I’m halfway into my second week without having Facebook on my smartphone, and I realize I’m really enjoying it. I’ve been having some real issues with irritability and anger and aggression over the past months, and I think that my Facebook activity was really fueling those issues and making things worse.

And when I say “worse”, I’m talking about road rage that has been flaring up more and more over the past few months… blow-ups at home over little things that escalate very quickly… things getting tougher at work between myself and others… and more. These are just a few of the things that have been getting worse over the past months. They are not things that I can afford to just let run rampant. I’ve lost jobs over less, and it’s not worth it. Especially for someone with my irritability and impulse control issues.

But how could Facebook have made things worse for me?

Well, first, there’s the sleep thing. When I don’t sleep properly or have enough rest, it feeds my irritability and aggression. With Facebook, I was spending an awful lot of time staying up longer than I should have, and waking up earlier than I should have – and instead of going back to sleep, checking FB and reading everything that was going on with people. I was literally losing sleep to Facebook, which is not something I should lose to anything – especially not a social network where people are either posting inane crap or fighting.

The other big (maybe bigger) thing was the level of conflict and aggression that seems to have taken over FB in general. Especially during the election… geez, what a bunch of loons we all turned into. And it’s still going on, as folks continue to argue and fuss and attack each other about politics and who’s to blame for what. The thing of it was, even though at first I was really turned off by all the aggression and arguing, and I managed to stay above it, after a while, I got sucked into it, and I found myself starting to act like other people there — which was NOT what I wanted.

At all.

I found myself actually posting things and responding to things that I never would have bothered with before. It wasn’t just disrupting my peace of mind – it was totally wrecking it. And over what? A few sentences that couldn’t be properly discussed or understood more deeply?

The other thing was the constant distraction. Having online media so readily available hasn’t exactly done wonders for me. And having Facebook on my smartphone at work, just gave me the opportunity to step away and lose myself in it for 15-20 minutes. Like smoking a cigarette… without the lung cancer. But even with milder doses of pointless distraction… still not the most productive use of time. In fact, it was breaking up the flow of my day — from morning till night. Not good.

The vacuousness of it just drove me nuts after a while. All those little snipes, back and forth, either for or against, for or against… just for the sake of sniping, like a martial arts match that’s just there for the competition’s sake, not actual self-defense. Social media, as entertaining and distracting as it can be, is not a place where I can really hone my own views and discuss with others to the degree I like. That just doesn’t happen online. And as a result, there is a lot of misunderstanding — and yet more resulting conflict. It just feeds on itself, like a wildfire. And what long-term good actually comes out of it? Sure, social media can fan the flames of revolution, but then what? Does anybody have a clue?

Who can say? I can’t answer that here in this forum. All I can say is, leaving Facebook behind has done a couple of things for me:

1. I am resting better now. I don’t waste as much time lying around looking at people’s blather/jokes/rants/truisms. And not only am I going to sleep when I go to bed (instead of lying there for half an hour reading FB), but I am actually giving myself time to wake up before I jump into the day.

2. I realized that the mindset I was getting into — combative, argumentative, aggressive — which was affecting my driving and personal relationships, is NOT what I want to have in my head. When I was on FB, my mindset was like a WWE match. All the time. And I thought that was okay. Because it’s how everyone was, and it was fun. Energizing. Entertaining. But after getting off FB, I realize that my mindset was pretty corrupted — wasted, really — and I need to change.

See, the thing that hurt me the most with FB, was getting used to the bad behavior, the fighting, the insults, the accusations, the protests, as “normal”. That is NOT how things have to be. It’s how some people are, but it’s not how I want to be. I don’t want to be that person who sits with an electronic device and praises those who share my opinions and snipes at people who don’t agree with me. I don’t want to be that person who posts wildly about all my pet causes and gets into shouting matches with people who don’t agree with me, or simply have a different perspective. I don’t want to be that person who thinks that just because I have very strong opinions, that makes me right and it gives me the right to go after others who disagree with me.

For a long time, I kept Facebook at bay and didn’t get involved. Then I gave in. Now I remember why I kept it at arms’ length. And I’m getting back to that old way of being. Seriously, I have so much going on in my life right now, the last thing I need is yet another leech on my time and energy and peace of mind.

Good-bye Facebook.

Hello sanity — it’s been a while.

Taking better care

Because I want to be here for a long, long time

In the aftermath of my recent dr. appointment, I’ve decided I need to bump up my exercise routine slightly. Start lifting slightly heavier weights. And see how that goes.

Yesterday, I did just that — I put 5 lbs more on my dumbells and had a good workout. At the time, it didn’t feel like was pushing myself all that much, but today I’m stiff and sore, so I know it had an effect.

So, this morning I did an easy workout and focused more on my leg-lifts, which are as much about improving my balance as strengthening my knees. Vertigo has been a big problem for me for the past weeks, and I’m finally getting to a point where I can walk around without feeling like I’m going to throw up. And I did my leg lifts with just a little bit of wobbliness.

There’s progress. It’s also progress that I didn’t push myself too much this morning. In months past, I would have just made myself continue the heavier workout, but this morning I was smart and backed off. I just need some movement, not a big Workout, to get my day going.

Now I’m back to thinking about the last three weeks and how it’s tweaked my TBI issues way more than they’d been tweaked in the past couple of years. Maybe it’s a sign of progress, that I’m able to wade into situations that set me off, and get through to the other side in one relatively intact piece, albeit shaken and sick. Or maybe it’s a sign that I just pushed myself too hard over crap that was someone else’s creation, and that it’s really not worth the pain and suffering.

Maybe it’s both. Could be. I do have to ask if it’s really worth getting into those kinds of situations, but ultimately, there’s a pretty good chance that those kinds of situations won’t be going away entirely, even if I do move on to another job, so being able to handle the hassle is a skill I need to refine. If nothing else, this has been a really good learning experience, and now that I’m on the other side of it and getting more rest, I can take a look at it all from a more sane point of view, and learn from it.

Looking back on all the frantic stuff

Let’s take a look at that checklist again:

Emotions/Moods

[x]  Excitability!check – I’ve been in an uproar for three weeks running, and it’s gotten old. The weird thing about it, is that it feels so justified. I feel like I have every right to be excitable. When I stop to think about it, I realize that it’s TBI talking, not reality, but it doesn’t change the experience itself — that ongoing adrenaline BLAST that just won’t let up. That firecracker response to every unexpected even that came up. Geez, how depressing, really — seeing myself react so stupidly to stresses I used to thrive on. I was on a tear for three weeks running, and I wasn’t proud of it. Once upon a time, I could be thrown into these situations and would come out on the other side stronger and better than before. Not this time. At least, that’s not how it feels to me.

[x]  Everything feels like an effort – check — God, did it ever. I mean everything felt like such a goddamned effort. From extracting information from people to just getting all the tasks squared away and taken care of. What a frickin’ chore it all was. I felt like I was running through quicksand, the entire time. Chasing after the elusive goal, running from the tigers in hot pursuit of my tail. I still do feel that way, to some extent, although the quicksand is more like wet sand now. I’m not drowning in it, but I’m still struggling to make progress. And that feeling that everything is just a trial and a pain in the ass has extended out to all the other projects I have going on. I had hoped that when this situation was through, I could go back to getting things done in good order, but now I feel even less capable than I did before this whole sh*tstorm started.

[x]  Feeling unsure of yourself – check — BIG check on this one. See above. People kept trying to bolster my self-confidence, telling me, “You can do it,” and part of me believed it, but for chrissake, I had really good reason to be unsure of myself, because there were so many pieces in the puzzle, and there were so many things that could have gotten missed, and in fact they did get missed. I mean, really obvious things that were right in front of me, that I was sure I had figured out… they slipped right by me, and I had to scramble at the 11th hour to get them in place. “Why do you question yourself?” they asked me. Duh — that’s why. Personally, I feel that people who aren’t unsure of themselves are often complete idiots, but that’s not in synch with the dominant paradigm, where everyone has to be so self-confident and self-assured all the friggin’ time. Please. Who the hell comes up with these ideas? Positive psychology proponents? Or Wayne Dyer? Tony Robbins? Who? Sometimes I just need a break — and I need people to admit that, every now and then, a healthy dose of self-doubt makes for better decision making and better performance. This aspect of my issues is not all bad, all the time.

[x]  Feelings of dread – check — Yeah, pretty much all the time. Dread about the project, dread about my life, dread about the job, dread about all the other things I wasn’t getting done, dread about my marriage, dread about, well, everything. And dread about what was to come later — that this was just a precursor to more of the same later. It wasn’t until I gave up hoping for the best, that I started to feel better. Just accepting the dread and accepting the sense that this and all the other projects that I’d ever have to do with these people were doomed, somehow made it more tolerable. But what a thing — to find relief only from giving up hope.

[x]  Feeling like you’re observing yourself from afar – check — It was the weirdest thing… that sense that I wasn’t even all there… The feeling that a part of me had stepped away and was watching myself flail through that project… not like some mystical out-of-body experience where you’re floating in space above your body, but like I was sitting in a small, dark, stale-sweat-smelling, trash-littered, popcorn-covered-sticky-floor movie theater in a rundown mall on the outskirts of an old depressed steel town, watching myself hack through the underbrush on the movie screen in front of me. I felt so disconnected from my life, from my mind, from my body, from my whole experience, and it wasn’t even until afterwards, when I could get a little distance, that I realized what a surreal experience it was.

All in all, I have to say that some of the issues above were specific to the project — they got set off in an irrational fashion because of the stress and the pressure. But others were generally applicable to my overall situation. Feeling unsure of myself is, I believe, just a logical result of having been in so many situations where I was SURE (and I mean 100% ironclad, absolutely positively SURE) that I was on -track, only to realize — often at the 11th hour — that I was only 80% on, and the remaining 20% was landing me in hot water.

In fact, if anything, that lack of sureness may have been what saved me, because it kept me from being too cocky, too brazen, too eager to take things for granted. It’s when I get into thinking that I’ve got everything covered (when I don’t) that I get into real trouble.

And if there was one thing that probably got me through, it was that lack of sureness, that constant re-tracing of my steps to make sure I didn’t miss anything.

Now, the thought had occurred to me that I might have been perseverating on certain details — like re-checking the code for the 209 attachments distributed across 56 web pages over and over again. And I did kind of fixate on some of the small details, and that threw me off in my planning and time management. But if I hadn’t revisited those 209 attachments a bunch of times, they would have turned out like crap. They would have broken. And then I would have been totally screwed. So, all things considered, I think I did okay.

And here’s the thing about TBI that really strikes me — some of the issues we have are based in unrealistic thinking, while others are based in actual experience that arises from TBI. The sense of doom that I had, the depression I had, the excitability… that was based in unrealistic thinking that got “stuck” in my mind. But the self-doubt was based in actual experience. And it can be pretty damn’ difficult to tell the difference at times.

It might have been different if my neuropsych had been around to help me think things through, but for this one I was on my own. Who knows how it might have been, had they been around? Maybe they would have made things worse, by trying to talk me out of my self-doubt and trying to get me to be easier on myself. Easier on myself could easily have led to screwing things up. I had to push hard, and it took its toll. And they might have tried to minimize my difficulties, telling me I wasn’t really having all that trouble. They’ve done that a bunch of times, and it really bothers me when they do. As though I’m making all of this up… That’s just even more demoralizing — to have someone gloss over your difficulties as though they don’t matter and you don’t actually have to do anything about them… just tell yourself a different story about your experience.

It might have been helpful to have a sounding board to bounce all this off of… then again, maybe it was best that they were away. I don’t think I could have handled being told that it wasn’t as bad as all that.

Anyway, now the project is over and I am getting my life back. I see my neuropsych on Tuesday, and we’ll see how they respond to my experience. I’m kind of dreading talking to them about it, because they do tend to minimize my experience and tell me that it’s not as awful as I think it is. I appreciate the sentiment, and I’m sure they’re trying to help, but this time I had a terrible, awful time of things, and I need that to at least be acknowledged.

But that’s neither here nor there. It’s off in the future and who knows what will happen?

Anyway, in the spirit of restoring normalcy to my life, it’s time to take out the trash and rake up some of the leftover leaves from last winter.

Onward.

Dealing with it all

The storm is a-brewin'

So, yesterday I pulled out my Big List Of All The Stuff That TBI Can Bring, and I checked off all the issues I’ve had going on with me for the past couple of weeks. And after looking at everything — realistically — and realizing how much I’ve had going on (and after getting some nice comments from a reader) I’ve settled into feeling pretty positive, overall, about getting through this time.

A couple of years back, I would have been completely — and I mean completely — derailed over this extended episode. I had my moments (well, days actually) of really Bad Behavior, but I can’t get fixated on them. They’re just part of everything, and the important part is that I’ve moved through, learned my lessons, and I’m able to communicate to others the conditions that can (and will) cause others considerable suffering, if they repeat this cycle again. And I can tell them why. And I can tell them how to avoid it all.

So surprise, surprise, I’m human after all. But even more than that, I’m able to transcend and transform the whole experience into something that can benefit others at work.

And on top of that, I get a whole new appreciation for how far I have truly come in the past several years. Three years ago, I might have just bolted from the situation — just picked up and left. Or gone ballistic and gotten myself fired. Three years ago, I might have collapsed under the pressure and not recovered. That’s how it was for a few years… drifting from job to job, not really digging in anywhere, and certainly not pushing myself to really perform.

This time is different. And I realize that I’ve developed some pretty effective techniques for handling the truly rough spots that used to derail me. I’ve got to get going to work in a few minutes, but I do want to talk in detail about the ways I’ve managed to handle this ridiculous level of crap.

First, in the Behavioral department, here’s how I handled things:

[x]  Impulsiveness – I realized, a few days into the project that being overly impulsive and jumping from task to task was never going to help me get it all done. I had to build 8 different versions of a somewhat complex website in 8 different languages, and I had to coordinate pulling together all sorts of media, text, and regional resources in an extremely short timeframe. After going at things sort of willy-nilly for a few days, I started to melt down and was having huge problems handling the workload. So, I collected all my information and make up a plan, breaking out the different kinds of tasks that needed to be done, instead of jumping from one thing to the next. I call it “the jumping spider syndrome” where I’m all over the place, hopping from one apparent problem to the next without any rhyme or reason, and like a jumping spider, where I land is never very predictable, and it’s never a given. But when I sat down with my lists of Things That Had To Be Done and I organized them all in my head, things started to sort themselves out. I even spent a whole day (a week ago Saturday) not “doing” anything, but thinking through how I was going to do everything — planning it out, getting clear in my head about what my plan of attack would be. Then on Sunday, I got sick as a dog, and I had more time to think (when I wasn’t asleep or in excruciating pain).

[x]  Aggression (verbal/physical) – Holy smokes, was I on a tear for the first week. I was seriously aggressive over the project. The people who had made the arrangements that put me in that tough spot were gallivanting around, busy being important, and there I was left holding the f*cking bag. Their f*cking bag. I was doing all the work, and they were taking all the credit. Idiots. My aggression was off the charts, in large part because there was so much friggin’ work to do, the project was already 2 months late, I had lost 2 weeks off the end of it, and I was locked on target for getting things done. But perhaps the worst part of it all was that the people who had created the mess suddenly decided they should really help me get things done, and their idea of “helping” me was to encourage me to “take it easy” and “not work too hard”. Had they lost their minds?! What is wrong with people? If this was going to get done in the ridiculously short timeframe that they had locked us all into, I had to work harder, not “take it easy”. Please. So, after having some completely pointless and fruitless conversations with people who were both the cause of the problem and were undermining the solution, I basically blocked myself off from everyone with an attitude that warned everyone I was NOT to be Disturbed until this whole project was done. I told the people whose projects were going to be late that they were going to be late because of this project, and I just got down to work. I focused my aggression on the project at hand, and I basically gave up trying to explain the most basic, fundamental facts of the matter to people who just didn’t get it at all. I didn’t get rid of the aggression. I directed it. I used it. I focused in. And I stayed late into the evenings, getting things done, when all the pains in my ass were out of the office, so I could actually focus, instead of having to stroke their egos and play up to their anxiety. Holy crap… Come to think of it, one of the things that eased the aggression was my deciding that there was actually something wrong with these people and they were handicapped by some invisible challenge that they were blind to. That was my explanation, and I gave up on expecting them to have any sense at all. I decided that their heavy drinking and personal pecadillos had taken too great a toll, and they were simply incapable of behaving like adults. In a strange way, that helped.

[x]  Raging behavior – Again, I was on a tear. I was in a flat-out rage for days on end, and everyone knew not to come near me, not to talk to me, not to interact with me, and if they had anything for me, they should just drop it off at my desk and walk away. All the people who felt guilty were coming around trying to make nice to smooth things over. The only problem is, the only thing that actually smooths things over is people behaving like responsible adults and pulling their weight and using their power wisely… not coming around to make nice and schmooze and pat me on the back and bolster my ego. News flash — that doesn’t work with me. And the more people try to smooth things over, the more suspicious and distrustful of them I become. It’s like someone who beats or cheats on their spouse buying them gifts afterwards. You want to do me a favor? Act like a friggin’ adult and take some responsibility. None of this BS where you prance around, making yourself look fabulous, then think that making others “look fabulous” is going to change a goddamned thing. … Oh, I see the rage is still an issue 😉  Anyway, like with the aggression stuff, I eventually gave up on these people having any sense at all, and I just buckled down and used the rage. It’s so pointless to even discuss this with people who create these scenarios, because they occupy a universe that’s parallel to mine, and parallels by definition never meet. So, there’s no point in trying to explain to people. Just buckle down and do the work. And keep the f*ck away from people till the project is done. Because I’m no friggin’ fun till that’s settled.

Anyway, considering the levels of my indignation and outrage and frustration and just plain pissed-off-ed-ness, I think I’ve done pretty well. I’m not likely to forget this anytime soon. And all the lazy, kiss-ass, brown-nosed people I’ve had to deal with over the past couple of weeks have shown their colors, so now I know what I’m dealing with.

And that’s not all bad.

One thing I noticed — after not taking time to sit and breathe for close to two weeks — is that when I do sit and breathe for 10 minutes in the morning and before I go to sleep, I feel a whole lot better about my life and myself. I know things aren’t perfect, but when I balance out my fight-flight with just 10 minutes of stopping, well, that makes all the difference in the world.

I’ve started doing it again. And it helps.

Now, I’ve got to get to work to put this project to bed. Wish me luck.

Yup, wrong again. And right again.

Feeling like you're out of options?

Okay, so the past couple of weeks have been an exercise in … well, everything. I’ve been working my ass off since March 26, really cooking along at this project, trying to explain to the people around me why I actually need to work at this (hint: it’s not because there’s anything wrong with me — people just have no friggin’ idea what it takes to do this job and get things done) … then I tried to take a day off a week ago Saturday, got sick as a dog the next day… and I’ve been slogging along like a manic drone, just trying to get everything done that needs to get done. And I’ve got another five days to go till the bulk of it is out the door.

Then we have Phase II. Good times.

But in retrospect, I can see how I made this a ton harder for myself than I “needed” to. My first mistake was to underestimate the amount of work. The second was to not lay out all the moving pieces and figure out how they were all going to fit together. I just assumed (BIG mistake, as usual) that things would work when they were put together. But I should know by now that I work with a bunch of folks who love their shortcuts and they love to just get crap done and off their plates, with no view of the future and no consideration for anyone past their own little cubicle-verse. It’s not their fault. They’ve been working for a relatively small company on relatively small projects for the past 10 years. Now they’re being asked to build enterprise-class applications that will be reused over and over and over again in a thousand different ways before all is said and done. They’re not lazy (well, some of them aren’t). They just don’t quite get it. Yet.

It’s not my intention to blame them for the fundamental instability of this whole thing. That’s my bad. Because I know better, and I can work around them when I put my mind to it. I just didn’t do that. And I waited too long to get a jump on things. Because I was too busy being pissed off at the other folks, to actually dig in and make my life easier.

It took me about a week to get my sh*t together — on Sunday/Monday when things started getting really dicey at home, with me being woken up at 3:30 a.m. by someone in an uncontrollable weeping anxiety-induced rage attack who just couldn’t handle having to learn some new things about the new computer I hooked up over the weekend. I mean, just total meltdown — all because things weren’t working the way they wanted them to.

And at 4:00 a.m. as I realized I was NOT going to get the full night’s sleep I really needed to be viable and competent at work in a few hours, it occurred to me that I was probably acting just like this — and I decided to stop.

So, I did. I just buckled down and got down to work. And seriously folks, I have done some super-human work in the past week. Of course, it’s not done yet, and I have a bunch of outlying issues to deal with, thanks to my poor planning and whiny-ass behavior, but I have done a truly stellar job. And I’ve managed to eke more cooperation out of colleagues who are not only down the hall but all over the world, than I realistically expected to get.

It’s all working out.  At a price, sure, but it’s all working out. And these are lessons I’m not likely to forget next time. Or maybe I will.

Looking back on the past couple of weeks, I try to find the ways that I could have made my life easier. And I look for my blind spots. I think back to my list of 84 ways TBI can make your life really interesting, and I think about the things that have contributed to this situation. Viewing the list, it looks like a ton of issues have all come up:

Behavioral
[x]  Impulsiveness – check
[x]  Aggression (verbal/physical) – check (my apologies to my coworkers)
[x]  Raging behavior – check (again, my apologies to my coworkers)

Communication
[x]  Trouble being understood – check
[x]  Trouble understanding – check
[x]  Trouble finding words – check
[x]  Trouble communicating in generalcheck

Emotions/Moods
[x] Agitated, can’t settle down – check
[x]  Angerrrrrr!!! – check
[x]  Anxiety – Feeling vague fear, worry, anticipation of doom – double check
[x]  Depression, feeling down – check
[x]  Excitability! – check
[x]  Everything feels like an effortcheck
[x]  Feeling unsure of yourself – check
[x]  Feelings of dread – check
[x]  Feeling like you’re observing yourself from afar
17. Feelings of well-being
[x]  Feeling guilty – check
[x]  Feeling hostile towards others – check
[x]  Impatience – check
[x]  Irritability – check
[x]  No desire to talk or  move – check
[x]  Feeling lonely – check
[x]  Nervousness – check
[x]  Feelings of panic – check
[x]  Rapid mood swings – double-check
[x]  Restlessness – check
[x]  Tearfulness, crying spells – check
[x]  Feeling tense – check
[x]  Feeling vague longing/yearning – check

Day-to-Day Activities
[x]  Being overly busy (more than usual) – check
[x]  Feeling like you can’t get moving, you’re stuck – check
[x]  Feeling like you can’t get anything done – double check

Mental
34. Altered consciousness
35. Aura or weird reverie, trance
[x]  36. Trouble concentrating – check
[x]  Trouble making decisions easily – check
[x]  Trouble reading – check
[x]  Analytical skills suffer – check
[x]  Trouble telling what’s real or not – check
[x]  Being easily distracted – check
[x]  Being forgetful, can’t remember – check
[x]  Nightmares – check
[x]  Worrisome thoughts – check

Physical – Eating
[x] Food cravings – check
[x] Eating less / more than usual – check
[x]  Heartburn / indigestion / upset stomach – check
48. Losing weight

Physical – Head
[x] Headache(s) – check
[x]  Stabbing pain(s) in your head – check

Physical – Hearing
51. Hearing music others don’t
[x]  Ears ringing (tinnitus) – double check

Physical – Pain
[x]  Backache or back pain – check
[x]  General body aches – check
[x]  Joint pain or stiffness – check
[x]  Neck pain – check
[x]  Touch feels like pain

Physical – Sleep
[x]  Waking up too early – check
[x]  Being fatigued / tired – check
[x]  Difficulty falling asleep – check
[x]  Waking up during the night
62. Sleeping too much

Physical – Vision
[x]  Trouble seeing at night – check
[x]  Being sensitive to light – check
[x]  Double/blurred vision
66. Spots, floaters,  or blind spots

Physical – Sensations
67. Your skin feels like it’s crawling – ironically, not
[x]  Feeling like you’ve gained weight – check
[x]  Sensitivity to cold – check
[x]  Sensitivity to noise, sounds – check
71. Smelling odors / fragrances that others don’t smell

Physical – General
[x]  Feeling dizzy / have vertigo – check
[x]  Your heart races or pounds – check
[x]  Hot flashes or sudden feelings of warmth – check
75. Losing consciousness / fainting
76. Metallic taste in your mouth
[x]  Muscles spasms or twitching – check
78. Muscle weakness
79. Seizures
[x] Nausea – oh yeah – check
[x]  Sexual desire feeling “off” – check
[x]  Skin breaking out / acne – check
[x]  Hands or feet swelling – check
84. Vomiting  – wish I could

So, it’s been an eventful couple of weeks. And times like this I’m not sure if my issues are directly TBI-related or just life in general. Everybody feels this way at times — but all at once? See the image at the top of this post for a 1,000-word replacement description of how it’s felt.

All I can say is, I’ve been in countless situations like this in the years prior to my most recent TBI, and while I didn’t particularly care for the experiences, I never had this level of off-the-rails panic, anxiety, aggression, frustration, etc. And being aware of the fact that I have not been handling this well has not helped me at all. That is what’s been the most dispiriting of all. Just that feeling of not being able to handle sh*t, not being on my game, not being able to handle anything — at the get-go. And really beating myself up over this whole thing. Like it’s an unredeemable mess.

But what I need to remember is that NOTHING is an unredeemable mess. It’s just not. So long as I keep going, so long as I continue to observe and learn and find workarounds — and don’t isolate myself from outside help — and I can manage to accept myself and not get rigidly locked into thinking that I have to be one way and one way only, then I can make room for more in my life — more experience, more wrongness, more rightness — than I would have, if I were completely focused on everything being perfect all the time — OR ELSE.

In the spirit of being truly human, here’s OceanLab with a song that fits my life pretty well this morning. Just beautiful.

So, the thing is, when I look back on my life, the hallmark of my experience has been being wrong — over and over and over again. I have been wrong so many times, I have all but give up on “getting it right the first time” as is so popular and lauded by our dominant paradigm. I mean, countless small details escape me. Or I’m so focused on paying attention to the small details, that the big main ones get lost in the shuffle. And when I try to write things down and keep track of them that way, I rapidly lose my place and everything gets even more jumbled up.

What a mess things can be.

Then again, in the spirit of “failing early, fast and often” as a paradigm for continuous, incremental improvement, I absolutely utterly excel. I don’t know anyone who fails early, fast and often as much as I do. And when I think about it, it seems to me that the ideal of getting it right the first time is pretty unrealistic. You’re going to fail, if you live life right. And you’re going to fail a lot, if you don’t hold back. That’s what I do — I don’t hold back. I dive right in. And I learn as I go. If I don’t, I’m screwed.

Maybe that’s one of the benefits of having had so many concussions/mild TBIs — I’ve acquired the ability to adjust rapidly to being utterly clueless in countless situations. Seriously, friends, when I’m in high-stakes situations, my impulse control generally goes right out the window, and I often end up in the midst of a terrible, terrible mess. The only redemption for me is to dive deeper, drive harder, and hack my way through the weeds, till I come out on the other side. I’m in the underbrush as often as not, and since I usually can’t tell what I don’t know till I get there, I often end up standing at the edge of a proverbial cliff with the local law enforcement at my heels — complete with barking dogs and loaded guns.

Such is my life of adventure.

Good thing they dumped their fuel!

Of course, a lot of this I could avoid, if I could just calm myself down and think things through rationally up front. And I often can do that. But every now and then, I get hit with something like this project that totally blindsides me and throws me off. I get angry. I get aggressive. I get hostile. And I get physically ill. I go into a tailspin, and I have to pull myself out of it quick, before I end up like an F/A-18 fighter jet crashed in a Virginia Beach apartment complex courtyard.

Of course, I’ve got plenty of experience doing this. I’ve messed up more times than I can count — and if my memory were better, I’d have lots of great stories to tell. The problem is, I don’t always remember the things that have happened before — if someone sits with me and talks them through, I can often piece together what once was. But when I’m on my own and there’s no one available to talk to  — and when I don’t take the time to sit myself down and intentionally work my way through the scenario and get my head on properly — things get ugly. I just didn’t do that, this time. I was too busy being pissed off about the timing of this and being upset with my boss and my boss’es boss who signed me up for this jungle march.

I really need to watch more adventure movies. Old movies about WWII. I should also go back to reading military histories like I was before. They really help me.

Yeah — what ever happened to me reading my big book of Samurai legends? I recall that it was helping me immensely before. Did wonders for my attitude and outlook. Gotta dig that book up and start reading it again. Like a Bible of sorts. Yeah, do that, why dontcha.

After I finish the work I’m doing today. No, wait – while I’m finishing the work I’m doing today. The stories are short, so I can read them in the midst of my slog through the jungle — the jungles of this project, and the jungles of my brain.

The thing I have to remember through all of this is that it’s a learning experience. Everything is a learning experience. Without exception. The difference is with me — will I make the effort to learn what I need to learn? Will I have compassion on myself for screwing up and find ways to redeem myself, even after the worst sort of behavior possible? Will I have the wherewithall to adjust and adapt — often in mid-stream — so that I don’t get hung up on rocks like a cruiseliner sailing too close to some Mediterranean island?  What will it be? Will I decide that my brain is too broken to handle anything well, or will I realize that my brain is constantly relearning how to do things — over and over again, sometimes the same lesson repeatedly — just like everyone else who bothers to pay close attention to their life?

What’s it gonna be? Am I gonna settle for being wrong, over and over again? Or will I see this as a chance to figure it out differently and get it right the next time — over and over again?

It’s up to me. I have a choice. So, it’s time to make the better choice of the two. And it’s time to get back to work.

Onward.

TBI and Aggression – the comorbid mix

More thoughts on Aggression, for the series Then And Now – Managing TBI Issues Over the Long Term

As Google shows, TBI and Aggression are the subject of a whole lot of research and discussion. There are close to a million results when you search for +tib+aggresssion.

Physical aggression, verbal aggression… They’re two different things, but they still have some common origins. And how they manifest can depend on the individual, the nature of their injury, their environment and stressors, as well as a ton of other issues.

Aggression is one of the toughest aspects of TBI, for individuals, families, and society as a whole. Plenty of incarcerated violent offenders have a history of traumatic brain injury, so we ultimately all pay for those injuries, to one extent or another.

I’ve been looking through a great presentation from the Defense Centers of Excellence called Mild Traumatic Brain Injury & Co-Occurring Disorders: Scope of the Problem. It talks about the different issues that show up along with TBI among veterans seeking medical help.

From the presentation:

  • Of the veterans presenting to a polytrauma network site in Lew’s study (2009), 81.5 percent had more than one diagnosis and 42.1 percent had three co-occurring diagnosis, including pain, post-traumatic stress disorder (PTSD), and post-concussion syndromes.
  • In another study by Ruff and colleagues (2008), approximately 66 percent of veterans presenting with headache and TBI symptoms had cognitive deficits on examination, more severe and frequent headaches, more reports of pain, higher rates of PTSD, and impaired sleep with nightmares.
  • Veterans with positive TBI screens are more likely to have a diagnosis of PTSD, depression, and substance abuse disorder.

I’m not a veteran, but I can attest to the presence of plenty of issues that would qualify as additional diagnoses. The pain, headaches, insomnia, memory issues, post-concussion stuff, not to mention tinnitus, chronic fatigue, irritability, anxiety… all of this mixed in with a bit of PTSD. I could go on. In fact, it seems odd to even break it all out into separate diagnoses.  It’s all just TBI, from where I’m sitting.

Of course, it could also be other things. Just Plain Life has had its effect. I can’t lay everything at the feet of traumatic brain injury, I suppose.

Anyway, looking at the many things that come up in combination with TBI, I can see in my own life how it all connects and can really feed into my anger and aggression issues. TBI and its host of related issues can really put you on the defensive, which can translate to some pretty aggressive behavior.

I have noticed in my own life that the times when I have been the most aggressive, were the times when I was feeling the most vulnerable, helpless, exposed. I’ve felt overwhelmed and put-upon like nobody’s business. Like an animal backed into a corner, with nowhere to run. So much was going on, and I felt like I was getting farther and farther behind, unable to follow what’s going on, because everyone was going too fast for me to keep up, or they were not letting me get clear on what’s happening, so I was losing my grip on what’s happening.  And my head would get going about all the awful things that are about to happen because I’m not following what’s happening around me. And I would freak.

See, here’s the thing — TBI can put a huge strain on your overall system. Let’s not even think about the cognitive issues, for a minute. When you’ve got intense balance issues as well as problems with light and sound, and you’re prone to fatigue (which just accentuates the sensory issues), just getting through the morning can be a challenge. And the part of our bodies which requires a whole lot of energy is our brain. Even people with fully functioning, neurologically intact brains require a ton of energy to keep functioning normally. So, when you’ve got even more demands on you — physically — it can impact your cognition as well.

Here’s a diagram of how I see it happening in my own life:

 

TBI-Aggression Flow - Click to see a larger version

It’s all connected – body, mind, spirit – and when the body is taking a bigger hit from all the extra demands of just standing up and walking across a brightly lit room filled with loudly talking people, something’s gotta give.

Problem is, with TBI, one of the results of fatigue is an increased irritability. Heck, even without fatigue, with TBI, you tend to get an increase in irritability. And that irritability, coupled with any impulse control issues you might have, can lead to outbursts.

On top of that (if you’re like me) and you’re up in your head about your interpretation of what’s going on (which usually means something really bad and threatening, like people hate you and want to get rid of you — and is usually completely wrong), your impaired thinking process can result in some behavior choices that are not only inappropriate, but completely uncalled-for.

The outbursts can take an ugly turn, because now you’re not only struggling to keep up and defend against the perceived threat of an overwhelming situation, but you’re also defending yourself against the perceived threat of someone deliberately trying to get you. And when you’re threatened on that level, anything you do and say to defend yourself from everyone who is out to get you can feel 1000% justified.

Nobody else sees it that way, however. As far as they’re concerned, you’re just unstable and irrational and possibly dangerous.

Getting to the bottom of what’s going on and keeping the cycle from escalating can be quite a challenge. It would be great if we could say, “Okay, just stop this and this, and everything will be fine.” But it’s a complex interaction of factors that feed into the aggression mix. Comorbid factors. Stuff that happens as a result of TBI. Stuff that happened that led to the TBI. Trauma. Pain. Emotions. Everything.

Perhaps that’s the best protection, however — just the awareness of the fact that dealing with TBI-related aggression is not some easy-peasey piece-o-cake, and that it demands some pretty regular management strategies to keep on top of things. Managing comorbid symptoms and aggression are lifestyle issues — they are intimately related to how we live our lives as a whole — not just how we behave when we’re standing in line at the post office.

Aggression and TBI and gender – does the mix matter?

This is another segment about Then And Now – Managing TBI Issues Over the Long Term – in particular, about Aggression.

Thinking about aggression and TBI, I got to wondering about whether the impact of aggression might make a difference, depending whether a survivor is man or a woman, a boy or a girl. I did some googling, but I ran out of steam trying to sort through all the different pieces of information.

Apparently, research points to women having worse long-term outcomes than men. Interesting. And unfortunate. There are a number of different possible explanations, which I found  at http://www.dawncanada.net/ppt/Women%20and%20Brain%20Injury.ppt (Good presentation! Very informative. I’ll have to examine it more closely when I have more time…) Some of them are that perhaps the medication prescribed interacts differently with women’s chemistry than men’s. Or women report more issues, and therefore appear “sicker” than men. Or perhaps it’s because of psychosocial factors. That is to say, women tend to be more verbally “fluent” than men, so they present as being much better off than they are cognitively. They seem fine, but they may be struggling in ways that only an objective test can pick up — but nobody thinks to administer a test, because “she seems fine”.

Conundrum.

Anyway, in thinking about TBI-related aggression, I got to thinking about different scenarios where a man exhibiting aggression would fare better than a woman exhibiting the same behavior. Aggression in men is often tolerated much better than aggression in women. With men, aggression is often expected, where with women, there’s a completely different standard that they’re expected to follow.

Say you’re standing in line at the post office during the holidays. Everyone has been standing in line for 45 minutes, holding heavy packages and wishing they were somewhere else… when in comes a guy who’s frazzled and obviously in a big hurry. He goes to the back of the line for a little bit, but after a few minutes he starts to fidget and curse under his breath. He then proceeds to jump the line and push his way into second place. The guy standing behind him gets bent out of shape and pushes him out of line, the two of them trade words, then start pounding on each other. The police are called, and the two men are hauled out of the post office and given a talking to by a couple of officers. They won’t let it go, though, and they still keep trying to punch each other in the face, so they’re separated in two separate police cruisers and driven off to jail.

Now imagine the scenario with an aggressive woman:

Say you’re standing in line at the post office during the holidays. Everyone has been standing in line for 45 minutes, holding heavy packages and wishing they were somewhere else… when in comes a woman who’s frazzled and obviously in a big hurry. She goes to the back of the line for a little bit, but after a few minutes she starts to fidget and curse under her breath. She then proceeds to jump the line and push her way into second place. The guy standing behind her gets bent out of shape and pushes her out of line, the two of them trade words, then start pounding on each other. The police are called, and the two of them are hauled out of the post office and given a talking to by a couple of officers. They won’t let it go, though, and they still keep trying to punch each other in the face, so they’re separated in two separate police cruisers and driven off to jail.

Doesn’t sound quite right, does it? How about a woman who’s just defending her own turf:

Say you’re standing in line at the post office during the holidays. Everyone has been standing in line for 45 minutes, holding heavy packages and wishing they were somewhere else… when in comes a guy who’s frazzled and obviously in a big hurry. He goes to the back of the line for a little bit, but after a few minutes he starts to fidget and curse under his breath. He then proceeds to jump the line and push his way into second place. The woman standing behind him gets bent out of shape and pushes him out of line, the two of them trade words, then start pounding on each other. The police are called, and the two of them are hauled out of the post office and given a talking to by a couple of officers. The man and woman won’t let it go, though, and they still keep trying to punch each other in the face, so they’re separated in two separate police cruisers and driven off to jail.

And then there’s the situation with two women:

Say you’re standing in line at the post office during the holidays. Everyone has been standing in line for 45 minutes, holding heavy packages and wishing they were somewhere else… when in comes a woman who’s frazzled and obviously in a big hurry. She goes to the back of the line for a little bit, but after a few minutes she starts to fidget and curse under her breath. She then proceeds to jump the line and push her way into second place. The woman standing behind her gets bent out of shape and pushes her out of line, the two of them trade words, then start pounding on each other. The police are called, and the two of them are hauled out of the post office and given a talking to by a couple of officers. They won’t let it go, though, and they still keep trying to punch each other in the face, so they’re separated in two separate police cruisers and driven off to jail.

It has a totally different feel from the scenario with two men. The situation with two men sounds like “boys being boys”, you might say. But two women behaving really badly and then coming to blows? Maybe in a toy store in LA, but in “polite society” this would stand out as an exception.

The point I’m trying to make here, is that there are different standards for acceptable behavior with men and women. And the fallout afterwards also tends to be different. With men, things can get “heated”, but with women, they get “out of hand” and the consequences are as different as the consequences for adultery in secular America versus church-centric America. In one case, it may elicit little more than a shrug, while in other cases it may result in being shunned and isolated.

Our society has a very different set of expectations for different genders, so when a woman with a TBI starts to act out, it really stands out. And it can be isolating. Unexpected, unacceptable behavior, along with social censure, can add to the cognitive load of a TBI survivor, which cuts into the available resources for just living their life, and also cuts them off from valuable social connections that can support recovery. Ultimately, if you have enough censure and isolation, without the proper feedback mechanisms for determining and modifying appropriate behavior, I would imagine things could degenerate over time and ultimately fan the flames of TBI complications, long after the initial injury has faded from memory.

If this is true in the case of women, then what about girls? I’m specifically thinking about girls who are concussed and don’t get proper care and have their concussions eventually become lasting traumatic brain injuries. What about girls who get hurt, don’t get the help they need, and end up exhibiting behaviors that alienate their friends, their families, their support groups that are necessary for healthy growth and maturation? What about them?

What makes things even more complicated, is that some of these symptoms — the aggression, the mood issues, and more — may take months to show up, so during a time when so much is in flux and changing around them, they’re all of a sudden hit with this weird new character trait of a short fuse and an explosive temper. And seemingly out of nowhere. What do they do then? If a girl is expected, pressured, trained to be a little lady, and then all of a sudden she becomes more like a wild animal, what then? If her popularity and self-image is dependent upon her behaving in a certain way, and then TBI suddenly makes it impossible for her to behave that way, what’s the impact to her development overall as a girl, then a woman?

Now I’m not saying that girls have it harder than boys, but there are differences in gender expectations, differences in behavior expectations, and if there’s one way TBI can really throw a wrench in things, it’s in the behavior area. So, if most of the studies of the impact of TBI are concerned with boys/men, what does that mean for our overall understanding of the impact — not only to the individuals, but to society as a whole?

My grandfather used to say, “Women have to be better than men. They are the ones who create our culture.” He was fine with that idea, while my mother always pursed her lips a little bit when he said that. He was an old school kind of gentleman, but there was a nugget of truth to it — although the truth was more about expectations, than actual fact.

Ultimately, I think that gender and TBI should probably be studied more closely. There’s so much to it — it’s quite mind-boggling overall. But we really need to factor it in. And when we talk about managing long-term issues, I think it can be helpful to consider to social and cultural contexts. As different as each brain injury is, as individual as each recovery is, we can’t overlook factors like gender, as well as class and ethnicity and age. It’s all a huge ball of string that begs to be unraveled, but that’s a bit beyond me right now. I’m on vacation(!) and it’s a beautiful day outside.

But first, I could really use a nap…

Brain Injury Location Tied to Higher Risk of Aggression

Prefrontal cortex

Found this the other day, via BIACACLC Brain Injury Ass’n on Twitterwhere you get injured in your brain can determine the risk of aggression.

Researcher Jordan Grafman, director of traumatic brain injury research at Kessler Foundation in New Jersey and his colleagues studied the aggression levels of 155 Vietnam War veterans who had suffered a penetrating traumatic brain injury, and divided them into aggressive and nonaggressive groups.

In the aggressive group, 79 percent were injured in their prefrontal cortex, whereas 21 percent were injured elsewhere in the brain, the study said.

But in the nonaggressive group, 47 percent were injured in the prefrontal cortex of the brain and 53 percent were injured elsewhere in the brain, according to the study.

“The locus of brain damage is important … as it will clue you in to the long-term risks to the social behavior of the patient,” Grafman said.

Read the whole piece here

This is an important consideration – where you get injured can affect how you express yourself after you’re injured.

But even knowing that can’t always guarantee that you’ll be able to predict what people will do and how they will behave. The brain, as we all know, is a tremendously complex organ and people express their personalities differently, so a similar injury may result in completely different behaviors, depending on the person.

Which just makes TBI even more annoyingly complex for people looking for a silver-bullet cure. If you can’t predict accurately how people will behave, how can you control that behavior? How can you manage it effectively with pills and such?

At the same time, for those of us not looking for a pill cure, it is encouraging to think that even if you do experience a TBI that messes up your prefrontal cortex, that’s not the end of the line for you, and you always have the possibility that you’ll be able to manage yourself better than expected or predicted. This kind of stuff happens all the time with medicine — the doctors say one thing (you’re going to die in three months) and then it doesn’t happen. It happens all the time in life — I don’t think the predestination people are right — or maybe they’re 100% on, and all our human prophecies amount to nothing in the face of what fate has in store for us.

In any case, this is interesting information that bears consideration – if only for the sake of giving us something to watch out for and better understand. Aggression is definitely a problem post TBI, and the more we know about it and understand it, the better.