And now winter has arrived

snow covered buildings
It’s not this bad, but this is how it feels.

It’s snowing again. It snowed a lot, the other day, and now it’s snowing again. I’ve been mainly moving snow with my shovel, this winter, pushing it aside, instead of using my snowblower. I need the exercise. I was turning into a lump. But today (or maybe tomorrow) I’ll use my snowblower instead. Winter’s got the upper hand today.

Whatever I do, I need to be smart about my choices. And that means using the resources I have – to save my back. Earlier today, I got out the snowblower, made sure it starts, filled up the gas can, and prepped myself mentally for a big day of snowblowing tomorrow. I might even do some tonight, before it gets completely pitch black. I need to move snow. And I need to use my noggin about it.

My back, shoulders, arms, and legs are all pretty sore. It’s good for me. I need the heavy exercise. It’s the one thing that actually helps me get rid of excess energy.  If I don’t do heavy exercise on a regular basis, I can become irritable – and that’s no fun for anyone.

So, this winter, I’ve been shoveling. And it’s been great.

This storm, however, seems to have other ideas. So, I’m being smart and not pushing my luck.

And that’s progress for me, because once upon a time, I would push it. I would test my luck and keep pushing myself to go-go-go, even if I was tired, even if I was getting uncoordinated. I would wear myself out and then either be at risk of falling, or I would actually fall.

I almost fell, the other day, when I was clearing my drive. Black ice underneath silky, slippery snow. It was treacherous. I was careful. I didn’t push it. And I’m glad I didn’t.

I really do love winter, I have to say. The cold wakes me up, it makes me feel alive, and the snow is great to move. I love “playing” in the snow, shoveling it and moving it around. It’s just the ticket to get me out of the house and out of my head.

Just. Fantastic.

Today, though, I’m pretty much laying low… recuperating and letting my body rest. I’ll get plenty of exercise tomorrow, I’m sure.

Emotional Problems After Traumatic Brain Injury – Peer and other support

Meeting Of Support Group
After brain injury, you need support

Peer and other support

Remember, too, that not all help comes from professionals! You may benefit from:

  • A brain injury support group — some are specialized for the person with TBI, others are for family members, and others are open to everyone affected by brain injury.
BB: Not everyone has access to this. But if you're reading this, you have access to the Internet, and there are support groups online, like the forum Traumatic Brain Injury and Post Concussion Syndrome
  • Peer mentoring, in which a person who has coped with brain injury for a long time gives support and suggestions to someone who is struggling with similar problems.
BB: Again, it can be difficult to find someone who can help you. But if you reach out online, you may find someone. Also, you never know who's had a TBI. We're everywhere.
  • Check with your local Brain Injury Association chapter to find out more about these resources. Go to http://www.biausa.org/ to find brain injury resources near you.
BB: I got some great info from my local BIA chapter. I attended some support group meetings. But I wasn't "impaired enough" for some people there, so I quit going. I guess I've gotten too good at hiding my difficulties.
  • Talk to a friend, family member, member of the clergy or someone else who is a good listener.
BB: They definitely need to be a good listener - and able to deal with you. Family and friends may not be able to help, because they may be too invested in you being like you always were before. It's a tricky line to walk, but it's important to reach out for help.

Read more at: Emotional Problems After Traumatic Brain Injury

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Emotional/Behavioural Changes after Brain Injury – Part 2

head with brain opening and question marks coming out

Continued from Part 1

From The Toronto Acquired Brain Injury Network.

My comments are in bold like this.

Emotional/Behavioural Changes

Impulsivity and disinhibition

A person may lose their ability to control their actions or their speech. This problem often goes hand in hand with lack of awareness, and the person may not be aware of breaking any social rules or etiquette. There are strategies that can help to improve the situation, and prevent a person from developing unacceptable behaviours through habit.

BB: The first thing that we need to know, as we recover, is that we're breaking social rules. We may not be aware. And while the people around us may not be comfortable "calling us out" on our behavior, it's important to do it. And it's important to persevere in convincing us that our behavior is just not good. Because we may literally not know. We may also resist accepting that fact. But brain injury and "bad manners" often go together - and if you  never realize you're behaving badly in the first place, it's impossible to fix it.

Emotional Lability

This describes a person’s tendency to laugh and cry very easily and to move from one emotional state to another very quickly. Loss of control over emotions means the person may express their feelings inappropriately or at the wrong time. This can be very tiring and embarrassing for family members to deal with, but in time a person can begin to re-learn emotional control.

BB: I am not a fan of emotional lability. Nor is anyone around me. It can be embarrassing and stressful, and it can make things worse. The best thing to do, for me, is find some humor in it. Over time, this can sort itself out and become more manageable. In the meantime, you just have to make the best of it -- and remember to not over-react to every emotional storm that comes along.

Self-centredness

Someone may become self-centred. For example, the person may not show any interest in family matters and only be concerned with their own needs. Brain injury can affect a person’s ability to judge how someone else is feeling. The person may also become used to the huge amount of attention they receive while in hospital.

BB: Recovering from brain injury requires you to become self-centered, in my opinion. You have to pay attention to yourself in new ways. You have to get familiar with yourself again. But it's easy to get too caught up in yourself, and that can distance others. Ultimately, the thing that's saved me, time and again, is getting past myself. Learning now to be less self-centered. It helps me with depression, it helps relieve my sense of being disconnected from others. Putting others first... that's been a big benefit for me.

Apathy and poor motivation

Lack of motivation, or apathy, is a direct result of injury to the part of the brain that controls emotion, motivation and forward planning. Over time, lack of motivation can lead to social isolation and lack of pleasure. For example, a person may show no interest in hobbies enjoyed previously, or they may not get out of a chair all day. To help, activities can be broken down into small steps to avoid overwhelming the person.

BB: This is a big one for me. Most of the time, I just don't care about much of anything at all. Seriously, I don't. And so many things I've started... well, they've just fallen apart and went nowhere, which made me feel like a total loser who wasted everyone's time. My motivation generally sucks. I wish it didn't, but then again... a lot of times, I just don't care, one way or the other.

But yet, I need to keep moving. I need to stay productive. I need to keep myself from falling into "disrepair" and ending up feeling worse than I already do. Life has always been painful for me. It hasn't been a long exercise in glee and joyfulness. It's been awkward and uncomfortable, and I've been in multiple kinds of pain for as long as I can remember. 

But something in me needs to keep moving. I find motivation where I can get it - generally not from the things that other people get motivation from. Just staying alive. Feeling like I'm doing something productive with myself. And constantly coming around again to take another shot at what I want to do.

Motivation is a tough one for me. I guess I've just developed habits around getting stuff done, and they work for me when I have no motivation to do anything, at all.

One thing that keeps me motivated, is doing things for others. Serving others. Being available to others to help, so they can have the best life possible. That motivates me, I guess. It's probably my biggest one. The rest of the things -- money, success, fame -- nah, I'd rather do something useful that benefits others, to be honest.

Depression

Depression is a very common emotional reaction experienced in the later stages of rehabilitation—often when a person realizes the full extent of the problems caused by the accident. This can be seen as a good sign: the person is aware of the reality of the situation and is coming to terms with the emotional consequences. “Healthy” depression can be worked through in time, as adjustments are made. If a person feels emotionally blocked and unable to move on, professional counseling from someone who understands head injury may be helpful.

BB: I never gave much thought to this before, probably because I've always been depressed, and it's nothing new for me. When I was in high school (I had a handful of mild TBIs in the course of three years), I went through a period that was utterly, completely black. Literally. I couldn't see anything, at some points. Everything was dark for a little bit, and my vision wasn't working.  Fortunately, it seemed to happen when I was sitting down. But the emotional darkness was the worst. I just felt like I didn't even exist, and I didn't care, one way or the other. 

I'm not sure that it had anything to do with realizing how messed up I was. I didn't realize those blows to the head had any effect on me at all. I just felt awful. Whether it was the mTBIs or just being a teenager, is anybody's guess.

Someone asked me once, if I had a history of depression. I said, "Of course," and they seemed sad. I didn't mean to make them sad -- just tell the truth.

Anxiety

It is natural for people who have had a traumatic experience to feel anxious afterwards. Individuals may experience a loss of confidence when they are faced with situations and tasks that are difficult to cope with. However, problems can occur if difficult situations are continually avoided, or if those caring for them encourage dependence rather than independence. Talking about fears and worries is very helpful. Learning ways to stay calm under stress can also reduce the effect of anxiety on everyday life.

BB: I know this one all too well. And what most people don't realize, is that anxiety isn't just about the injury itself. If anything, the injury is just a small part of the total anxiety-generating stuff. Insecurity and instability builds throughout the course of your recovery (because some recovery is invariably happening, even if it doesn't seem like it), as you walk into different situations that you feel should be OK, but then you screw things up -- many times without even realizing it -- and it happens over and over again. Everyone around you is afraid to say anything, because you might A) blow up, B) cry, C) fight them on it, D) feel terrible. Everybody's walking on eggshells, so you never get the information you need to recover sufficiently, or adjust your behavior and adapt to situations.

So, people just basically leave you to your own devices, which is a terrible idea, because it leaves you alone with the very thing that's causing you problems -- your brain. And the anxiety builds over and over and over, because you can't get the help you need to adjust and recover -- and regain your dignity.

Small wonder, that we start to avoid situations. Sometimes it's just easier to not even bother, than get dragged across the hot coals of embarrassment all over again.

Inflexibility and obsessionality

Examples of this behaviour include: unreasonable stubbornness; an obsessive pattern of behaviour such as washing or checking things; or fear of possessions being stolen. The person can lose the ability to jump from one idea to another, and becomes “stuck” on one particular thought. This type of behaviour is often made worse by anxiety or insecurity, so it is helpful to reassure the person and and redirect their attention to more constructive ideas and behaviour.

BB: You never know if the stubbornness is unreasonable or not. There may be a very good reason for it - but nobody's asking the right questions, so you end up looking "unreasonable" to people who might be able to help you, if they just took a different route or opened their minds.

Getting stuck on an idea or a frustration is a big problem for me, to this day. If I'm tired, I can get "stuck in a loop" where I'll keep arguing about the same point, over and over and over again, making everyone around me absolutely nuts with frustration. And they don't know how to get me out of it. 

It's impossible to argue with me at those points. Best thing to do, like they said, is redirect my attention in another more productive direction.

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Emotional/Behavioural Changes after Brain Injury – Part 1

lightning striking the ground under dark clouds
Sometimes the storm seems to come out of nowhere.

From The Toronto Acquired Brain Injury Network.

My comments are in bold like this.

Emotional/Behavioural Changes

Some people are left with changes in emotional reaction or behaviour after a brain injury. These are more difficult to see than physical or cognitive changes. However, they can be the most difficult for the person and their family to deal with.

BB: I had no idea that a TBI would affect me emotionally, or change the way I acted. Like so many people, I figured that a bump on the head was just an external thing. I'd feel pain on my scalp, and maybe I'd feel a little woozy, but it would clear up in a few minutes... or hours. How wrong I was - so many times. Emotional and behavioral issues have been the bane of my existence (and my family's) for years and years, starting back in my childhood when my behavior was erratic, and my emotions were volatile.

Not everybody will experience these problems and their severity will also vary.

BB: The severity can vary from person to person, as well as from situation to situation. With me, I can be fine, one day... be not-so-great (but seem fine), the next... and then completely lose it a few days later. It's often cumulative, but nobody on the outside sees it building up. That happens inside. Where nobody can see. And when it erupts... hooo boy.
fireball explosion
The problem for me, is that when I blow up, it puts people off, and then they think that's how I always am... and then they walk on eggshells about it, all the time.

And I sometimes never get a second chance, because they've made up their minds about me in a negative way.

Agitation

This frequently occurs at a very early stage after the injury. It can be a coping mechanism for the person, who may be disorientated and very confused. It is most often a stage a person passes through, rather than a permanent change. Examples include: restlessness, pacing and pulling at intravenous tubes.

BB: I've been extremely fortunate to never having had intravenous tubes to pull at, but I know the feeling of not being able to sit still, being extremely agitated - especially after a TBI. A number of times, I can recollect getting hit in the head, and then being flooded with agitation and an overpowering need to MOVE! Like when I got hurt during an informal pick-up soccer game in high school, after the hit, when I was lying there, dazed and confused, I suddenly felt like I'd been given super-powers, and I leaped up and started playing like a crazy person. I don't think I played better than I had before I got hit, but I felt like I did. And I was ON FIRE - or so I thought.

In another soccer game, when I got my bell rung, I knew I'd been hurt, but I felt this incredible urge to GET UP AND GO!!! And I started racing around the field -- in the wrong direction, no less. I nearly scored on my own team, which I think was a red flag for everybody on the sidelines. I did get taken out of that game, and I paced the sidelines in confusion and anger, because I NEEDED TO BE IN THERE! But it was wise to pull me from the game. I was not in good shape, at all.

So, while agitation may be a coping mechanism for some, as they say above, I suspect it also has to do with the mechanism of the brain - the release of all those chemicals, and the general confusion that causes. The brain is trying to figure things out - plus, it's firing on ALL cylinders, like there's no tomorrow. In addition to being a behavioral coping mechanism, it's a result of the brain's basic function.

Explosive anger and irritability

If there has been damage to the part of the brain that controls emotional behaviour and the ability to tolerate frustration, emotions can swing to extremes. The stress of coping with even minor crises, such as misplaced shoes or a noisy vacuum cleaner, can be too much and trigger an angry outburst. If these stresses can be identified, it may be possible to reduce them.

BB: Amen to this. The part of the brain that controls emotions is particularly susceptible, as it's out in front and there are so many types of injury that can affect it. Car accidents, where your brain slams up against the inside of the skull... or tackles that snap your head back and forth... falls, etc. Minor events can turn into crises -- just being blindsided by a sudden change or something unexpected happening, can set me off. Little things can turn into huge things, in an instant. One minute, I'm fine, then all of a sudden, it's off to the races with emotional overload and over-reaction.
galloping horse
Prolonged stress will also do a number on me, as will fatigue. The more tired I am, the more irritable I get - a tired brain is an agitated brain. And when I get too agitated, it's not cool.

Sudden outbursts... extreme reactions... it's all part of a day in the life for me, sometimes. Unless I can get enough sleep and take good care of myself. If I can keep on my schedule and be smart about eating and drinking enough water, that helps. So does meditation and just taking time to chill out. 

Lack of awareness and insight

The ability to recognize your own behaviours and change them when needed is a sophisticated skill that can be affected by brain injury. This can affect someone’s ability to: be self-aware; have insight into the effects of personal actions; show sensitivity; or feel empathy. It also means that a person may not fully appreciate or understand the effect that the accident is having on their life, health or family.

BB: I honestly had no idea how my TBI was affecting my household, back in 2005. I'd gotten injured at the end of 2004, and 2005 was the start of the downhill slide. I became incredibly self-centered and obsessed with myself. Small wonder - I had to recover and build myself back up, as my Sense-Of-Self had taken a huge hit. I didn't know who I was or what I was about, anymore, and it was devastating. I didn't recognize myself, and I was so caught up in figuring it out inside my head, that I never realized the extent of the changes on people closest to me (who were outside my head).

It took talking with someone on a regular basis about what was going on with me, to help me see what an ass**** I was being, and to do something about it. Until I started talking to a neuropsych on a regular basis, I had no way to understand myself and objectively examine my behavior, because nobody I talked to actually understood how TBI affects the mind, body, and spirit... so they made all kinds of flawed assumptions about who I was and how I was. It was incredibly unhelpful for me, and it did more harm than good. 

I got lucky. A lot of others don't have that opportunity. And that's a damned shame. It's criminal, really.

I’ll continue this post in Part 2. Watch this space for notifications.

Source: www.headway.org.uk

Source: Emotional/Behavioural Changes | ABI Network

Emotional Problems After Traumatic Brain Injury

From the Model Systems Knowledge Translation Center (MSKTC) comes this great information – which especially pertains to me, today.

My comments are in Bold like this.

Brain injury and emotions

A brain injury can change the way people feel or express emotions. An individual with TBI can have several types of emotional problems.

BB: Fantastic (sarcasm). There's not just one, but several emotional problems I can have.

Difficulty controlling emotions or “mood swings”

Some people may experience emotions very quickly and intensely but with very little lasting effect. For example, they may get angry easily but get over it quickly. Or they may seem to be “on an emotional roller coaster” in which they are happy one moment, sad the next and then angry. This is called emotional lability.

BB: This just happened to me this morning. I'm still fatigued from my trip, and while I was making my breakfast, my thoughts were interrupted, and I blew up. My spouse really wanted to talk to me, go over what we were going to be doing today, plans for how to organize the house, etc. And that's completely understandable, because I've been away for four days, and they had a lot of time to think. Plus, they missed me. 

I got overloaded and blew up, slammed around in the kitchen, broke down and cried for a few minutes, then regrouped and managed to eat my breakfast in peace, then joined them in the living room to talk about the day and our plans. 

Roller coaster, for sure.

What causes this problem?

  • Mood swings and emotional lability are often caused by damage to the part of the brain that controls emotions and behavior.
BB: Brainline says:  The frontal lobe ... helps govern personality and impulsivity. If damaged, there might be no “braking mechanism” for self-control. A person may find [they] cannot control [their] anger or aggression. 

That's what happened to me this morning. I got irritated, and my irritation picked up speed like a freight train until I was pretty upset... then really furious. And then I got furious at myself. And then I got furious at my spouse for not cutting me a break. And then I felt generally broken and useless, which spiralled into a bit of a freak-out meltdown. A small one, but still a scary one, because I was slamming stuff around, and that makes my spouse feel unsafe in our home.
  • Often there is no specific event that triggers a sudden emotional response. This may be confusing for family members who may think they accidently did something that upset the injured person.
BB: It can be hard to know when I'm going to "go off", because I'll be working hard to keep it together, and I'll seem to be fine, then all of a sudden, I'm blowing up, apparently "over nothing". There is a sequence of events that sets me off and triggers that sudden emotional response, but it's all internal, so nobody can see it building up.
  • In some cases the brain injury can cause sudden episodes of crying or laughing. These emotional expressions or outbursts may not have any relationship to the way the persons feels (in other words, they may cry without feeling sad or laugh without feeling happy). In some cases the emotional expression may not match the situation (such as laughing at a sad story). Usually the person cannot control these expressions of emotion.
BB: I hate the episodes of crying. That's what happens to me most. I don't cry or laugh unless I'm feeling sad or happy, but it can come up very quickly, and it's not always clear to others just how or why I'm reacting the way I am.

Come to think of it, there have been an number of times when I've laughed for no apparent reason -- usually under the worst of circumstances... usually when an authority figure is either nearby or the "target" of my laughter. I've laughed at people telling me how their child was diagnosed with a terrible, life-threatening disease (and my boss was standing nearby and got so pissed off at me that they had to walk away). I've laughed at things bosses have said, seeming to ridicule them. I may have misunderstood their meaning, to begin with, but it could also be due to my brain mis-firing. The really noticeable times when that happened, were within a few weeks of having had mild TBIs from car accidents. I could read and write normally again, but my inexplicably jocular emotional lability was a real problem. For me and everyone arounnd me.

What can be done about it?

  • Fortunately, this situation often improves in the first few months after injury, and people often return to a more normal emotional balance and expression.
BB: I found this to be true. I did start to act and react more normally over time. However, if I don't get enough sleep, I'm back to where I was before -- sometimes worse. Sleep is the key for me. If I don't get enough of it over an extended period of time, I suffer, along with everyone around me. 
  • If you are having problems controlling your emotions, it is important to talk to a physician or psychologist to find out the cause and get help with treatment.
BB: For me, talking to a neuropsych on a regular basis really made all the difference. It was bad enough that it happened, but not understanding why it was happening, and not having a clue about how to help it made things worse. But when I learned that I need to get more sleep and cut myself a break, it really put me on the right path.
  • Counseling for the family can be reassuring and allow them to cope better on a daily basis.
BB: My spouse has a therapist they talk to, and that therapist has dealt with brain-injured people in their own practice, so it's really helpful for my spouse to have access to that information. It's rare, to find a therapist who really understands TBI, and we're both lucky that this person came into our lives. My spouse has become so much more tolerant and understanding of me, as well as appreciative of the progress I've made over the years. And that appreciation has made a lot of things easier for both of us.
  • Several medications may help improve or stabilize mood. You should consult a physician familiar with the emotional problems caused by brain injury.
BB: The problem is, brain injury can affect how you react to medications. It can make you more sensitive, or less, and some of the medications (Benzos) actually make things worse. Some mood stabilizers can make the brain more tired -- and that's a recipe for more emotional outbursts, and the pain and suffering that follows. So, your doctor needs to know about TBI and its effects on how the brain handles meds, before he/she prescribes them to you. And if you're not feeling right or you're having more trouble due to meds, let your doctor know. Be smart. Protect yourself.

What family members and others can do:

  • Remain calm if an emotional outburst occurs, and avoid reacting emotionally yourself.
BB: This is one of the biggest challenges for me. I always prided myself on how even-keeled I am, and how I kept my head on straight during a crisis. Watching myself get all emotional and overwrought over things that I don't believe warrant all that emotion can be very upsetting for me. And I know I'm not alone. We may have injured brains, but we still have our pride.
  • Take the person to a quiet area to help him or her calm down and regain control.
BB: I have to take myself to a quiet area and let myself calm down. I need to remove myself from the situation and get my system leveled out. Then I can rejoin civilized society. But not before. If I go back too soon, I can freak out even more, the next time.
  • Acknowledge feelings and give the person a chance to talk about feelings.
BB: I need to talk about my feelings in terms of "I". As in "I feel upset because I feel like everything is spinning out of control, and my brain can't keep up, and then I feel stupid and helpless."
It does no good to lay blame -- to say "You made me feel bad because ____________" Especially because the other person usually has NO idea what they did to provoke me. The fact is, they may not have provoked me - my brain provoked itself, and I need to talk about how I feel in a way that doesn't blame the other person who already feels defensive and vulnerable to my emotional over-reaction.
  • Provide feedback gently and supportively after the person gains control.
BB: It often helps, if I can come up with a clear explanation of why I freaked out (I'm tired, I'm frustrated, I'm overworked, I'm hungry), and then I come up with clear steps to fixing that. I tell whoever I freaked out at, what I'm going to do, to stop my behavior ASAP. And I make sure they know I'm going to take more steps to fix it over the long term. Sometimes it helps if I tell someone how they can help me in the future. Like my spouse helping me to get to bed at a decent time. And take naps during the day, when I can.
  • Gently redirect attention to a different topic or activity.
BB: I just shift my attention to other things. I do something I've been wanting to do for a while, and that makes me feel better, because I'm using my overabundance of energy for something productive. It always helps, when I channel my energy into other things that have productive uses, like cleaning and organizing. And when I'm done, I have something to show for it. 

I just need to make that shift, which isn't always easy.

Read the rest of this great article at: Emotional Problems After Traumatic Brain Injury

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Emotional Changes after Brain Injury

The Model Systems Knowledge Translation Center has great info on TBI. Here’s one of their great infocomics on emotional changes after TBI (click to download):

Emotional Changes After TBI Infocomic
Emotional Changes After TBI Infocomic

Driving After Traumatic Brain Injury | From the Model Systems Knowledge Translation Center

Driving is an important part of a person’s independent lifestyle and integration into the community. Because we take our driving skills for granted, it is easy to forget that driving is the most dangerous thing we do in our everyday lives. A brain injury can affect the skills needed to drive safely. If and when an injured person may safely return to driving should be addressed early in recovery. The injured person, family members, and health professionals should all be included in this important decision. If anyone has concerns that that driving may put the injured person or others in danger, health professionals may recommend pre-driving testing.

How can a TBI affect driving ability?

A brain injury can disrupt and slow down skills that are essential for good driving, such as:

  • Ability to maintain a constant position in a lane.
  • Having accurate vision.
  • Maintaining concentration over long periods of time.
  • Memory functioning, such as recalling directions.
  • Figuring out solutions to problems.
  • Hand-eye coordination.
  • Reaction time.
  • Safety awareness and judgment.

Read the rest of this great article: Driving After Traumatic Brain Injury at the Model Systems Knowledge Translation Center

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Hello officer – the tremor you’re seeing is not fear. It’s fatigue.

transportation security administration officer screening a bagI recently had to fly halfway across the country for a work commitment. I had to fly out early, which meant I had to get to the airport really early… and that meant I had to wake up really really early.

Not much fun, to be honest.

But I did it.

I hadn’t been sleeping well, for several days prior to that – I was getting maybe 5 – 6 hours a night, which is no good. But that’s what I had to work with, so… that’s what I worked with.

The drive to the airport felt like it took forever.

And just getting from the parking garage to the terminal was another slog. One of the wheels on my carry-on was “wonky” and it vibrated really loudly, as I pulled it along. Not the best thing, when your hearing is already over-sensitive.

Anyway, by the time I got to Security, I was a little shaky. I was operating on maybe 2 “cylinders” (out of a potential 4), and I hadn’t had my full breakfast like I usually did. I was off balance and out of sorts, and when I handed my boarding pass and ID to the security officer, my hands were shaking a bit, like they do when I’m overly tired.

The officer gave me a look, and I tried to exchange a few words, but I was “off kilter” and my voice was shaky. I started to get nervous, wondering if they were going to alert others that I was a sketchy character. They gave me another look, and I just shut up. I sounded a little drunk and discombobulated, and my hands were trembling. That’s never a good sign, when you’re trying to board a plane. So, I did my best to gather what dignity I could and just moved on to the x-ray screener – hands over head – and then walked on through.

Fortunately, my luggage made it through without incident. At the last minute, I remembered to pack only small bottles of liquids and creams. That was a last-minute change, because I was going to take full tubes of toothpaste and a special skin cream I need to use for my beat-up hands. At least I got that right.

In the end, it all turned out okay. But I really hate that feeling, when my neurology is acting up on me, and I’m interacting with someone who can flag me as a risk, take me aside, pat me down, possibly strip search me (worst case). The worst case didn’t happen – not even close. So, that was good.

And the trip went pretty well, from that point on.

So it goes.

And so I go… onward.

TBI Recovery – more work than you can ever imagine

5-Minute Read

shoestrings tied on a shoe
I always tied my shoestrings in a way I didn’t like – till last month

After nearly 50 years of tying my shoes in a way that makes the laces stick out in weird ways, I’ve finally started tying them in a way that makes them neatly lie flat across my shoes.

I’ve been bothered by my “askew” shoestrings for as long as I can remember. When I was a kid and first learned to tie them, I was happy I’d just figured out how to tie them. But the way they lay — all scrunched up and crooked — really bothered me.

I told my dad once, and he said I could tie them differently, by looping the shoelaces around in the opposite direction. At the time, it was too much for me to wrap my head around. It didn’t make sense to me. Plus, I’d only mastered the motion (and muscle memory) of tying them properly in the one way I knew how.

And I was afraid I’d lose the tenuous skill I’d already learned.

Years later — nearly 50 years, to be more accurate — I’ve finally decided to tie them in the way that makes the loops lie flat across my shoes. They’re less likely to trip me up, that way. And I like how they feel better than the old way.

I’ve been doing this regularly, for the past couple of weeks — making the concerted effort to tie them in the way that makes them neat and tidy.

But you know what? I keep going back to the old ways. Back to the old habit of tying them in a way that’s really second-nature to me, after doing it that exact way for all these years.

And that’s taught me, yet again, about how and why TBI / concussion can be so difficult to recover from. The “wiring” that you’ve trained to use in a certain way — habits of thought and action, movements of your body, ways you think about things, routines of sleeping and waking — may have changed in ways you cannot see, but it’s all switched around, so you have to find new ways of doing things that you’re used to doing in one certain way… since forever.

And no matter how well you train yourself to do things the new way, no matter how much conditioning you have, no matter how well you like the new way, no matter how badly the old way has been disrupted, your brain and your body are still going to try to do things the old ways, the ways that they think they still know how to do.

They don’t, of course… or maybe they need to be intensely retrained. But they don’t realize it. And that’s one of the hallmarks of TBI: not knowing what’s messed up, until it’s too late (and then, sometimes not even realizing it yourself).

No matter how convinced I am of the new way of tying my shoelaces… no matter how much I may like the new way of doing things… no matter how much I used to hate the old way of doing things… that’s what my brain and body and muscle memory are used to. It’s what they feel comfortable doing. Even if it doesn’t work.

So, I have to keep after it. Like all of us who are dealing with somewhat broken brains / disrupted wiring. Our systems will go for the way that they think is easiest and what’s most familiar. They just don’t know it won’t work out.

And that’s what we have to keep learning and relearning and readjusting to, over and over again. No matter how long ago the injury happened.

It takes a ton more work and effort and attention and focus and determination to recover — even from a “mild” traumatic brain injury. That’s what most people don’t understand… but every long-term survivor knows, all too well.

Be that as it may… Onward…

Nine years ago, I started this brain injury recovery blog

9 year blogging anniversary emblem
Emblem reads: Happy Anniversary with WordPress.com! You registered on WordPress.com 9 years ago. Thanks for flying with us. Keep up the good blogging.

And it’s been one of the best things in my life – ever.

At the time, back in the “wee hours” of 2008, I was so confused, so anxious… and afraid. I couldn’t believe I had been injured as much as I had, in the course of my life, and nobody had ever noticed. Nobody had ever thought anything of it. I know I was good at covering things up — but was I really that good? Doubtful. Rather, people saw there was something “wrong” with me, and they attributed it to:

  • laziness
  • poor character
  • sinfulness
  • being young and “unformed”
  • lack of proper training
  • rebelliousness
  • anything else you can think of that blames a person for how they’re behaving

The fact of the matter was, I’d been clunked in the head — a bunch of times. And those injuries, which were never properly recognized or treated (or even just factored in) shaped my life and personality and behavior in certain ways that made me look either like a flaming idiot, or just plain “trouble”.

Part of the problem was, I appeared to be pretty smart in certain ways. I could do some things really well — like memorize a whole sheet of vocabulary words in an hour’s time, and then not only test well on them, but also be able to use them in conversation… or be a great track team captain, motivating my teammates to do their best. But for some reason, under various circumstances (which could never be predicted by people who weren’t paying attention, anyway), I’d “fall apart”. Become a discipline problem. Become combative, resistant, defiant, and disruptive in class as well as group activities.

Looking back now, I can see how tired I was, so many times, and that fatigue flipped the switch on my issues. It was like flipping on the lights in a lecture hall — all of a sudden, my issues were lit up bright and glaring.

But of course, I was just being rebellious. Sinful. Willfully difficult. I was just being bad.

Now, I know better. And I’ve forgiven myself for so many things I did wrong when I was younger. The fights, the conflicts, the drug and alcohol abuse, the poor grades, the times I screwed up great opportunities during my youth and young adulthood, because I couldn’t put two ideas together.

Looking back over the years, I can see so many times I came up short — I didn’t live up to my abilities, or to others’ expectations. And I’ve been pretty hard on myself, all these years. And I need to keep forgiving myself, because it’s so easy to forget there was an actual reason I screwed up, when I “should” have done better. It’s a daily practice, this forgiveness business. Even to this day, I still have old habits of thinking about myself in pretty task-master-ish terms. And I need to keep practicing. Because it’s oh-so-easy to fall back into the training of my youth, and tell myself I’m just slacking or I’m taking the easy way out, or I’m being a total loser… when I’m really just in need of a good night’s sleep and a different way of tackling my problems.

I have come an incredibly long way, in these past 9 years. I’ve gotten a lot of help along the way… which is now pretty much gone, because my main supporter moved halfway across the country. But I’ve learned a tremendous amount from those years we worked together, and I am eternally grateful for their help. I’ve been seeing another neuropsychologist, since they left, but this new one is not nearly as experienced or insightful — or as patient and compassionate — as the other one was. I’m kind of on my own with this new one. But they serve a purpose, and you do what you can with what you have, so…

Anyway, since I’m now into my 10th year of active mTBI recovery, there are certain things I want to do, to commemorate the progress I’ve made. Like looking back at my past blog posts and elaborating on them. I’ve written a lot, in the past 9 years, and there’s still some food for thought there. I’d like to put that to good use.

So, I shall. And keep moving forward. Always. Onward.

It’s a new year — Happy New Year to everybody!

Let’s make it a good one.