Ah, Groundhog Day…

I have a feeling I’ve been here before…

I’m not talking about the recent event when the behavior of a groundhog (or groundhogs, depending on your regional preference) determines our future. I’m talking about the movie,”Groundhog Day”  where Bill Murray’s character goes through the same day over and over and over again.

This is my life in a nutshell. I cycle through the same experiences / crap / joys / sorrows on a regular basis, each time without much active recollection of how it was before and what my experience was then. It applies to the good things, as well as the bad things, and my neuropsych is repeatedly surprised that I’m wrangling with the same issues that I was wrangling with, several weeks, months, or even years ago. Sometimes I have “new” experiences that are repeats of what I experienced only the day before, and I have to go through the whole learning process all over again.

One example I can think of was back in December, when I had that business trip overseas. Each day, I got up with this terrible, terrible dread — almost crippling anxiety over what was going to happen that day. It was awful, and I literally did not want to leave my room. I just wanted to stay behind closed doors, where I had no interaction with anyone, where I couldn’t possibly screw things up, and where I could move at my own pace and not adapt to anything new or different around me.

And each day, I literally forced myself to get dressed and go out into the world. Each day, I rediscovered that I was able to communicate, that I was capable of understanding what others were saying, even if I didn’t get every single word, and that the world outside was something to be explored and discovered, not dreaded and avoided.

Then the next day when I got up again, it was back to battling the crippling dread, the fear, the anxiety… the monumental effort of getting myself OUT the door… and the happy discovery that I could indeed handle myself well in the world beyond the hotel room. And at the end of each day, I was able to kick back and really enjoy myself in that space, just reveling — all over again — in the “discovery” that I was really going to be okay.

Now I have another business trip coming up that will take me overseas. This time I am going to a country where I do not speak the language. I have been studying a bit, which has been kind of funny — I found some audio files to learn from, but when I started to listen to them, it turned out to be all “Stop or I’ll shoot!” and “Put down your weapon!” and “How many armed men are there?” — apparently a law enforcement or military training course. At least I know how to say “Don’t shoot!” if I get into any trouble while I’m on my trip. You never know… there are some pretty rough neighborhoods where I’m going.

Anyway, the point I’m making is that for some reason, I seem to have just a terrible, terrible memory for things that have happened to me before. This is true of good things… and bad things. I seem to get myself into situations, over and over again, doing the same thing and expecting different results, and then I suffer and chafe when things don’t turn out like I think they’re going to.

Like trying to get out of the house to get to work… Time and time again, I get up thinking that I can just take a little time to check my email and/or do some little things around the house, and then I’ll be able to get to work on time. And time and time again, I get sidetracked on one thing or another… and I end up rushing and being later than I wanted to be. I make up the difference at the back end, of course, staying late — even later than I would have to, actually, because I start to warm up around 6 p.m., and it’s hard for me to take a break when I’m finally making good progress. Even so, even if I do make up the difference in the hours, the simple fact is that I do this over and over again, thinking that this time it will be different.

Insane? Well, according to some, it is. Whatever you call it, it gets frustrating, and I feel like a complete idiot.

I guess part of the equation of this apparent failure to learn, is the fact that I have to stay very present in the current moment, or I can really lose my bearings. I think this 100% here-and-now mindset has developed over years of having to navigate so many issues — light sensitivity, noise sensitivity, exhaustion, vertigo, nausea, pain of all kinds, headache, distractability, and more — but still needing to be functional. I think I just developed the habit of focusing so completely on the present so that I could function in that moment, that everything else — before and after — just disappears. Or it never has a chance to get set in my mind.

I think also the stress of daily living over the years has impaired my ability to learn. Just having to deal with all the sh*t of my issues and symptoms and the screw-ups and the adjustments and the confusions and distractions… it can get pretty stressful, and I’m sure it’s had some impact on my ability to learn.

Then again, in other areas I learn extremely well — like this language thing. I’m actually picking up a lot of good stuff, and I think I’ll be able to at least ask people for help and understand basic numbers and directions, and be able to thank people for their help, without too much struggle. Languages seem to come pretty naturally to me, and it surprises me how much sense they make to me after a relatively short period of time.

So, it’s not like I’m completely disabled with my learning. But experiential learning? There, again and again, I end up going through the same things, as though it were the first time ever.

Well, I can’t worry about it. If I approach it like it’s a grand adventure of constant discovery, and I treat each situation like a fun opportunity to have a “new” experience, it’s fine. It keeps me fresh, actually. It keeps me interested in my life. It’s never boring — that’s for sure. The worst thing I can do, is treat myself this means there’s something wrong with me, that it means I’m somehow damaged. If I don’t judge myself and I just accept that about myself — and come up with ways to work with/around my very limited memory… and I don’t get it in my head that this means I have early-onset dementia and I’m losing my mind…. I can work with this.

Hell, I’ve been working with it for as long as I can remember. I just “get lost” sometimes and I have to find my way out of the shadows and dead-ends… which I can do pretty well. I’ve had plenty of practice, you see.

Anyway, life goes on. I have a number of very interesting projects I am working on, and that’s keeping me interested and engaged in my life. I’m learning new things pretty well, and I feel good. I also got a lot of sleep yesterday afternoon, after I was done with my work. I worked from home, so I was able to just crawl into bed when I was done for the day. That was nice. I got about 7 hours of sleep last night, so that’s good, too. And I have all day today and all day tomorrow to kick back and take care of myself. Because I’m flying out in another week, and I need to be healthy and whole to make this trip.

So it goes. Part of me would like to have a better recollection of the things that I have experienced in the past, so that I don’t keep making the same mistakes, and I don’t keep pushing myself and wearing myself out. And I’m thinking about ways I could do that — maybe keep a log of what works for me in different situations, so I can draw on what has worked for me in the past… I had that kind of a log going, about 3 years ago, and it was working well for me. I think maybe I need to resurrect it, so I can continue to draw on my experiences and get my sh*t together better than I currently am. It’s an idea….

Anyway, the day is waiting, and I’ve got to get a move on. It’s always interesting and never boring… and I need to remind myself of how things have been in the past, as I work through my present and into my future.

I’ve been here before, I’m sure… now I need to figure out how to make the best of it.

 

The benefits of ignoring bad advice – part 2

I ran out of steam the other night before I could really go into the benefits of ignoring bad advice – medical and otherwise. But that’s good. I’m paying attention to my energy levels, and I went to bed earlier last night than I have done in months. I’m still tired, but at least I got some rest.

Anyway, when I think about bad advice, I’m probably a poster child for ignoring it. Not – mind you – because I just don’t feel like doing what others tell me to, but because I usually do exactly as others tell me, and then I find out all too quickly that they’re full of sh*t and I have to change my direction… or else. I’m willing to try just about anything, especially when it’s suggested by a qualified professional. I guess it’s just my luck that the things they suggest are often the worst possible things I could do – and I have to find out the hard way that they’re completely wrong in my case.

Take, for example, the years I spent in excruciating, crippling pain, about 20 years ago. I suddenly started having terrible pain in my joints. It truly sucked. I also had a small patch of rough skin on my face that got dark. I went to a doctor, and they told me they needed to do some tests. So, they did their tests, and they came back with a diagnosis that was a very serious, relatively unknown ailment that people didn’t know much about at the time. They told me that was the reason for the rash and the pain, and I should see another specialist to help me figure out this serious situation.

Long story short, I spent the next several years not only in excruciating pain, but also living a life that was just a shadow of what I could have been living. I went to plenty of specialists and followed their advice, was compliant with their orders… and my condition just got worse and worse and worse. Until finally I did something that was not in keeping with their instructions – I went outside and got some exercise. And I stretched. And the next day I felt remarkably better. I continued to get exercise, changed the shoes I was wearing from hard soles to soft, and I stretched. I also quit smoking and started eating better. And wonder of wonders, the pain abated.

I can’t say it’s gone away entirely, and some days it’s back with a vengeance, but I’m not living in constant debilitating pain, day in and day out, anymore.

And I seriously question if their diagnosis was correct to begin with.

Now I realize that there are some situations where you should definitely NOT disobey your doctor’s orders. But if you’ve followed their instructions and things just aren’t getting better, you owe it to yourself to try something different.

Likewise with work (or, should I say, over-work?) My current job, I see now — after a frenetic year — is a setup for overwork. The two people I report to are on opposite ends of the spectrum, and their boss is out in a completely different spectrum, period. They either want EVERYTHING DONE RIGHT NOW, or they just don’t care if/when things get done. If I follow either of their leads, I’m toast. Seriously. Even though one reports to the other, they don’t seem to have any interest in behaving as though there is a chain of command. It’s odd. Why would they complicate things like that? Chains of command make some things — like getting work done — so much easier. I guess it’s a case of the person in charge not wanting to be the heavy… or maybe the subordinate person threatened to quit, and they know where bodies are buried, so they have to be placated. Or maybe everyone is just weak? Who knows. Probably the latter. Ocam’s razor strikes again.

Anyway, enough about them. I just have to follow my own lead, do what I feel is best, and trust that I know myself and my habits well enough to manage them properly. Of course, there’s always the chance of my “issues” showing up and getting in the way, but that’s nothing new. I just need to be aware of that and manage it.

But whatever I choose, in all things, I need to take care of myself. Make sure I get sufficient rest and exercise. Eat right. Don’t bombard my body with sugar and cheap carbs, and make sure I get away from the work, on a regular basis. Step outside. Get some fresh air. Stretch the gunk out of my bones and muscles. Do what makes me feel good and strong and keeps me going.

Just keep going. Take care of myself. Be smart. Keep going. So long as I do that, I have nothing to lose.

Why complain?

I’ve been thinking a lot about my work with my neuropsych, lately. My work has gotten past the basic survival stuff, where I’m just getting my head around what is going on with me. I’ve gotten to the point where I’m looking beyond my immediate issues and focusing on the big picture, to where I can make a difference in my own life — and possibly the lives of others.

I’ve always had a deep need to make difference beyond my own individual life, and so often my issues have gotten in my way.  Susceptibility to distraction and short-term interference… the anxiety that would come up and completely turn me around. And of course the anxiety is fed by the cumulative effects of that “TBI Cascade”:The Downward Spiral of Agitation and Fatigue

It doesn’t always happen like this, but the fact that it has happened in the past, makes me susceptible to anxiety about it happening again.

I think that’s the biggest thing hanging over my head – it happened before. Is it going to happen again? The fatigue, the confusion, the agitation, the busy-ness, the frustration, the pain, the distractability, the failure to understand, the failure to be understood. Anxiety over all this actually makes things worse, and it can be a real killer.

One of the ways that my neuropsych has helped me immensely is by helping me think through how to handle these things. The main thing they’ve accomplished is convincing me that I can handle these things. That I do have the resources and the capability to deal effectively with these problems. Before (as in, just about all my life), I would let them get the better of me, and I would get so turned around and upset by what happened — and the prospect of it happening again — that I would be completely thrown off track. Not good. Not good at all.

It didn’t help matters at all that people around me all treated me like the things that I had done and said in the past defined me in the present and also determined my future. What a load of crap. I see that now, but when I was 10 years old, being browbeaten by my father for being “stupid” and screwing up all over again, I couldn’t see that. The adults in my life couldn’t see it, and I certainly couldn’t, at that age. I mean, part of me knew they were all wrong about me, and I wasn’t stupid and retarded and mentally ill, the way they said I was. And I constructed a private world inside me (not unlike Marwencol) where I could be safe and act out in my own mind the kinds of scenarios where I was safe and secure and could be fully functional.

I had a very lively imaginary life, when I was younger. It was the one place where I could be safe and normal, and nobody gave a crap about the things I messed up. Nobody ever gave up on me in my imaginary place, they always gave me the benefit of the doubt, and I was always treated with respect and high regard by the imaginary personalities I invented  and interacted with behind closed doors.

Even up till the time when I started my neuropsych rehab, I was engaged with this imaginary world. I would have some great conversations with people in the car, driving to and from work. Some people talk to themselves. And I guess I was, except that my conversations were always directed towards another person who I imagined was there. That person would always be attentive and respectful and treat me like an intelligent individual. I didn’t have to constantly prove myself to them. Maybe I was talking to my “better angels”. But at least I was interacting. Some people don’t even bother to pretend. They just shut themselves off and don’t even try. Or they find solace in playing roles in the outside world that someone else invents for them. They aren’t really there and the roles aren’t really them, but they find solace in them, and they are able to function in the world as a result.

It’s like I was role-playing for life.

But anyway, back to complaining… I have to say, after working with a neuropsych for the past three years, I have found my physical issues to be much more manageable. Fatigue can be managed by just being realistic and mindful about my energy levels. And the pain has been greatly alleviated by reducing stressors in my life (not to mention exercising more and seeing a network chiropractor regularly for several years). So many of my really BIG physical issues — tinnitus, pain, balance problems, sensory sensitivities — arise from fatigue… when I manage my fatigue with common sense and responsible choices, many of them let up. And so many of my cognitive issues arise from the physical issues that arise from fatigue, so having a way of dealing with the fatigue and sleep problems and energy levels, that I get to solve a bunch of different problems by handling that core issue.

So, where does complaining come in? Well, basically, it comes into play when I am feeling hugely sorry for myself, and I am thinking that I can’t do anything about what’s going on with me. I tend to complain when I am over-tired and in this mindset that I am “stuck” with whatever bad situation is in front of me. Instead of doing something about it, I belly-ache and whine and moan about this, that, and the other thing.  And nothing gets done. Nothing changes.

Which is completely contrary to the truth of what is possible. The truth of the matter is that I do have the ability to change things. I can make different choices in my life that lead to different outcomes. I needn’t stay stuck in how things are, when they don’t serve me and my goals. Of course, in order to see that things don’t serve me, I need to know what goals I have, what I intend to accomplish, and how to bring that into being.

It’s all management issues. And when I get overwhelmed and tired and forget what I’m about, it can be all too easy to fall back into complaining-mode.

But why complain? Really? I have more power than I realize, to effect the kinds of changes I want to see in my life. We all do. The problem is when I/we get too fuzzy and foggy and overwhelmed with minutiae to develop a clear idea of what those changes can/should be.

That’s where long weekends like this come into play — an extra day to rest and rethink my life. I do a lot of rethinking on a regular basis. I have to back out of the busy-ness of the day-to-day and remind myself of what I want to do with my life, as a whole. It’s not just about what I want to accomplish at work, not just what chores I need to get done, what tasks I want to check off my to-do list. It’s about something much larger and more important, more lasting, more enduring, and ultimately more impactful, than just taking care of stuff that needs to be done.

Why complain, when I can create something far better?

Why indeed?

Then and Now – TBI Issue Management

Almost year ago, I published a list of 84 ways TBI can make your life really interesting, which is a list of 84 different issues that can arise as a result of a traumatic brain injury. I pulled together the list from a number of different reputable sources — books, websites, papers — and sorted them by type, from behavioral to communication to mental to emotional, etc.

The list itself actually dates back to about 2008, when I put together a list of all the issues I’d been having that I needed to manage. I’ve been using this list for several years, now, to monitor and track the things that make my life more challenging, and it’s really helped a lot — sometimes, mainly because it just reminds me that I have these issues and I need to be mindful of them.

It’s tough to manage things that you can’t see, after all…

But with things in plain view, I was able to manage. At first, it was tough, but eventually I learned. It took a lot of work and a willingness to be honest about what was going on with me — like any self-improvement work, I suppose. Except in my case, instead of it being “all in my head/heart”, I had some underlying neurological issues that played into the whole picture.

In a way, having the underlying neurological issues was a relief. I had felt for the longest time (30+ years) like there was something wrong with ME, for how I behaved and the ways I handled the world around me. I thought I wasn’t trying hard enough. Or I was being lazy. Or stupid. Or I was deliberately sabotaging myself. As it turns out, I was dealing with neurological issues which in and of themselves weren’t terribly severe, but which combined to exacerbate each other to the point where I was practically disabled in some ways.

I had plenty of talent and plenty of smarts, but contrary to all appearances, I couldn’t seem to get my act together. I had told myself for years that I was “choosing” to not employ my talents fully, when in fact I was constantly undermined by distractability, fatigue, anxiety, constant restlessness, agitation, chronic pain, and sensory sensitivities (to light and sound) that derailed me in times when I needed to be at my best. I was on a constant roller coaster of up and down emotions, taking two steps forward, two steps sidewards, two steps back, three steps forward, and getting all turned around in the process. Anxiety, not intention, determined my life’s direction, and I can tell you, I was going nowhere fast.

Even in those times when I was feeling like I was getting somewhere, I sometimes got hurt again, and then I had the setback of yet another tbi to deal with.

All the while, there I was, thinking there was something wrong with ME… I was a loser, I was a waste of space, I was a charter member of underachiever’s anonymous. And that sense was probably just as debilitating as any of my neurological/physical issues.

I wasn’t doing myself any favors by being so down on myself.

But when I started learning about TBI and started tracking my issues in light of my neurological situation and background, things started to really come together. I was also amazingly fortunate to connect with a neuropsychologist who believed (as I did) that the problems I had were “fixable” and they’ve been working with me to help me think differently about myself and my abilities, and see my whole life, not only my tbi’s, as an opportunity to learn and grow.

Once I quit blaming myself and being ashamed of my issues, a lot of my troubles started to clear.

But it wasn’t until I took a close look at what was going on with me and got honest about the havoc it was wreaking in my life, that I was able to DO anything about it.

I could have gone on indefinitely, telling myself — and the world — that “That’s just the way I am – you got a problem with that?!” Being constantly defensive about my limitations and difficulties and pulling out all the stops to justify them and defend my “right” to be a screw-up. It’s how I’d been living for close to 40 years, so why stop now?

Well, watching everything you hold dear go to shit, and realizing that you’ve got no foundation (financial, professional, interpersonal) to support your life has a way of forcing you to get honest. That’s why I stopped all the B.S. in my head. Plus, I was really tired of feeling like crap all the time, constantly wondering why nothing ever worked out the way I wanted/expected it to.

Anyway, I guess the bottom line is, you can’t fix something if you don’t know it’s broken. And getting past the idea that it was ME that was broken, rather than how my brain was working, was an important part of restoring my daily and long-term functionality.

Speaking of functionality, I’ve got errands to run. Have a good day, everyone. Stay strong.

 

I haven’t got time for the pain

I haven’t got need for the pain, either.

I confirmed something very important, this past week – if I do not exercise vigorously, first thing in the morning before I do anything else, I pay for it in pain.

For those who know what it is like to battle chronic pain on a daily, weekly, monthly, yearly basis, over the course of months, even years, you know what I mean, when I say, I will do anything in my power to keep this pain from taking over my life.

For those who are lucky enough to not have that experience, you can say instead, I will do anything in my power to keep [insert something you detest and despise] from taking over my life.

I happen to be one of the former types, plagued all my born days (at least, as far back as I can remember) with pain. Painful touch. Painful movement. Painful just about everything. The only times I have been pain-free have been in the extremes of human experience — when I am either so deeply engrossed in what I am doing that my focus blocks out any sensation at all… when I am pushing myself beyond my limits to see how far I can go… when I am so deeply relaxed and entranced that nothing of human experience can penetrate the divine aura that surrounds me.

In those extreme places, I am free of pain, I am more than myself, I am a piece of a very, very, very large puzzle that dwarfs discomfort with its vastness.

But one cannot always live in the extremes. I’m neither a cloistered monastic, nor a sheltered academic, nor a professional athlete, nor a maverick rock climber. I am a regular person with a regular life, and that life just happens to be fraught — at times — with almost constant pain.

Ask me if I have a headache on any given day, and my answer will not be “yes” or “no”, but “what kind of headache?” and “where precisely do you mean?” It’s a given, that my  head will hurt. And my body, too. It’s just a question of degrees.

At its worst, the pain is debilitating. 20 years ago, I had to stop working and drop out of life for about 5 years to get myself back on my feet. Over the decades since then, the pain has fluctuated, its impact on my life varying. The variation has been due, in no small part, to my mental determination to not let it stop me. In many cases, I refused to even acknowledge it, even though objectively I knew it was there. I went for years telling myself  I was pain-free, while at night I would be forced to stretch and press points up and down my legs and take plenty of Advil to get myself past the searing ache in my legs, hips, and back.

Denial is a funny thing — so useful, so essential, at times, and so easily used, even when facts to the contrary are obvious and intrusive.

Over the past several years, however, as I’ve become more and more cognizant of my TBI-related issues, pain has made itself known to me, and I have ceased to deny it. It’s a double-edged sword, that. Even if I don’t deny it and am determined to do something about it, my plans don’t always work, and I cannot always accomplish the level of pain control I would like.

In those moments when my honesty is far more than my ability to deal effectively with my discomfort, I curse my newfound determination to be upfront and frank about every little thing that is amiss with me. I have so many other issues to think about — do I need to add unstoppable, unmanageable, uncontrollable pain to the mix? Wouldn’t it make a whole lot more sense, to acknowledge and focus on issues I can actually fix?

But now that the lid is off Pandora’s box, there’s no sticking it back on. I have to address this pain situation, I have to do something about it. I cannot just sit around and boo-hoo. Nor can I run away from it and keep telling myself it’s not an issue. It is an issue. A very sticky, troubling, problematic one that holds me back, perhaps more than any other issue I have. It’s not just physical, it’s emotional and psychological, too. And it demands acknowledgement and work, to address it.

So, I do. I get up in the morning — like it or not — and I exercise. I roll my aching, complaining body out of bed, pull on my sweatshirt over my pajamas, slip my feet into my slippers, grab my clipboard and pen, and I haul my ass downstairs. I fill the kettle with water, put it on the stove, and turn the knob to 3 or 4, to give myself plenty of time to work out before the water boils. Then I pull the curtains in the room where the exercise bike is, so I can work out in private, put my clipboard on the magazine holder on the exercise bike, climb on, make a note of the time I started, and I begin to pedal.

I ride for at least 20 minutes — 15, if I’m really behind in my schedule — and I work up a sweat. I hate and resent the first 10 minues of every ride. It is boring. It is monotonous. It is sheer drudgery. But it is necessary. If I don’t exercise, move lymph through my veins (the milky white substance that moves toxins out of our systems doesn’t move on its own — it requires circulation to clear out the junk we put in), and oxygenate my brain.

After the first 10 minutes, my brain has started to wake up and is complaining less about the ride. About that time, I start to think of things I’m going to do for the day, and I start to make notes. I scribble on my clipboard, trying to control my handwriting well enough to read my notes later, and I make an effort to be careful and legible. On and off, I pick up my pace and push myself, working up a sweat and an oxygen debt that gets my lungs pumping. When I’m warmed up and getting into a groove, my mind wakes up even more, and I let it wander a bit — kind of like letting a squirrelly puppy off its lead when you take it for a walk in the park. I let my thoughts ramble, let my mind race here and there, and then like walking a puppy, I eventually call it back, focus once more on my day, and make more notes about what I need to accomplish.

When I’ve reached my 20-30 minute mark, I stop pedaling, get off the bike, and go check on my hot water. I turn up the heat, if it’s not already boiling, and stretch in the kitchen while the kettle starts to rumble. When the whistle goes, I make myself a cup of strong coffee, and while it’s cooling, I stretch some more. I drink a big glass of water as I stretch, feeling the muscles and tendons and fascia giving way to my insistence. I’m warmed up, after pedaling, so I can stretch more easily. I can move a lot better than when I got out of bed, and I’m actually starting to feel pretty good about doing this exercise thing, as soon as I get up.

Once I’ve stretched, I head back to the exercise room and lift my dumbbells. I work with 5 pound weights (for now), moving slowly and deliberately. I focus intently on my form — practicing my impulse control. I make sure my body is aligned properly and my motions are smooth and not stressing my joints and ligaments and tendons. There’s no point in exercising if I’m going to just injure myself. I do a full range of upper-body exercises, presses, curls, flys, extensions, pull-ups… all the different ways I can move my arms with my 5-lb dumbbells, I work into the third part of my routine. I take my time — deliberately, for discipline and focus and impulse control are big problems for me that really get in my way — and I work up a sweat as I hold certain positions and move far more slowly than I prefer.

When all is said and done, my legs are a little wobbly and my upper body is warm with exertion. I am sweating and a little out of breath, and my body is starting to work overtime to catch up with itself again.

By the time I’m done, my coffee has cooled enough to drink it, and I can make myself a bowl of cereal and cut up an apple to eat.  I sit down with my clipboard again, make more notes, review what I need to accomplish, and I get on with my day.

The days when I skimp on the effort and take it easy, are the days when I am in the most pain at the end of the day. The days when I really push myself with my weights, moving sloooooowly through the motions and keeping myself to a strict form, are the days when I have the most energy and am feeling the most fluid. The days when I don’t stretch very much, are the days I have trouble falling asleep at night. And the days when I do stretch are the ones when I am able to just crash into bed and am down like a log all night.

Two days, this past week, I did not do my workout full justice, and I paid dearly for it, the rest of both days. I learned my lesson. I haul myself out of bed, now, and I hold myself to a disciplined workout. Anything less gets me in trouble.

I’ve got enough trouble, without the pain on top of it. And if there is any way I can cut back on whatever complications I can, I’ll do what I can to do just that.

It’s hard to start, it can be tedious to do, and it often feels like an interruption to my morning, but without it, my day is toast. And I am lost at sea… floating in a brine of burning, searing agony that surely must have informed the medieval concept of eternal hellfire and brimstone.

And yet, something so simple can push back the waves, like Moses parted the Red Sea. Something so simple, so basic, so good for me. Salvation comes in strange packages, sometimes. But it’s salvation nonetheless, so I’ll take it.

After all, I’ve got much better things to do with my life than suffer needlessly.

Getting back into it…

I had a pretty rough weekend, and thank heaven it was a holiday. Gave me time to rest and recoup. I’ve been bothered increasingly by a lot of pain — “tactile hyperesthesia” I’m told it’s called. And it’s been driving me nuts. My clothes hurt me, any physical contact bothers me, and I have a hell of a time interacting with other folks who are demonstrative and like to reach out and touch you when they’re talking to you.

Times like these, I notice how tactile women are when they communicate. They reach out and touch you a lot more than men do, and it’s not only distracting, it’s also painful.

Small wonder, I tend to avoid the company of women unless there’s some structured activity going on. I’ve got nothing against women, but being around people who make a habit of making physical contact with you, when physical contact is painful, isn’t my idea of a great time. No matter how much I want to be around them, no matter how much I like them, no matter how much they want to be around me and like me, the simple fact of my sensitivities is distracting and uncomfortable and makes it very hard to interact.

With men, there’s less contact, but the ones with whom I have a good relationship also tend to make contact — handshakes, touching my arm or shoulder to get my attention, slapping me on the back… Ugh! The classic male prohibition against making physical contact with others might be poo-poohed in enlightened circles, but for me, it’s a huge relief.

The same goes for dealing with people in a highly structured corporate environment. Being in a working situation where roles are very clearly defined, and there is a code of conduct that everyone sticks with, no matter what, makes things that much easier to deal with in the course of each day. I’ve tried working for small companies and start-ups that had a more “family” feel to them. What a nightmare it was for me! Words cannot express. I ended up flaming out, several times, melting down and screwing up everything within reach, leaving those companies behind without any good explanation for why I was coming apart at the seams. The lack of structure and the “family feel” with its personal, intimate tone, seemed to be comforting for a lot of folks I worked with, but for me, it was a nightmare.

Me? I like an impersonal, detached corporate environment where nobody knows much of anything about each other’s personal lives, and nobody ever makes physical contact with each other. Call me stunted, call me damaged, call me asocial. That’s what works for me. Give me structure, and I get to be human. Remove that structure, and I start to unravel.

Anyway, I’m getting ready right now for heading out to become human at my massive multi-national corporate employer, meanwhile thinking about how to approach a new personal project I’m working on. It’s a program for tracking my issues each day. I had wanted to do it with one type of technology, but that’s turning out to be less fitting for my purposes. I need to use a different type of technology, a different programming language, which I have not been able to learn for the last 4-5 years. I started to learn it, around the time of my fall in 2004, but since then, I haven’t been able to make any headway.

Now it looks like I’m going to have to. I have no choice — this language is the only one I can use for my purposes. So, I have to learn it. And I’m freaked out. Because I’m not sure I can.

But I have to remember that I’ve recently taught myself the ins and outs of another programming language which had also eluded me for a number of years. And I am pretty proficient in it, by now. So, logically speaking, there is hope. I have to have hope. I have to believe — no, not believe, but actually know — that I have the ability to learn this stuff. Even if I have trouble reading and remembering what I read. Even if I have trouble following sequences. Even if I have trouble concentrating for extended periods of time. I was able to learn that other language. using my own learning style and a lot of unconventional approaches, and the only thing keeping me from learning this new language, is me and my reluctance to start.

So, I’ve got to start. Get myself back in the game. It’s the end of a long weekend, and the fall season is just around the corner. The five-year anniversary of my last TBI accident (and the 14-year anniversary of one of my earlier TBIs) is coming up.  I’ve been working my way back, slowly but surely, and things are looking up.

Life is good. I can get back.  And so I shall.

Connections between pain and PTSD

The past couple of weeks have been crazy for me, and it’s taken somewhat of a toll. I’ve been busy with work, busy with other activities, busy, busy, and more busy. I also did some traveling for about a week to out-of-state relatives, for a big family get-together. In and of itself, it was a great time. But the change in my schedule, the long hours of driving — over 30 hours, all told, in the car — not being able to get enough sleep, and the change in food choices (how do they eat that stuff?) all threw me off, big-time.

I managed to keep it together and not completely blow-out/melt down during the trip, or immediately afterwards, which often happens when I travel to this particular branch of the family tree. But the past few weeks have been packed full of crazy-busy-ness that I now realize has been a pretty concerted effort to dull the pain of the trip.

I’m not talking about emotional pain… though it’s never easy to spend time as an outsider, when everyone else is connecting and having a wonderful time being together — I’m the oddest bird in the family, and between my difficulties in keeping up with what’s going on around me and my narrow and intense interests that aren’t run-of-the-mill, people often don’t know what to do with me.

What I’m talking about is physical pain.

Yes, physical pain — the kind that burns, that aches, that throbs, that stings. The kind that makes my clothing hurt me, that rakes my legs when my pants rub against them… the kind that makes me jump whenever someone touches me… the kind that sends a shock wave of smacking ache to the marrow of my bones when my spouse puts their hand on my forearm… the kind that keeps me from sleeping, because I can’t stand the feel of sheets on me, but I also can’t stand the feel of air-conditioning blowing across my skin… the kind htat gets worse when I am stressed or tired or upset or all of the above… the kind that I often don’t even know is there until someone makes contact with me, and I jump, and they feel like they’ve done something to hurt me. They have. They didn’t mean to, and they would never do it on purpose. But they hurt me.

It’s not just the emotional pain of family visits that gest me. It’s the physical pain, as well.

Here’s the deal — for as long as I can remember, I have had issues with a whole slew of sensory problems, the most disruptive of which was body-wide pain. I can remember, ever since I was a little kid, feeling like I was being hit, when people would just reach out to touch me in very innocent, social, appropriate ways. I would shrink back from them, and they would often take offense or get angry with me for “rejecting” them. It sorta kinda messes with your head, when the people who love you the most cause you intense pain when they try to show their affection for you. And it tends to muck up your relationship with them, when you can’t accept their (appropriate) affection, but they don’t understand why.

To tell the truth, I didn’t even understand why. It’s hard to explain, unless you’ve been there, but the experience of painful touch is such a visceral, physical thing, it sometimes doesn’t translate into words. It’s just there. You can’t describe it, you can’t even really pinpoint it. Sometimes you have no idea it’s there, until someone makes contact with you. Then, all you know is, it hurts, and you pull away to avoid it, so you can just get on with your life.

And you do things to avoid/mitigate it. You steer clear of expressive people. You avoid demonstrative friends. You always keep more than arms’ length away from other people, just in case they reach out to you. You spend time with people who either don’t like you or couldn’t care less about you, because the chances of them touching you is small to none — and it’s easier to be around those types of people, than the friendly ones who like to make contact.

These things are done on a subconscious, instinctive level, and sometimes they don’t even register with you when you’re doing them. Like pulling away from people when they come close. Like shrinking back from a hug someone is trying to give you. Like jerking away quickly when someone touches you accidentally.

And depending on how sudden or shocking the pain is, it can trigger a whole cascade of other sensations/symptoms/reactions that look a whole lot like PTSD.

Over at Helpguide.org, I found this list of symptoms

Re-experiencing the traumatic event

  • Intrusive, upsetting memories of the event — memories of past painful contact tend to show up suddenly
  • Flashbacks (acting or feeling like the event is happening again) — yes, it does feel like it’s happening all over again
  • Nightmares (either of the event or of other frightening things) — sometimes nightmares do follow an extremely painful episode, tho’ that’s rare
  • Feelings of intense distress when reminded of the trauma — yes, it is intensely distressing to be reminded of it, it just sends me in a downward spiral
  • Intense physical reactions to reminders of the event (e.g. pounding heart, rapid breathing, nausea, muscle tension, sweating) — my heart sometimes starts pounding, I tense up, and I feel sick to my stomach, when people touch me, sometimes

PTSD symptoms of avoidance and emotional numbing

  • Avoiding activities, places, thoughts, or feelings that remind you of the trauma — I tend to avoid physical human contact of any kind; women frighten me, because they tend to be so tactile, and it’s literally too painful at times, to interact with them
  • Inability to remember important aspects of the trauma — I tend to block out the particulars of painful experiences. All I know is, it’s hurt me before, like it’s doing now
  • Loss of interest in activities and life in general — Why should I get involved, if it’s just going to hurt like the dickens?
  • Feeling detached from others and emotionally numb — Oh, yes… ’nuff said.
  • Sense of a limited future (you don’t expect to live a normal life span, get married, have a career) — how precisely am I supposed to live fully, if the experience of basic human interactions promises me pain?

PTSD symptoms of increased arousal

  • Difficulty falling or staying asleep — could have something to do with my insomnia?
  • Irritability or outbursts of anger — yet one more contributing factor
  • Difficulty concentrating — it’s tough to concentrate, when you’re on high alert. Especially if you’re working with tactile people.
  • Hypervigilance (on constant “red alert”) — someone might be approaching…
  • Feeling jumpy and easily startled — but of course

Other common symptoms of post-traumatic stress disorder

  • Anger and irritability — not being able to establish comfortable human contact makes me nuts and pisses me off
  • Guilt, shame, or self-blame — why can’t I just be normal like everyone else and tolerate a hand on my shoulder?
  • Substance abuse — been there. Thank heavens that’s behind me.
  • Depression and hopelessness — my occasional visitors
  • Suicidal thoughts and feelings — once upon a time, occasional visitors. Now, very rarely.
  • Feeling alienated and alone — not just feeling… BEING alienated and alone
  • Feelings of mistrust and betrayal — it’s hard to not feel that way, when everyone around you might possibly cause you pain
  • Headaches, stomach problems, chest pain — the first two, yes. The third, not so much

So there we have it — PTSD arising from chronic body-wide pain. Painful touch. There’s even a word for it — Allodynia (meaning “other pain”) — a painful response to a usually non-painful (innocuous) stimulus. I haven’t been formally diagnosed. That would require that I talk about it to my doctor. And talking about it out loud to anyone has never really been an option for me, except for with my last therapist who is long gone by now. It’s just too painful. Emotionally and physically.

I’d rather keep my own counsel and just live my life. Pain-free. Alone, but pain-free.

Being alone not only keeps me out of arms’ reach (literally) from people who may hurt me, but it also keeps emotional upheaval at a minimum. It’s hard to get worked into a state, when you don’t have much contact with people who affect you emotionally. I can block out all the politics and social drama pretty well. But the emotional connections I have with people… well, they’re trickier. So, I steer clear of them, by and large. And I steer clear of emotionally charged subjects with people — like avoiding talking about my chronic pain issues with my doctor.

It’s wild, how emotional distress can heighten physical pain. Emotional pain sets off an alarm state with me, and that alarm state unleases a whole avalanche of stress hormones and hypersensitive biochemical agents into my system. And the buildup of all the stuff that gets “stuck” in my system does not help me. Not one bit.

Over at Healthjourneys.com, Belleruth Naparstek quotes from her book Invisible Heroes and describes it well:

Chronic Pain Conditions
This constant activation of the alarm state leads to an accumulation of metabolic waste products in the muscle fibers, and the release of kinins and other chemical pain generators in the tissue, resulting in myofascial pain and the appearance of those seemingly intractable chronic conditions such as fibromyalgia, chronic fatigue, irritable bowel syndrome, chronic headache, TMJ and more.

And because these conditions are generated in the brain stem and the motor reflex centers in the spinal column, and routed through a perturbed, automatic, arousal circuitry, peripheral forms of treatment provide only temporary relief.  Constantly activated by everyday sensory cues, normal muscle movement and spontaneous memories, symptoms grow and become more and more entrenched over time.  In other words, this is one nasty gift from the kindled feedback loop that, if not interrupted, will just keep on giving.

Our epidemiology research has already shown us an astounding percentage of people with baffling chronic pain conditions and “functional” diseases that have no obvious causes, who have been found to have prior histories of severe trauma.  Probably if we could tease out the subset of traumatized people who experienced substantial dissociation during their trauma, and a truncated freeze response in the midst of it, we might find closer to one hundred percent suffering from posttraumatic stress.  Unfortunately for them, they are often assumed to be malingering or engaged in attention-seeking behavior for neurotic reasons, instead of suffering from a very serious, self perpetuating condition with a potentially worsening trajectory.

Included in this group of maligned and misunderstood patients would be scores of people suffering from pelvic and low back pain, orofacial and myofascial pain, genito-urinary and abdominal pain; interstitial cystitis; and the previously mentioned headache, fibromyalgia (FM), chronic fatigue syndrome (CFS), and reflex sympathetic dystrophy (RSD); irritable bowel syndrome (IBS), inflammatory bowel disorder (IBD), multiple chemical sensitivity (MCS) and migraine.

And there it is — in part, anyway. The post over at Belleruth Naparstek’s blog asks Is There a Connection Between Fibromyalgia and Traumatic Stress? but it’s not just about Fibro, to me. It’s about the “and more” she mentions. It’s about the “whole lot more”.

So, what the hell can I do about this? I’m of the mind that the best reason to talk about anything difficult, is to figure out what to do about it to make it better. To reduce the quotient of human suffering in the world. That includes my suffering (I’m in the world, after all). What can I do about this pain business?

Well, first, I need to get back on my schedule. I need to get back to my sleeping routine, which I’ve been doing pretty well with. I need to get back to eating the right kinds of foods at the right times of day — and I’ve been doing that pretty well, too. I also need to exercise and do other things that will enable me to discharge some of the built-up stress from the trip. I tried explaining to my new therapist how disruptive that sort of travel is to me, but they didn’t seem to “get” the intensity of it, so I’m not getting much support there. Screw it. I’ll support myself. I’ve been having a lot of good long cries, in the privacy of my own company, over the past few days, and that seems to be helping me. I also need to get back to my regular work schedule and just get some stuff done. Being productive has a way of chilling me out nicely, so I’ll do that.

And drink plenty of water. Take some Advil before I go to sleep. Listen to the Healing Trauma CD from Belleruth Naparstek to deal with the PTSD. Have a good cry. And another. And another. And make sure I let loose in my own company, away from others who neither understand nor want to understand just how hard things are for me… and end up minimizing and negating and invalidating my feelings about what I really go through, and tell me I’m fine and I don’t have a problem and I shouldn’t worry about this stuff,  just because they either don’t have the emotional resources to hang with me, or they’d be too traumatized, themselves, if they knew what it’s really like to live in this body.

Most of all, I need to keep it simple. Count my blessings. Remember just much good there is, along with the bad. And remember, tomorrow is another day, and all things considered, I’m pretty lucky to be alive.

The perils of pseudo-psychological problems

Something has occurred to me repeatedly, over the past month, as my sleeping habits have improved. Namely, that many of the “mental health” issues I’ve been experiencing over the past several years, have had a distinctly physiological component to them. In fact, at the risk of sounding radical, presumptuous, and heretical – though I’m seldom reluctant to be just that 😉 – I suspect that a ton of my “psychological” issues have actually been physical ones.

I’m sure I’m going to really piss off some of the psychotherapists in the room by saying this, but I have to say that catching up on my sleep and figuring out how to get a full night’s sleep more than one night in a row, has done more for my mental health than two years of therapy.

And no, I did not have a bad therapist. They were great – awesome – and they really helped me a great deal, if only by sitting there and not making fun of me when I talked about this and that.

But let me tell you – as a TBI survivor who had/has a whole raft of physical ailments (chronic pain, insomnia, sensory hypersensitivities, weight fluctuations, heart palpitations, vertigo, tinnitus, and more…), just living with all those issues can really mess with your head. And as long as only the symptoms of my physical distress were being addressed, not much moved.

I did get in touch with my feelings. That’s for sure. I figured out that I actually mattered, and that it was important for me to take care of my own health and well-being, not constantly do the martyr-hero thing and sacrifice my own safety for the sake of others. I had space to learn to look at myself and my life through a less negatively critical eye and consider that maybe, just maybe, I had a right to do more that survive in life. I had/have a right to thrive.

But one of the things I really got in touch with was the fact that my physical well-being is a huge contributor to (and predictor of) how well my mental well-being holds up. When I’m tired and in pain and weak, my ears are ringing like the dickens, and my head spins wildly and I feel like I’m going to fall over every time I move, it’s pretty damned difficult to maintain a positive mental outlook and count my blessings. When I’m not feeling well physically, the chances of me feeling well mentally and emotionally decrease exponentially.

There are some people who manage to keep a cheery, chipper outlook, despite significant physical issues. I’m usually one of those  people, and I usually manage to not let my physical problems bother me. But when I haven’t had enough sleep for weeks and months on end, chances are pretty good that I’m going to feel depressed, anxious, irritable, low — and show other signs of clinical depression.

Okay, so here’s the thing — when I was in therapy with my prior therapist, they repeatedly came back to the suspicion that I was depressed. They asked me a number of times if I thought I was depressed, and if I’d said “Yes,” I’m sure they would have followed up on that, however a therapist does that. And they probably would have plumbed the depths, looking for what it was that made me depressed — some repressed past trauma, some childhood violation, some incident that I’d blocked out to keep from being unhappy.

And lots of talk would probably have ensued. Talk, talk, and more talk.

Now, talking is all very well and good, but as Belleruth Naparstek said at a conference I once attended (and I believe she’s said in her book “Invisible Heroes”), sometimes talking does more harm than good, by dredging up old traumas and forcing you to relive them. That can be very unpleasant, as I’m sure everyone is aware. And for me it’s really problematic, because I prefer to dwell on problems with a solution in mind, and if I’m dwelling on a past incident which cannot be changed (it’s already over and done), I get even more agitated and irate over it.

Some people might say that I’m just not willing to deal with the emotional fallout of misfortune, but I say I’m a solutions-oriented individual and the main reason I think about things, is so that I can change them, so why in the hell would I spend all this time thinking about stuff that cannot be changed? The therapists in the room who would say I’m emotionally “blocked” would probably try to treat me… with more talking about shit that makes no sense for me to talk about.

Make no mistake — I’m not at all reluctant to discuss misfortunes I’ve experienced in the past. But any discussion that takes place with me, has to be about devising solutions and coping mechanisms for the problems I have as a result. I’ve had some really shitty things happen to me, but you know what? It’s over, and I’ve managed to forgive just about everybody in my past for their shortcomings… even myself. The problem is not that I’m represssed. It’s that people want to process the wrong type of stuff with me — problems, problems, and more problems — and my reluctance to discuss stuff I’ve already been through a thousand times in my head is interpreted as repression or avoidance or some other psychological/emotional impairment.

What’s more, when pressed to explore the nether regions of my soul with talk therapy, I tend to get turned around. As good as I am at writing, I’m can be kind of pathetic when it comes to spoken conversation. I have an intensely visual mind, which follows conversations and spoken communication with series’ of images that are like an associational, disjointed movie in my head. I literally see pictures of what people are talking about, and when people start talking about things for which I have no picture — or I have several of them to choose from — it takes me a while to catch up and keep up. It’s not that I’m stupid. Or that I’m slow. I’m just incredibly visual in my own mind, when it comes to spoken language, and visual processing doesn’t lend itself as well to spontaneous conversation.

So, when I’m talking to someone about what’s going on with me, and they start talking about things that aren’t immediately famliar to me — or that I’m not expecting them to talk about — it’s really easy for me to get agitated and introveted. I need time to catch up. I need time to keep up. I need time to translate their words into pictures and process the information visually, so that I can make sense of what they’re saying to me. But I don’t always have that much time, and over the course of my life, I’ve gotten into the bad-but-pragmatic habit of just pretending I know what’s going on, while making mental notes in the back of my mind about what was just said, so I can go back to it later and rethink it all and hopefully make sense of things.

The problem is, in a therapeutic situation where I’m supposed to be making some sort of progress and addressing issues, this really works against me. It tends to make me look reticent and/or like I’m deliberately withholding. I’m not — I’m just trying to process the information and make sense of it. Believe me, if I could answer immediately like other people, I would. But my brain just doesn’t work that way.

I also tend to get really frustrated with myself and get agitated, which looks like I’m uncomfortable talking about certain things. It’s not that  I don’t want to let other people in. I do — more than I can say. But I get so turned around in my head, and I get so upset with myself for not being able to follow, that I start to flail and spin and then shut down. I feel like I’m getting backed into a corner, and I get revved… and by the end of the session, I look like a totally basket case who needs to spend years sitting across the room from someone, before I can get in touch with my feelings.

This sucks on so many levels, I can’t even begin to tell you. The worst thing of all is having someone who is supposedly trained and experienced in these matters misunderstanding, miscalculating, misdiagnosing, and mis-treating conditions which don’t even exist the way they think they do. On the surface, you’re exhibiting classic signs of clinical depression and post-traumatic stress disorder, but underneath it all you’re struggling for words that will explain exactly what is going on with you, and why you’re acting the way you do. And the bitch of it is, because you’re the (sick) client and they are the (trained, experienced, licensed) therapist, you’re not in a position to be taken totally seriously when you do manage to tell them a little bit about what’s up with you. ‘Cause they think you’re seriously mentally ill and you can’t possibly know what your real problems are.

After all, you probably have no recollection of what that nasty-ass uncle did to you as a toddler when your mother’s back was turned.

It’s a problem. I hear plenty of stories about therapists who don’t know  what they’re doing… as well as those who know very well what they’re up to but have no scruples or morals. I hear plenty of tales about over-prescription of medications, as well as  misdiagnosis of mental health issues that have more to do with fundamental differences of information processing, than pathology. The mental health profession has been pathologizing the diversity of human experience for as long as it’s been around — perhaps that’s a hallmark of any helping/caring profession that’s trying to get on its feet. Applying labels like “hysterical” or “deviant” or “sick” to people who are just different from the norm is a time-honored tradition in the mental health field, so there are no surprises there. But it’s a problem that’s been shifting and changing over the past 30 years, and that’s a good thing.

Now, if I can figure out a way to explain to my new therapist the nature and degree of my physical issues, so they can see my issues in light of my insomnia, pain, and physical sensitivities… and not spend an inordinate amount of time focusing exclusively on my past emotional trauma, that will be a good thing.

Shoring up my reserves

It’s been a really rough 24 hours. I finally got to a breaking point, and melted down in a huge screaming/crying jag last night. I just ended up pushed over the edge by my fatigue and exhaustion and being overloaded by a lot of extra issues, including homeowner concerns — maintenance, upkeep — and health problems.

My newest concern is not having adequate dental coverage. It’s a huge added stress in my family that I know I need to rectify. Dental bills can run into the many thousands, as Judge Sonia Sotomayor can attest (she’s got $15,000 in back dental bills according to her personal financial records), and it doesn’t feel good, even in terms of hundreds of dollars. I’m not over my head in hock over dental bills, at this time, but I could get there quickly, and I need to arrange for coverage, so I don’t get to that place.

But the prospect of doing that drives me nuts. I get so turned around and confused by all the information, and then I never know if I’ve made the right decision, and I’m afraid I’ll end up paying all this money and making decisions that can’t be reversed very easily. I know I need to keep my head on straight about this and not panic. I just need to figure out how to do it, map out my plan, and do it. But I haven’t been able to manage that. I’ve just been kind of marginal, lately, and I haven’t been able to get a lot of the things done that I need to.

So much of this TBI business really is about having adequate resources to deal with what life throws my way. Whether it’s learning new things at work, handling odd jobs around the house (which I’ve been lagging at, too),  or arranging for medical/dental coveratge, how rested I am, how involved I am, how strong I’m feeling all have a huge role to play. And my resources have been slowly but surely eroding away, over the past while. I haven’t been sleeping well for months, now, and that makes it difficult to handle much of anything. My temper’s short, I don’t get the things done that I need to, I tend to push off all but the most exciting and interesting activities (which means I push off about 85% of what I’m supposed to be doing), and I have trouble learning and processing information.

For a while, there, I was pretty intent on keeping my sleep deficit to a minimum. But then I got sick of having to live such a limited life, always going to bed at a responsible hour, sleeping a full 8 hours (or at least 7), and being very deliberate about everything I did.

How boring!!! I didn’t want to have to tip-toe through life, always anticipating everything I did and said and thought, and adusting my behavior to be nice and acceptable. Plenty of other people wing it, and they’re fine. And I’m sure a lot of people out there have sustained TBIs and don’t even know it. Does that stop them? Not always. Sometimes… maybe lots of times… But it seemed to me — and it still does — that life is a messy prospect, at best, and in the end I’ve always been more of a creative bohemian type, even if I am a software engineer, so I’d much rather enjoy my life and be flexible and keep up my activity level and have a good time and do things that interest and uplift me, instead of playing it safe all the time and being so careful about every danged thing.

It was such a relief, to just stay up past my 10:00 bed time and watch a good movie till the end, without needing to watch the clock. It felt so good to just get up first thing in the morning – around 5:00 or so – and futz around with this personal resources management program I’ve been designing. It felt so great to not be tied to a schedule, to not force myself to be on some hour-by-hour time-clock, day in and day out. Maybe that works for some people, but it doesn’t work for me. It works for maybe a few days, but then it starts to break down, and my self-management techniques turn out to be more of a burden than a help.

Of course, I’ve found out the hard way (again…) that I can’t keep driving and driving and driving myself. Even if it’s all fun(!) I need to pace myself and give myself time to recharge. Last night, I headed off to bed at 10:30, and I got to sleep around 11:00. And I slept till about 6:00 this morning. Seven hours is the longest I’ve been able to sleep in weeks — I usually clock in around 5 or 6. I don’t know if it’s that pineal cyst that’s throwing me off, or it’s my stress level, or it’s my pacing during the day.

I know I’ve been spending too much time, late in the evening, on the computer. My diagnostic neuropsych tells me that computer screens emit light that is very similar to daylight, so our bodies think it’s day, and they need to wake up. That could explain why sitting down to my laptop in the evening always makes me feel better. And it could explain why I have a hard time winding down later in the evening when I log off. I know I need to change that. It’s not like I don’t have anything else I could be doing. Relaxing is a lost cause with me — I’m also in a lot of pain, these days, so unless I keep my mind busy, I am in a lot of discomfort. But I can find other things to do that relax me, don’t get me all charged up. Things like washing dishes or folding clothes from the dryer. Things that need to get done, boring or not.

It could also be that I’m so tired, I can’t rest — which is what happens with me. I have to do something extra-ordinary to drag myself (kicking and screaming) into slumber. Left to my own devices, I’ll just keep going…

I think this weekend is going to be a Benadryl weekend. I don’t have any outside commitments that are overly demanding on my cognitive abilities, so I’m going to just take the drugs and sleep as long as humanly possible.

With any luck, by Monday, I’ll have gotten at least a little bit back on track.

A Perilous Relief – The Physical Backdrop(s) of My Risk-Taking Behavior(s)

At the risk of sounding like I’m sitting around feeling sorry for myself, let me tell you about my physical experience. I don’t want pity, I don’t want clucking of tongues, I don’t want you to feel sorry for me. This is just my experience, and I’ve acclimated to it over the years. But I’d be lying, if I told you it’s easy…

To fully appreciate just how my risk-taking and danger-seeking constitute attempts to soothe my overworked physical/mental/emotional system, you’d have to understand just how anxious, sensorily overloaded, and painfully sensitive I tend to be. And you’d have to understand the impact that repeated injuries, including head injuries, have had on my everyday life. I have, in fact, sustained numerous mild traumatic brain injuries since age 7, the experience of which is consistent with my sensory and other physical issues. (See http://www.traumaticbraininjury.com/content/symptoms/mildtbisymptoms.html for a list of mild tbi symptoms.)

All my life, I have had issues with pain and handling sensory input. As a child, I had a hard time differentiating between different sounds, but at the same time, my hearing was very sensitive. I was very attuned to fine details, and I was highly distractable. I experienced touch as pain, which caused many forms of regular human contact to be uncomfortable, even painful for me. I was not very limber, I had trouble touching my toes, and doing exercises like somersaults was difficult. Cartwheels were out of the question. I was an active child, and I loved to climb and play and join in with games, but my coordination wasn’t always the best, and I was often picked last for team games in school.

I loved to play sports, but I didn’t have a very broad range of abilities. For example, I loved to play softball. I loved it so much, that I wanted to become a professional softball player, when I grew up. Baseball didn’t appeal to me, because having a small, white object hurled at me scared the bejesus out of me. I had a hard time judging distance and speed, and the larger, softer softball wasn’t nearly as frightening to me.

There were a couple of problems with my pro ballplayer aspirations, though. The first was, I had a hard time catching fly balls. When my dad would practice with me and hit flies to me, I couldn’t judge the distance to the ball, or I shrank away from it in fear. My preference was to let the ball drop and then pick it up and throw it to another player. But that kind of choice-making in a serious ball game would have cost my team dearly.

Playing the outfield was not an option for me.

Sliding was out of the question. I was to hesitant and too gawky to do it very well. And the pain that came afterwards was inhibitive, whenever I considered sliding.

I couldn’t react quickly enough on the spot to play shortstop.

My coordination issues kept me from being a very good baseman. My reaction time wasn’t consistent, and my ability to catch and tag wasn’t very good. I wanted to play shortstop, but it made me too nervous, and I couldn’t think and react quickly enough to make a very good player at that position.

I made up for all this by throwing myself wholeheartedly into the small range of activities I could do well. I had too much trouble with fielding and reacting quickly to be an all-round good player. What I could do, was play third base, hit, and be a good team captain. Third base was a kind of in-between position that was half-baseman and half shortstop, that let me be in the infield, but in a more marginal position. I was a pretty decent batter, and I also learned I could switch hit. I’m right-handed, so I always thought that I should bat right-handed. But I actually found that I was better able to bat left-handed. It just felt so much more natural to me. Most of all, I was a good team leader — a captain who led by the example of just throwing myself into the game and doing my best at any and all times, even if I messed up, now and then. I think, if anything, my spirit helped the team more than any amount of technical skill.

But still, it wasn’t easy to come to terms with the fact that I just didn’t have what it took to become a professional softball player.

When I was young, there wasn’t really anything like a diagnosis of sensory integration dysfunction or sensory perception disorders, and attentional challenges weren’t yet on the radar. All I know/knew was, I was immersed in a seething cauldron of sensory input and there was really no escape.

I’d like to say things got better when I grew up, but I can’t say that’s so. All I can say is, I’ve gotten used to these problems, which doesn’t make me very happy, actually. But there it is.

Below is a run-down of the persistent physical issues I’ve had to deal with most of my life, and that still plague me intermittently. I’ve tried to be as thorough as possible, so you can get an idea of the scope and intensity of my “sensory landscape.” These issues can range from mild to extreme, and they manifest with varying degrees of frequency. I do not experience all of them simultaneously, but many can appear concurrent with others.

Ringing in my ears (tinnitus)

I have a constant ringing in my ears. I’ve had this as long as I can remember. It used to drive me crazy as a teenager, but eventually I got used to it. It’s a high-pitched whine, not so much ringing — a very thin, reedy, penetrating whine “over” several other deeper tones. It rarely goes away. If there’s no ringing when I wake up, it usually starts by mid-morning. It’s worse when I’m tired and/or stressed and/or have allergies. It’s better when I’m rested.

Vertigo, Dizzy-ness, Light-headedness

I have occasional feelings of being “woozy” and/or losing my balance suddenly. Sometimes it can last for a day or more. Sometimes, when it’s really bad, it lasts for days — nearly a week, in the past. I have to be very careful that I don’t fall, when it’s particularly bad. Holding onto things, keeping myself rigidly upright and intently focusing my attention on something in front of me helps. Tactile activities help me focus — holding onto things, making contact with things around me, like fabrics and curtains, arms of chair, objects held in my hand. It’s much worse when I am tired, and when I have allergies, it’s worse. It gets better when I’m rested, but it usually takes at least a day or so to clear up, even when I am rested.

Balance (Vestibular) details (when they’re at their most extreme)

When I’m experiencing “vestibular challenges,” the whole world spins wildly around me… swaying and shifting. Every time I move, no matter how small the motion, I feel like I’m going to fall over. I cannot move my head without being overwhelmed by waves of nausea that wash over me in progressive swells. When I turn my head this way or that — I never know when, or which way — there is a swooshing sound in my ears that is sometimes accompanied by pressure and pain. My ears hurt me with a dull ache that’s sharp at the center… like thick sticks that have small points being pressed into my eardrums. My stomach lurches, and my head pounds with a sick headache. A whining, whistling, high-pitched roar fills my ears, and through the intense ringing, I hear muffled sounds that annoy me with distraction. Even when I stop and hold still, the sense of imbalance continues, like a bucket of water that’s been swung to and fro, sloshing back and forth for a while, even after it’s set down on a level surface.

Going about my everyday business, I sometimes have a sudden sense of falling that eclipses and overrides all other sensory input in my system. The room spins, my legs become weak, and my head swirls in sickening waves of disequilibrium. The walls seem to move before my very eyes, the floor rolls beneath me, and my body feels like it’s swaying. For as long as the feeling lasts, I cannot think, I cannot talk, I cannot react to anything around me. I cannot hear or see much of anything around me. I’m dimly aware that there are objects or people nearby, but they don’t register. I’m faintly aware that people are talking to me, but I cannot respond immediately. All I can do, is try to right myself, try not to fall, try to fight back the waves of sickening vertigo, and hang on, till the nausea passes.

My condition does not seem to respond to “standard treatments”. I’ve tried ear drops and anti-vertigo medications, and they did nothing for me. I also wish I could just write this off as a simple balance issue and have that suffice. But there’s a whole lot more to my situation, than being off-balance. Vestibular issues are just the beginning.

Coordinated Balance (“Proprioceptive?”) Issues

I also have issues with sensing where my body is in relation to the world around me (“proprioceptive” issues). These tend to kick in most intensely when I’m off-balance. I cannot feel where my body is in relation to things around me, and I bump into objects all the time — corners of tables, sides of counters, chairs I’m passing… I also knock things off flat surfaces, if they are too close to the edge. I have a hard time gauging how quickly my body is moving in any one direction, which can cause me to misjudge distances and be uncoordinated. I fumble at picking up objects, I drop things I’m holding, and I tend to have trouble judging distances between myself and others. I also inadvertently bump or hit people when I’m just trying to reach out to them or move past them. When I’m trying to keep my balance, I tend to (for lack of a better word) “proprioceptively overreact,” which makes me either bump into things and people around me or shy away from them abruptly, neither of which is interpersonally optimal.

Hearing

My hearing is also affected by my simply not being able to pay attention to anything but staying upright and not running into things. I can be so intent on trying to stay balanced, that I don’t hear anything around me immediately. I’ll hear things, but they don’t immediately register. And when they do register, I’m often so far behind in figuring out what’s going on, I get the message turned around and am not successful in responding to what I’m hearing right away. When I’m really struggling to navigate contact with the world around me, it can take a few minutes for sounds to sink in and be processed in my brain. I hear them, but I don’t process them immediately. This can be a problem when someone is talking to me. I won’t hear them for a few seconds, and then when I do hear them, I am so busy trying to figure out what they just said to me that I miss what I am able to hear. This is less than optimal.

One of the most annoying and disorienting auditory aspects of my bad days is the whooshing sound, which comes and goes when I’m “off” — sometimes quickly, sometimes gradually. I can rarely predict when it’s going to happen (although during allergy season it is usually more pronounced). It often takes me by surprise and thoroughly distracts me from what I’m doing. I’m usually so caught up in going about my daily business, I don’t notice the dull roar or the achy pressure or even the whooshing sound until it’s unmistakable. And when I finally hear this whooshing sound, I tend to feel nauseous and dizzy. I seem to associate it with feeling lightheaded and sick on my stomach, and whenever I hear it — whether I’m nauseous and dizzy or not — I cringe. I freeze. My rest of body seems to remember what it feels like to hear that whooshing sound, and it reacts accordingly.

Sight

My vision can be affected, too. When I’m off-balance, and I’m not well in-touch with the world around me, my vision gets “re-assigned” to the task of helping me keep my balance. It’s hard to describe, but when I’m “off,” I can visually detect things around me, but I don’t readily process what that means. It’s like with my hearing — I know I’m seeing something, but my brain is too busy trying to figure out how to just keep steady and parse out all the input coming in, to interpret what that something I’m seeing is.

Probably the best quick example I can give of this, is from a time when I was driving through a parking lot, and I literally didn’t see another driver, who nearly hit me, and I didn’t hear him honking his horn at me, until I was nearly out of the parking lot. I was at an office supplies store, and I’d just bought myself a new headset for my cell phone, so I could drive hands-free and still talk on the phone. I try to avoid talking on the cell phone while I drive, but I was hoping that a headset might let me at least be able to accept incoming calls without being a hazard to other drivers.

I sat in my parked car for a few minutes, figuring out how to put the headset together, then I placed it on my head, positioned the mic in front of my mouth, and slowly pulled out into the parking lot. As I was rolling towards the exit, I noticed that a car was pulling out of a side lane just ahead of me. The headset felt like it was slipping off my head, and the microphone wasn’t staying in front of my mouth. My attention was focused intently on the feel of the headset on my head and the mic at my mouth.

As though in slow motion, I saw the front of the other car inch out into my path. I didn’t slow down, but continued to drive towards the exit. The headset felt strange on my head, and I could hardly think of anything but keeping my head straight. The front the other car was rapidly approaching the driver’s side front fender of my own vehicle, but I continued to drive on. I didn’t veer, I didn’t slow down, I didn’t speed up. I didn’t react at all — I just drove on. Only dimly was I aware that I had barely slipped past the front of the other car and avoided a collision. It never occurred to me that I should react in some way. It never occurred to me that I should interact with the other car.

As I continued to coast towards the exit, I could hear a beeping in the distance. The headset on my head continued to bother me with its pressure on my one ear and the feel of the microphone near the side of my cheek. The mic wasn’t pressing against my skin, but I was keenly aware of its proximity. I really felt like I was losing my balance, and I held my head absolutely still to keep the apparatus properly positioned. The beeping continued, and I wondered if someone’s car alarm had gone off. But the sound wasn’t rhythmic or regular, so it must have come from somewhere else.

I looked in my rear-view mirror, and I saw driver of the car I’d narrowly missed yelling and beeping his horn at me and wildly gesticulating, pointing at his head. At first, it didn’t sink in, that he was communicating with me, but when I looked up again, I realized that his behavior was directed at me. And he was furious. The headset kept slipping off the side of my head, ever so slightly, but enough to distract me.

Realizing what was going on around me, at last, I tore it off my head and threw it on the passenger seat beside me. When the headset was off, it was as though the lights went on in a dark room, and someone suddenly turned up the volume on life all around me. I could suddenly see. I could suddenly hear. Suddenly, I wasn’t sitting in an enclosed cell with a headset on, I was driving a car in a parking lot. I got out of the parking lot as quickly as I could, merged into traffic, and went back to work, shaken but grateful that I hadn’t done any damage.

I haven’t used that headset at all, since I bought it.

My vision and hearing aren’t the only senses that get “whacked” when I’m out of sync. My taste and smell do, too. My sense of smell tends to be either all-on, or all-off. It’s very rare that I smell something “normally” and can take deep breaths of scents, like perfumes or foods. If I get too strong a whiff of something, it makes my head spin and really overloads me. And if I’m already off balance, or I’m not connecting well with the world around me, my sense of smell sometimes completely turns off. My sense of taste is even less predictable. It’s muted and vague, and I often judge the foods I like more by their texture, than by their taste.

Touch – Pain

My sense of touch is quite variable — like my sense of smell, either it’s all-on, or it’s all-off. I can literally slam into things, and never feel the impact… sometimes I don’t know I slammed into something until I see the bruises on my leg the next day. But my sense of touch in my hands is very active. When I’m feeling nervous or agitated, running my hands over objects — like the interior upholstery and surfaces of my nephew’s new BMW — is very soothing for me. I’ve always loved satiny fabrics, and when I was a kid, I couldn’t fall asleep unless I rubbed the satin edge of my blanket. I rubbed that smooth, soothing edge so long and so often, I wore a hole in it!

On the other hand, I can experience a lot of tactile discomfort. A simple human touch can feel like a blow to me, and when people put their hand on my arm, sometimes it feels like they’re smacking me. Hard. It’s very strange and difficult to describe, and it makes me very uncomfortable to talk about it, but I experience pain and discomfort from things like clothing, hugs, harmless social touches, and jewelry. I don’t wear any bracelets or extra rings or necklaces, or even a watch, because the contact tends to be very uncomfortable — and distracting — for me.

There are a number of different kinds of tactile discomfort I experience. They are not like muscular pain, but are very much on the surface and localized in my skin surface. Here are some details and descriptions:

Burning – It feels like being burned with a hot coal(s), like embers are laid on top of my skin and are burning down through to the bone. This occurs often on my upper arms and across my shoulders and back. It’s usually worse when I’m tired or have a lot of stimuli coming in on me, and its origin is internal in nature (I’ll call it “autonomic”).

Twisting – It feels like I’m having my skin twisted by two hands having a firm grip on my skin, and twisting in opposite directions (like the “Indian burns” we kids used to give each other). It is mostly on my outer forearms and wrists, and it’s worse when I’m tired or stressed. (Autonomic)

Healing burn – It feels like having second-degree burns that are healing under my skin – not on the surface, not down at the bone, but just under the surface of my skin. This occurs mostly on my outer forearms and wrists, and it’s aggravated by having long sleeves. It’s usually worse when I’m tired or have a lot going on around me. (Autonomic)

Chafing – It feels like being rubbed by by a rough surface – either a piece of rough material, or in some cases, a surface that is a little sticky or ‘grippy’ and pulls my skin a little as it rubs. Some people talk about “sandpaper” type of pain, and this might be close to it, but it’s not exactly. It sometimes feels like a moist, tacky texture being rubbed across my skin. I experience this mostly on the tops of my thighs, aggravated by my slacks. Sometimes I feel it on my arms, and it’s aggravated by the touch of light clothing. (Autonomic)

Prickling – This feels like being jabbed with little tiny pins over an extended area. It’s somewhat similar to “sandpaper” type of pain, but not exactly. It sometimes feels like coarse sandpaper against my skin — not rubbed across it, but held in place, so it irritates me with its presence, but it doesn’t rake. I usually experience this when my clothing brushes my forearms and wrists, also happens without prompting on my upper arms and across my shoulders. (Autonomic)

Blistering – It feels like my skin is blistering and cracking, like paint cracking in the sun, or my lips cracking from being chapped. It usually happens when I am just lying still and trying to relax, like when I’m in bed and trying to sleep. The more I relax and just breathe, the more my skin feels like it’s blistering and cracking and peeling. It happens when my skin is exposed to the air and doesn’t have anything over top of it. It’s much worse when I am tired, but it can happen pretty much anytime. It often takes me by surprise. (Autonomic)

Brushing/Raking – This feels like having my skin brushed/raked/ stroked with a metal-bristle hair brush – the sharp ends pulled across my skin, not pressed in really deeply, but just on the surface, where it irritates and I can’t get away from it. I usually feel this on the tops of my thighs — when my pants brush against my skin lightly. It’s not startlingly painful, but it does hurt. (Autonomic)

Smacking – This feels like being hit hard with an open hand or broad surface – and then the pain scatters out across my skin, as though it were a campfire that had something land in it, and the coals and sparks scattered all around it. It usually happens when someone touches me for a few minutes (an short but extended period of time). Like when my partner put their hand on my forearm when we were driving down to visit family for Christmas. They just laid their hand on my forearm affectionately. It really hurt, and I could feel the pain spreading out around where their hand lay on my forearm. The pain continued, even after they took their hand away. (This is an interactive type of pain, brought on by human contact.)

Banging – This feels like being struck with a blunt instrument – and then the impact reverberates throughout my body. This usually occurs when someone touches me briefly without warning, often in casual conversation, like when my brother-in-law was talking to me at a restaurant one Christmas, and he was harmlessly touching my arm (in a friendly, appropriately affectionate way). This also happens when someone tries to hug me. I have also experienced this when my partner was checking me over for ticks, and they touched the backs of my legs, near my knees. The pressure was very light, but it felt like they were poking me very hard with a blunt object. (Interactive).

Please keep in mind that (thankfully) not all of these types of pain happen simultaneously, and they tend to vary. From one minute to the next, I can go from a relatively pain-free state, to waves of strong physical discomfort. I can be 75% fine one day, and be 15% fine, the next. One type of clothing can be unbearable for me, while others are benign, even pleasurable. And a person’s sudden touch can be excruciating one day, while the next, it can be welcome and enjoyable. “Pain” can also be relative, varying from mildly uncomfortable to downright agonizing. But I differentiate it from “discomfort” in that its degree is different.

Discomfort is something I can deal with, but pain is something that every fiber of my being seeks to escape. An itch is uncomfortable for me. Fabric sensitivity, even at its slightest, feels painful to me. It’s not just discomfort, which to me to me is just annoying and transitory. It’s pain.

My autonomic pain seems to be exacerbated by the qualities of the things I contact — the chemical makeup of fabrics, the quality of light and sound around me, the intensity of the sensation I have (such as the strength of pressure on my skin from the cell phone headset). It tends to get worse, also, when I’m over-tired or I’ve got a lot of different sensory input to process. I haven’t taken the time to figure out what kinds of textiles or materials give me the most trouble. Some days, everything gives me a lot of trouble. I just kind of go with it, and see how I’m doing, where I’m at, and I adjust accordingly.

My interactive pain tends to be exacerbated and complicated by my vestibular and proprioceptive issues. Being unable to gauge distances from people who are reaching out to touch me (no matter how appropriately), makes it difficult to A) prepare myself for their contact, or B) react appropriately. It is difficult for me to receive hugs from friends and loved-ones when my sensory issues are kicking in, and this contributes to my social awkwardness. I tend to stiffen and get tense, which actually makes the experience worse for everyone — for me, because it heightens my agitation, and for them, because they sense a reluctance from me that is physical rather than emotional or interpersonal, and their contact tends to become a bit more clumsy. Stress and strain tend to sharpen my pain, so when my vestibular and proprioceptive issues are acting up, the startling experience of a sudden physical contact can make even a simple touch extremely painful.

The different types of pain I experience can be helped by things like sleep, immobility, keeping away from the source of irritation, movement, stretching, steering clear of people and physical contact, preparing for physical contact with others, or just distracting myself from the sensation by some sort of activity. Analgesics like Advil are not very effective, although they do sometimes take the edge off things. A hot shower can be very relaxing, and swimming in a heated pool is probably the thing that helps me the most. Depending on the type of pain, and how well I’m rested, sometimes relaxing and being immobile makes it worse. Other times, it makes it better. It all depends how I’m feeling at the time, and how well I can redirect my attention to things other than the pain. I haven’t been able to figure out exactly how best to address this. I usually just think about something else and keep myself busy to keep my mind off it, as there’s really no escaping it, when the pain is in “full swing”.

Touch – Insensitivity

One of the other tactile issues I experience is on the extreme opposite end of the spectrum — lack of sensation. When I’m off balance, and my proprioceptive sense is diminished, I tend to run into things, but I often don’t feel it right away. I sometimes notice a sharp shooting pain when I bump into things, but the sensation disappears immediately, and I won’t know how badly I’ve bruised myself till later. I have also accidentally cut myself and not felt it until some time later. At times, when I have really cut myself deeply, or I’ve bumped myself hard enough to get a deep bruise, I’ve been so intensely focused on what I was doing at the time, I hardly noticed the pain and only realized I’d hurt myself when I felt the blood or saw the bruise later.

I suspect this may have something to do with adrenaline — my adrenaline is pumping so hard, at times, as I try to keep myself together, that it seems to numb me to the pain. I’m not a doctor and I don’t know nearly enough about human physiology, but my experience when I unwittingly injure myself is very similar to when I was injured while playing sports — I’d be so intent on the game and so “adrenalized” that I would hardly notice the pain. Again, I’m no doctor, but that’s how I experience it.


A Perilous Relief – Table of Contents

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