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

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

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

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

So, at least there’s that.

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

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

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

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

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

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

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

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

Onward.

St. Barbara of Arrowsmith-Young

Thanks for the help this past Sunday

So, on Sunday I spent the afternoon reading Barbara Arrowsmith-Young’s “The Woman Who Changed Her Brain”, about how she learned how to identify the underlying issues beneath her severe learning disabilities, which had made her life a living hell for 26 years of her life. I found the book for free on Scribd.com — my new favorite place of all time. You can read the book for free here: https://www.scribd.com/book/224350322/The-Woman-Who-Changed-Her-Brain-And-Other-Inspiring-Stories-of-Pioneering-Brain-Transformation – you just need a free login.

Anyway, I am finding a lot of similarities between her situation and mine, despite obvious differences. And it occurs to me that after hearing a number of accounts of her hitting her head (running into things, banging her head before she started to study, etc.) TBI might just factor into her account. She focuses on the learning disabilities parts, rather than the root cause, so that makes the book more accessible for folks who have had any kind of difficulty with learning and understanding and communicating — me included.

One section in particular jumped out at me yesterday:

I recall a twelve-year-old student with average intelligence but whose severe weaknesses in both the left and right prefrontal cortexes left her as compliant as a young child — so compliant that other children would toy with her and order her to stand and sit on command or to stay in the schoolyard long after recess was over or to surrender her Nintendo game. Her neurological weaknesses had robber her of her ability to evaluate a command and decide whether it should be obeyed. She addressed her problem areas and eventually was able to say no.

That’s pretty much me — but in very different kinds of situations. I didn’t have a problem with being compliant and going along with others as a kid. If anything, I was defiant and went against what anyone and everyone told me to do (except for my love interests — they could always boss me around).

The compliance and obedience and lack of questioning happened in adulthood. And I wonder if the three car accidents, the fall off the back of the truck, and the occasional head-banging — all in my early adulthood — might have affected my prefrontal cortexes to the point where I would just compliantly do whatever my spouse told me to do.

If that’s the case — and my compliance has been neurological, rather than emotional or character-based — then that’s a huge relief. And it means I can do something about it. For close to 20 years, I pretty much went along with whatever my spouse told me to do. It wasn’t so pronounced in the beginning, but then it got worse.

I had a car accident in 1997 where I was rear-ended, and I couldn’t read for several days. The letters swam on the page, and I couldn’t concentrate on anything. I recall feeling weird and shaky and being a bit “off” for some time after the car accident, and I wonder if maybe that affected my prefrontal cortexes and made me more compliant. People around me thought my spouse was bullying me, that they were being abusive and domineering, but honestly, I just went along… because it was the only thing that seemed useful to me.

I need to check around to find out more.

Anyway, that’s just one part of the book that I’m really enjoying. There are a number of different places where I recognize myself — the hesitance, the inability to get things done, the self-regulation problems… I’m not sure I want to think about them in terms of learning disabilities, but rather brain capabilities. And they apply to all kinds of situations, not just educational ones. That’s something that the author talks about a lot — how addressing these learning disabilities will improve functioning in the rest of life.

What Barbara Arrowsmith-Young has done is remarkable. She’s really figured it out — and from the inside, not from the outside. It’s amazing. I’m a huge fan, and if I were religious, I’d recommend her for sainthood. Her story is one of the reasons I got myself into neuropsych rehab, in the first place — when I read Norman Doidge’s “The Brain That Changes Itself” her story stood out for me more than any others. Because she took it on herself, and she did the work, instead of having someone else do it for her. And now she’s passing it on to others. She does public lectures. She has her Arrowsmith School. She’s written a book.

Unfortunately for me (and probably many others), the Arrowsmith School is expensive. And it’s in Canada, which is not an impossible distance from me, but still… I have to go to my job each day, I don’t have a lot of money to spend, and I’m thinking there must be another way to get this kind of help without being locked into a specific location, or paying someone to get me on track.

Again, I come back to living my life as the best recovery. Living fully and reflectively. Mindfully. Engaged. All those catchwords that basically say,

Do the best you can each and every day…

Be honest with yourself about what’s going on…

Learn from books and movies and the world around you, your experiences, your teachers and your mistakes…

Change what you can so you do better next time…

And share what you learn with others.

Absent the resources to enroll in the Arrowsmith School for months (if not years), and with the help from a handful of competent professionals, I seem to be making decent progress.

Speaking of which, I’ve got some chores to do.

Onward.

Amiss, but getting better

On second (or third) thought… no thanks

I’m scrapping the idea of going to the ER today. I stretched and moved yesterday, and I took a real break — spent the afternoon napping, reading Barbara Arrowsmith-Young’s “The Woman Who Changed Her Brain” (more on that later), and just puttering around the house, taking it easy. I’m going to mention the left-side weakness to my counselor, just so someone else knows about it. And I’m probably going to check in with my neuropsych on Wednesday. I do feel better, after taking some time off, and now the idea of embarking on a medical adventure doesn’t seem like a good use of energy.

Oh. My. God. When I think about having to explain my situation to doctors all over again… Yeah, no thanks.

So, a big shout-out to those of you who talked me back from that edge. I owe you.

It’s Monday. Only two more days in the office 20 miles from home. Then I move to the office 5 miles from home. It’s exciting. Also, I’m barrelling down the road towards a couple of big-big deadlines this week. That makes things easier.

It’s interesting — I’m gradually getting the hang of living by deadlines and holding people to them. In past situations I’ve worked in, there were two kinds of situations. Either

  1. The deadlines were fluid and there wasn’t a hard-and-fast rule about when things got done, and in what order. People were sort of lackadaisical about doing their jobs, and if it got done, then woo hoo. But if it didn’t get done, oh well.    Or
  2. Deadlines were in place, but everybody was a top-notch over-achiever who would have sooner cut off their left hand, than not do their job.

Now, everything is about the deadlines… but I don’t have a top-notch gang of over-achievers available to me, to get the job done. I have maybe one or two, who are usually overworked.

Sigh.

Well, it’s all very educational. Now I get to learn how to motivate people who have no real reason to be motivated at all. They don’t report directly to me, they aren’t all that thrilled about their jobs, and the burning desire to excel doesn’t seem to light up their days and nights.

Interesting.

So, now I get to learn how to make it all happen. And in the end, that’s going to be a valuable skill. I just have to acquire it.

I’ve got some more work to do on restoring a sense of self after TBI. I’m also restoring a sense of my own self — as much by slogging through the tough times, as experiencing the good times.

In a way, slogging through the tough times is even more useful to me than having everything go well. It shows me that I can do this thing, called adapting and overcoming. And it teaches me valuable skills along the way. I am extremely rigid and uncompromising in some ways, which can come in handy, when it has to do with personal integrity and delivering on my promises. When things come up to oppose my grand plans — as they invariably do — I can either buckle and fall to pieces (that sometimes happens), or I can learn from it and add to my overall knowledge and skill in handling those types of situations.

I choose the latter. And instead of tearing myself down — e.g., beating myself up for going off the deep end yesterday with the sensations I’m having on my left side — I can learn from the experience, chalk it up to, well, being human, and move on with a little more information under my belt.

And when I focus on learning and growing from experience, that builds up my feeling about who I am and how I handle myself.  Getting bogged down in despair and frustration is not how I want to be. It’s now how I understand myself to be. So, I have to find a better way. And recognize my limits — my tendency to go all catastrophic on things that happen with me — so I can keep them from taking over my life. I have limits, just like anyone else, and they are part of me — but only a PART of me, not all of me.

Having a broader sense of myself as a collection of many features and qualities, as well as a lot of strengths along with my weaknesses, makes all the difference in the world. I can’t gloss over the tricky parts, but I sure as hell can emphasize the cool stuff, and make the most of that.

Speaking of making the most of things, I need to really focus on getting into my day. It is SO HARD to get going for work, this morning. Mondays have been very difficult for me, lately. Transitioning into work and really getting invested, has been a monumental task. I dread everything about it, and I can’t seem to get into the day, no matter what I do. I know why, though. It’s old patterns from many years of bad experiences that are cropping up again, just at this point in time. Four months into just about every endeavor, this happens with me. Like clockwork. More on that later.

Anyway, the day is waiting, and I have a lot to get done today. Things are looking up, and that’s a good thing.

Onward.

After TBI: That house has burned to the ground

And now you’re going to have to move.

Seriously. The structure of your life is toast (literally and figuratively), and there’s no point in trying to move back in. Sure, you can try – you can pick up whatever you have left and set down on top of the old footprint of the structure, expecting things to return to normal. But when the rain and snow and wind come, there’s no point in being surprised.

Your house has burned, and you’re going to have to find a new way to live.

Now, you may say, “Oh, but my TBI was a mild one. It’s just a concussion, and it’s no big deal. My doctor says I’ll be fine in no time.” To believe that is a mistake. Doctors may know precious little, other than how to keep from getting sued, and the popular “wisdom” on mild TBI/concussion is anything but wisdom. Just because you can’t see what’s in there, doesn’t mean it’s not going to give you problems. There are millions of individual little miniscule connections that make up the sum total of who you are and how you live in the world, and when even a few of them get stretched and frayed and torn, it can wreak havoc on your life, just like a little crack in a dam can cause the whole structure to become unstable.

Not to worry, though. It is fixable. Not fixable as in — “I can make it all go back to how it was.” That is pretty much of a waste of time. You might as well accept it, because that’s the deal. Depending on your situation, for many years in the future — even the rest of your life — you can find yourself re-discovering how differently your brain functions, compared to before.

The point is: So What?

Seriously. Let it go. Get to work coming up with something new and different for yourself. It makes no sense to get stuck in the past, mooning over how awesome things used to be. If you’re honest with yourself, you will find a ton of things that weren’t awesome at all — some of which may have actually contributed to your brain injury / concussion. I think that after TBI there’s a huge temptation to get stuck in rigid thinking and have this unrealistically rosy view of before. I know I had it for quite some time, till someone asked me point-blank if things were really all that great, once upon a time, and then asked me to think of some examples when things weren’t that awesome.

And when I thought about it, I realized that my life had been pretty much of a mad scramble just to keep ahead of the sh*tstorm that seemed always about to burst open over my head. Okay, so I can chalk a lot of that up to prior TBIs, not to mention all the mental health issues that I literally gave myself, because of how I was thinking about my life.

The point is, I had it in my head that things were so awesome prior to my TBI in 2004, but they weren’t that way at all. Yes, I had more money. But not so much more. Yes, I had a career. But I actually couldn’t stand a lot of people I was working with, and I hated my mega-corporate employer with a blue-flame burning rage. Yes, I was more social. But the people I was hanging out with were victims and very unwell in their own rights.

If anything, TBI lowered my tolerance of all sorts of bullsh*t, which is actually one of the benefits of getting smashed in the head hard enough to turn your life upside down.

Once I got past the idea that everything was hunky-dory, and that I was only functional before, things started to loosen up. Of course, it’s taken me a long time — years — to let that fully sink in, but at least I got off to a start, a few years back.

The other thing that’s taken me a long time to come to terms with, is the fact of how much things have really changed with me — and how much they need to change. For the longest time, I was bound and determined to “bounce back” and get back to where I was before. The only thing is, where I was before, wasn’t actually so great, and it’s not where I want to be in the future. In a way, it was like I was living in a house that had a lot of structural and logistical problems, which I got used to working around and living with. And a mild case of Stockholm Syndrome set in, where I not only got used to dealing with the crap, but I also decided that I just loved it all that way, and I was lucky to have it.

Oh, how untrue. Turns out, I was accommodating a lot of BS that I never should have, and I was in relationships and work situations that just did not suit me very well at all. Only when I became incapable of sustaining the huge amount of energy and effort required to keep myself contorted in all those miserable accommodations, did I start to break out of that old shell. It has been hugely painful and frustrating and frightening and anxiety-producing, but oh well. At least I can see more clearly now, just how un-right things were before.

No matter how attached I was to that old way of living… no matter how convinced I have been that it was amazing and fantastic and awesome, etc… no matter how invested I was in keeping things the old way… the fact of the matter is that a lot needed to change. And it was going to eventually. Whether through brain injury or mid-life crisis or some other life event, it was all going to have to change.

And I see now that one of the things that’s held me back the most, has been my reluctance to drop what came before and try to create something new. The weird thing with TBI is now it can jack up your fight-flight response. I think that’s for two reasons — 1) TBI does affect the autonomic nervous system, the part of our system that “toggles” us between overdrive and chill, and it can jam our accelerators in place, like a floor mat on the gas pedal of a Prius. 2) Dealing with all the differences from how things were before can be a constant source of surprise and shock. One experience after another goes wrong, for no apparent reason, and you can end up seriously on-edge, constantly trying to keep up with what’s going on around you, constantly trying to figure sh*t out, that just doesn’t make any sense.

What happens when we’re in that constant state of overdrive and reaction, is that our brains become less able to learn. And we end up not learning the valuable lessons that we need, in order to alter our brain structures and develop new pathways and new patterns that we can rely on. I’m not sure that any of us ever feels “the same” after we’ve seemingly fully recovered from TBI. I’m not sure any of us ever gets to that point of feeling like our old selves — it takes some a lot of adjusting to the sensation of not having a clue what is going on, but going ahead and taking action anyway.

But if you can get past the uncertainty and make peace with the fact of feeling confused and baffled and constantly playing catch-up, and you can find it in yourself to keep going, anyway, you can put your life back into something new and different.

You just have to realize your house has burned down. And it’s time to move.

Yes, move. The first and most important thing I will say to anyone who has sustained a traumatic brain injury — especially mild TBI or concussion — is that you have to get moving. You have to exercise. If you never did before, now is the time to develop that interest and acquire that skill. You’re going to have a whole bunch of “sludge” in your system, both from the biochemical cascades that happen with concussion/TBI, where the cells of your brain become deluged with chemicals intended to help them cope with the injury.

BestPractice has a writeup on Concussion, including the pathophysiology, which sheds a lot of light on things:

The biochemical cascade of concussion is marked by an initial period of indiscriminate neurotransmitter release and unchecked ionic fluxes. [20] Excitatory neurotransmitters, such as glutamate, bind to N-methyl-D-aspartate receptors leading to further neuronal depolarisation with the influx of calcium and the efflux of potassium. These ionic shifts lead to acute and sub-acute changes in cellular metabolism and physiology. Acutely, the sodium-potassium pump works overtime to restore a homeostatic balance, requiring increasing amounts of adenosine triphosphate and a corresponding increase in glucose metabolism. This hypermetabolic state co-occurs with diminished cerebral blood flow. The disparity in energy balance and the tendency to restore ionic balance is met with the decrease in blood flow, creating a cellular energy crisis that is suspected to be the mechanism for post-concussive vulnerability, leaving the brain more vulnerable to a second injury and potentially longer-lasting, more severe deficits. After this initial period of hypermetabolism, the brain goes into a state of hypometabolism where the persistent increase of calcium may be responsible for impairing mitochondria, further affecting cellular metabolism and neural integrity, worsening the energy crisis, and potentially affecting post-traumatic neural connectivity. [20]

Axonal compression and stretching is also thought to be a major injury mechanism, creating a focal abnormality on the surface membrane of the axon within hours of injury, sufficient to impair axoplasmic transport, resulting in oedema. View image The swollen axon then separates, with the proximal section remaining attached to the cell body while the distal end undergoes phagocytosis by neighbouring glial cells. Axonal swellings may persist unchanged, or regeneration may occur over several weeks. If axons do not regenerate, reactive deafferentation may occur. [21]

Neuro-imaging studies using functional MRI suggest that a depressed mood after concussion may reflect an underlying pathophysiological abnormality consistent with a limbic-frontal model of depression. [21] [22]

That sludge stays in the system after the injury has occurred, and in my reading (and experience) I’ve become convinced that concussion/TBI disrupts brain and body function not only in the days after the injury, but over the long term. I read something a while back about how the gunk that gets poured into brain cells continues to stay around (I can’t remember where I read it – I may have a copy of it on my hard drive).

Bottom line is, when you sustain a TBI/concussion, your cells get flooded with all sorts of interesting crap, blood flow slows down, and together, this contributes to a buildup of gunk in your cells, which bog them down — and can also make you feel incredibly depressed. If your brain continues to carry that increased biochemical load, it doesn’t help matters.

What can help? Exercise. Plain and simple. Getting the blood pumping — or at least just moving more — will help the cells clean themselves out and renew. Fresh blood, fresh oxygen, fresh biochemistry helps to not only relieve the burden from the cells, but also to stimulate new growth — which is exactly what you want. You get double the benefit — and not only physically, but mentally and emotionally as well. A refreshed brain can rebuild not only its internal connections, but also the life around it. A renewed brain leads to a renewed life. What can be wrong with that?

Seriously. After TBI, you’ve got to move. Your doctor may tell you to take it easy till after symptoms pass, but sometimes symptoms don’t pass until after you start to exercise. Use your best judgment and check in with yourself to see how things are going — just don’t make a lot of excuses about reasons you shouldn’t take action on your own behalf.

Get up. Get moving. I don’t care if it’s taking the stairs instead of the elevator, if it’s getting up to putter around the kitchen during commercial breaks, if it’s going for a walk around the block. You’ve got to move. Just get up and do it. Your brain will thank you for it. And so will your life.