One day down, next day up

Yeah – that

Okay, I had my “down day” yesterday. I got up after 7 (late for me), I took it easy in the morning, then did a bunch of stretching and “physical therapy” for a few hours, studied my anatomy books, and took a nap. Then I called my parents to talk about their Christmas, talked to a sick friend, had an early dinner, watched a movie and some t.v. with my spouse, and then went to bed.

All in all, a very relaxing, restoring day. I took good care of myself and really focused on just being as well as I could possibly be. I also headed off a couple of arguments at the pass, which was good. I just stopped arguing with my spouse, before we got going. That’s progress. I think the food fix is working for me. At least, it seems that way.

It’s also good to just take the pressure off and decompress — just forget about accomplishing anything for anyone else, and take care of my own body, mind and soul, for once. I didn’t stress out about a lot of things. I just worked out the kinks in my body and rested as much as I could.

The thing is, after my physical therapy yesterday, I am really sore today. I worked a lot of knots out of the muscles in my back and neck and legs — all over, really — and now I’ve got a lot of “sludge” floating around that needs to get moved out of my system.

So, I got up this morning and got moving, first thing. I jumped on the exercise bike and rode for about 8 minutes, with some good intervals included. I know it’s not much, but I have not been on the bike regularly for quite some time — a couple of years, probably — and I need to work my way back to where I was before. I feel pretty good about the ride this morning — it was just enough to get my blood pumping and get me out of breath and make my legs a little wobbly when I got off the bike, but it wasn’t so much that I felt awful. I did get that headache towards the end, and my head is still hurting a bit right now, but I really don’t care. I’m active, things are moving, I feel better, and that’s what matters.

After my ride, I did some easy push-ups and stretching while I made my coffee, then I lifted weights while my fried egg was cooking. It takes about 5-7 minutes for my fried egg to cook up the way I want it, and that’s about enough time to do one “circuit” of my weights. I used to do that circuit each morning, years ago, then I stopped because I was overtraining, pushing it every single day without any rest, and I was starting to get too stressed and strained.

So, I just stopped.

It actually felt good to have that rest and extra time each morning — I was dedicating 20-30 minutes each morning to getting going, and it started to feel like it took forever. There also was no joy in it. But after stopping for a couple of years, and not replacing it with anything, now I’m feeling the results — lower energy, smaller range of motion, less good feelings in the morning. I can tell the difference between now and a couple of years ago.

So, I’ve started exercising again. I’ve done something about every other day, for a little over a week, now.

And it feels good.

After my rest day yesterday, I’m feeling really motivated to get going. I did my exercises this morning, as I said, and I’m feeling really energized by studying anatomy. It fascinates me, how our bodies are put together, and it’s also knowledge I can use — on a daily, moment-by-moment basis. I also discovered a website called Inner Body, which lets me study the body in its entirety, including all the skeletal, muscular, and organ systems. Fascinating. I’m looking at the bones of the head right now, because I need to understand the underlying structure that the muscles all attach to. I am most interested in the muscular system, because that’s what’s giving me trouble. But after spending a fair amount of time, yesterday, studying the muscular systems of the neck and back and legs, I realized that they kept talking about what bones the muscles were attached to, and if I didn’t know what bones they were talking about and the different parts of them, then I couldn’t really understand how the muscles were connected.

So, I need to learn the skeletal system, if I’m going to learn the muscular system. The skeletal system is a lot less complicated, because there are fewer parts, but it’s still a challenge for me to learn all the bones in the body.

I guess this is one of my goals for 2014 — to learn all the bones in the body (at least) — and if possible learn the muscular system as well. I think I can learn the skeletal system in a few months at the most. I just need to keep at it on a regular basis and keep refreshing my memory. And then I can learn the muscular system. Or I might study them simultaneously, so I understand the workings of them all, as they interact with each other, and better remember them that way.

For me, it’s all about how things are put together and how they interrelate to each other. If I can think about things in terms of a complete system that interacts with all the different parts, it makes more sense. I also need to find some videos of anatomy to understand the motions and movements, so it makes sense to me when people talk about adduction and abduction, flexion and extension.

Maybe if I can see it in action, it will make sense to me.

Let me Google that… videos of muscular system… Oh, I see there are plenty on YouTube. I’ll find time for that later.

Right now, I’m rarin’ to get into the day. I am a little tired, because I only got about six hours of sleep, last night, but I will take a nap later to make up for it. I’m off work for the next four days, so I have time. I just need to rest up, because next year is going to be a trip. I can feel it in my bones. And by the time I’ve learned all the bones in the body, I’ll be able to say which ones I can feel it in, and what parts of them are the most sensitive 😉

So, I’m making my list for things to do. I have some chores to do, which I can take care of at my own pace, now that the rest of the world is either at work or at the mall. I can take my sweet time, roaming around, and spend some time at the health food store, discussing Tyrosine with the folks who work there who always try to engage me in in-depth discussions. I have to be careful with those folks, because they love to up-sell me, but overall, it’s cool. As long as I don’t get sucked into their hypnotic displays of expertise, I’m fine.

I just have to keep moving today, and give myself time to rest and digest as well. I made some pretty phenomenal food on Christmas Day, and I’m going to take another crack at it. I’m gonna get my shopping list of Tyrosine-generating foods, stock up, and refill the cupboards. I’m also going to pay some bills that are due by month-end… because I can, now that I got paid again this week. And I’m going to do some work on some of my projects that keep me interested and engaged. I’m going to study the skeletal system today, learn some basics, and also take the information with me to practice as I’m going about my chores. I have a little holder for 3×5″ cards, and I’m going to write down things to take with me, so I can use the time I spend standing in line or waiting for something or another.

I started doing this several years ago, then I stopped, because I had a lot of learning difficulties after my TBI. I had trouble reading, I had trouble remembering, I had trouble sorting things out and also staying motivated. I’m hoping that my Tyrosine and dopamine increasing strategies will help me with this. It’s a plan, anyway.

It’s all good. Having a rest day is helpful. Getting going… even better.

Onward

Tony Dorsett is not dead

Tony Dorsett – all those years ago

The public debate about football and its effects on cognitive health — that is to say, how all those years of head trauma can really screw you up, years later — is heating up even more. PBS ran the special “League of Denial” about the NFL’s cover-up of the brain-damaging effects of their brand of football, and now Tony Dorsett and several other former pro players have been diagnosed with early signs of CTE – chronic traumatic encephalopathy. Bleacher Report has a good write-up on it here, and ESPN has their own, which I read yesterday.

I was really encouraged to read that there’s actually a way to detect CTE in living people. Up to recently, the word was that it can only be definitively identified in the brains of dead folks. But apparently now UCLA has a fix for that. So, that’s encouraging.

But it’s never good when anyone has CTE, and both Joe DeLamielleure and Leonard Marshall were also diagnosed, but Tony Dorsett…? That was a pretty emotional discovery for me. He was one of the players who got me really excited about the game when I was a kid. I always loved football, but there was something about his performance that was even more compelling — and it almost made me a Cowboys fan, for a while. Almost.

The article over at Bleacher Report has a writeup and includes the full gamut of responses from readers — everything from “the players knew the risks, and they did it anyway,” or “they just want to milk the system” to “they’re upset because they’re not in the limelight anymore and they’re just a bunch of cry-babies looking for attention,” to “you’re an idiot – the NFL covered this up for 15 years,” to well-informed responses based on science, to flat-out denial that anyone other than linemen could sustain repeated head trauma. And here and there are counter-arguments to refute ignorance-based “rationale.”

There’s a lot of back-and-forth talk, some more useful than others, but the most important thing is, people are talking about it, and more awareness is building around the whole issue. It would be nice if folks could share information and keep an open mind without calling names, but this is the internet, after all. I do find it hopeful that people are quoting actual scientifically based facts. And what I find most interesting is how many readers are reporting that parents are not letting their kids play football.

One of the questions that comes to my mind is whether all the talk might be doing more harm than good. There’s a lot of knee-jerk reaction going on, and brain injury is such an emotionally loaded subject which hits so close to each of us, that a lot of people just stop listening as soon as they hear “brain injury”. It’s not that they don’t want to learn or understand — we’re wired to shut down our higher reasoning, when we feel threatened at a deep level, and brain injury hits a lot of us in our most vulnerable spot.

A broken bone you can see and set and watch heal on the x-rays. A broken nose you can push back into place, tape up, and wait to get better. But a broken brain? It’s invisible. It’s mysterious. You can’t even see the real issues on imaging results — at least, not those that are widely available at a reasonable cost. And you don’t have a clear-cut route to recovery. Plus, we have this really bizarre expectation (based, I’m sure on decades of science that told us it’s so) that you only have so many brain cells, that once you damage the brain, you’re done, and there’s no turning back.

Only in the past years has science amended its views — and it’s done so silently, without so much as a hint of an apology for training us all to give up on ourselves.

What’s more, I think we’re not helped by the sensationalistic (if true) focus that’s being brought to CTE and the long-term effects of repeat head trauma. All the press focusing in detail on the horrible things that happen to you after head trauma might be cementing the public perception that once you’re brain-injured, that’s it. Tony Dorsett says he’s being proactive and is going to fight this and live his life to the fullest. But given how little is generally known in the public about brain injury in general, who knows how seriously anyone is taking this? I read one article where the writer referred to his condition as his “demise” — a freudian slip, if ever I heard one.

Frankly, I’d be surprised if anyone gave him the time of day after his revelation. Yes, he is Tony Dorsett — that is, he was. Once people find out that you’ve got “brain issues,” they have a way of distancing themselves from you. It’s something they don’t want to think about. They can’t help but imagine what it would be like for them — and it scares the bejesus out of them. So, they choose not to talk about it. They’d much rather talk to Sidney Crosby, who apparently has no more head/neck trauma issues to speak of.

From personal experience, I can tell you, repeat head trauma — even mild traumatic brain injuries — can do a number on you. It can turn your emotions upside-down, trash your impulse-control, wreck your judgment, saddle you with a bunch of unpredictable and seemingly insurmountable physical sensitivities, put you in a state of constant headache and general pain… in the process destroying your relationships, costing you your job, turning your financial decision-making inside-out, and generally doing the same thing to your life that a frat party does to a frat house. And it can all happen without you ever intending it to — and never actually wanting it to.

Now, I know a lot of folks are going to say it’s a character issue, or it’s an issue of self-control or what-not. It’s not about character. It’s about how the brain works, and how our lives are ordered as a result. And when you’re brain-injured (and unaware that you’re dealing with brain injury), the very thing that’s supposed to keep everything in order is what’s the problem.

And because it’s your brain that’s impacted, you can never even realize till it’s way late in the game — for some, too late.

The thing is — if we can all get past the terribleness of it, please — there is a way out. Brain injury, even CTE, doesn’t need to be the end. The brain is an incredibly “plastic” organism that by nature re-routes its wiring and recruits other parts to take on functionality that the original parts may have lost. There have been cases of people with advanced brain degeneration never ever showing any signs of that condition — the book Aging with Grace talks about that. And you can’t tell me that all the people who have lived full lives to a ripe old age have never had any organic brain issues. The brain is a mysterious and amazing organism. Our limited understanding doesn’t change its infinite possibilities.

If there’s one thing that I hope comes out of all this — even if it’s long-term — it’s the knowledge and experience that recovery from brain injury is possible. It is NOT a death sentence. I hope someone out there gets a clue — and publishes widely on it — about how possible (even probable) it is that a person can restore quality to their life and continue to live with meaning and purpose and a sense of usefulness, even after repeat head traumas.

Making a huge issue out of football being a cause of a brain-wasting condition is only part of the story. Saying that repeat concussions is a recipe for madness and early-onset brain degeneration is not the whole truth.And focusing only on the awfulness (to raise awareness and funding) leaves me with the feeling that this terribleness is permanent and irreversible. Logically I know it’s not 100% accurate, but part of me fears might be.

Tony Dorsett is not dead. Not yet, anyway. Who knows what will take him out in the end? He says he’s got issues. He says it’s wrecking his life. He says he’s considered suicide. And he says he’s being proactive and is going to fight this thing. There is still a whole lot we don’t know about the brain, CTE, tau, and how we might be able to clear the junk out of the brain.

Personally, my money’s on exercise, sleep, a positive attitude, staying active both mentally and physically, keeping connected to a community, and solid nutrition without a ton of artificial crap crammed in between the real ingredients. But that’s just me.

Whatever other folks may choose, I hope they do choose it, and I hope they don’t give up just because things look a little grim, right now. Things always look grim, before you have a chance to do something about them. But once you get going… you never know where it’s going to take you.

In any case, the day is waiting. I have a lot that I want to accomplish today — this whole weekend, in fact.  So, speaking of staying active, it’s time for a morning walk before I get into the rest of my day. That should get things moving…

Onward.

True Independence

There are many different ways to do things

I think I need to start seeing my chiropractor again. The headaches are back after quite some time of being away, and I haven’t been feeling that great, lately.

Lots of pain. I wake up in pain, and at the end of the day I’m in pain. I also haven’t been sleeping that great, either. All of these things were better when I was seeing my chiro, but I had to stop because I ran out of money and I couldn’t afford $120/month for adjustments. It’s just too expensive, even when insurance does cover it. When I’m fully covered, it’s $15 co-pay, and I have to go twice a week, so that’s $30/week — $120/month. That money needs to go to things like my electric bill, to run my air conditioners, pay off some back bills, etc.

Come to think of it, I guess I don’t need have the option to start seeing my chiropractor again. There’s just no way I can come up with that kind of money on a monthly basis. You’d think that it wouldn’t be a problem because of my job and my salary, but between car repairs, mortgage payments, food and gas, and … well, you know the drill. Something has to give, so I have to find another way to do better for myself and feel better in my daily life.

So, it’s back to the drawing board and doing basic things like stretching and moving on a regular basis… getting decent sleep by making it a priority and making sure I at least start to bed well before midnight. I also need to watch my posture and make sure I don’t stress out my body by slouching or getting stuck in off-balance sitting positions at work all day. Just basic stuff, really — but the kind of basic stuff that gets lost in the shuffle, because, well, it’s just not very sexy, it’s drab and everyday and it doesn’t always grab my attention.

But it’s the kind of stuff that matters — really matters — on a regular basis. And if I don’t pay attention on a regular basis, I just get into trouble. In a way, seeing a chiropractor was compensation for me living like a bit of an idiot. I wasn’t taking good enough care of myself, so I hired someone to fix what I’d broken and wasn’t taking care of. I get that now. So, it’s no more excuses — and back to basics.

Which is a good place to start for July 4th – Independence Day. If I think about taking care of the basics in terms of supporting my own independence from expensive experts and professionals (who may or may not be able to help me), then it becomes a lot more interesting and compelling, than thinking about it as something I “have” to do (sigh)… or else.

What a difference a slight change of perspective can make. It can mean the difference between an odious task and something I do on my own to make my life better, to make myself better, to be stronger and more free than ever, without being held back by lack of money or access to professionals.

If that’s not what Independence Day is about, I’m not sure what is.

Speaking of changes in perspective, I’ve been reading more on the Polyvagal Theory, and it’s making a lot of sense to me. The basics are pretty self-evident to me — we have a three-fold system for dealing with challenges in our lives:

  1. An ancient, primal (vagal) system which automatically shuts down our heart rate and breathing and muscle tone in response to inescapable threat. I call this “hypo-freeze” because hypo means “lower” — as in hypotension or hypothyroidism.
  2. A more recently developed sympathetic nervous system which causes fight-flight (and hyper-freeze — which is the high-muscular-tone freeze that’s completely different in nature from the hypo-freeze primal vagal impulse) to kick in to override the hypo-freeze, so you don’t get killed off by your body’s own automatic response to inescapable threat.
  3. A more developed vagal response system which can control the two earlier systems. This system is closely tied in with the muscles of the face and neck, and it can literally signal the “all clear” based on observing the expressions on others’ faces, among other things.*

Essentially, what can happen, is that you can run out of coping and response strategies when faced with inexplicable, inescapable, and seeming insurmountable challenges. When we run out of higher-level approaches (like being able to think things through), we revert to the older ways of responding. And then we can get stuck in those ways of responding, because the “neuroceptive” response (what we take in on a biological/neurological level, rather than an intellectual/conscious level) which is based on prior experiences, kicks in at levels thatprecede conscious thought.

Long story short, our bodies are wired to survive, and when they’ve become trained to respond with fight-flight, time and time again, we automatically jump to that without even thinking about it. Even if we are thinking about it, we sometimes (or often) can’t stop the process of kicking into fight-flight mode, because our bodies are so well-trained in doing that.

Which ties in with the readings I’m doing on trauma and PTSD. It puts trauma and post-traumatic stress in a whole new light. And it gets it out of the domain of the psychological mental illness… and into the domain of the physiological. It explains a whole lot, and actually excuses a whole lot, too. It doesn’t excuse the behavior, but it excuses the brain’s/mind’s role in “causing” bad behavior to happen.

And what happens, when we get our brains/minds off the hook for our “mental illness” and start to see our cognitive-behavioral issues as physical issues which were trained to be that way? For me, it tells me that I’m NOT crazy, that I’m NOT mentally ill (as well-meaning and ill-meaning people like to pronounce me). It tells me that I am dealing with a physical condition that was trained into place, and it can be trained to do something different. It doesn’t just get me off the hook in ways I never should have been ON the hook, to begin with. It shows me the way to do something about my situation — and approach my challenges in whole new ways.

Being human and all, of course I have a lot to learn, and my understanding is still imperfect. It will probably always be imperfect. But at least now I have more to go by, than I did just six months ago.

And that’s the beauty of the right information — and access to the right information. I have found a bunch of really great papers and links on the polyvagal theory (I’ll have to dig them up and share them here), which have served to really expand my understanding and give me much hope. I can’t say that my understanding is perfect, but when I practice what I read and I think about what it all seems to be saying, it helps. It helps a great deal. It’s information that I can put into practice, by doing my daily breathing exercises first thing in the morning before I start anything else, and also recognizing the biochemical processes that are kicking off when I (or others around me) start to get revved and rammy. It helps me come up with different responses and it motivates me to take better care of myself, get better sleep, take it easy (especially last night after the fireworks, which were both beautiful and very stressful with all the noise and lights — and me being behind on my sleep). It gives me more to go by, than “I’m a nervous wreck again” — and it shows me the way to level out after those extreme spikes and jolts that used to just wreck me.

Information is power. Knowledge (the ability to put information into action) is power. It’s all power of the best kind — not power over others, but power over our own lives, our own experiences, our own futures… beyond the dictates of fate.

Well, it looks like it’s turning out to be a beautiful day. The rain of this morning has given way to sunny, clear skies. We needed the rain, and now we have a clear day for the 4th. Not bad. Not bad at all.

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* People are calling the most recently developed vagal system the “social” vagus, but to me, that’s just a related aspect of the mechanism that doesn’t describe what it actually does. It describes how — based on just some of the ways it operates. The “social” moniker seems to have sprung up as a result of people connecting malfunctions of this vagal system with autism and other social challenges, so they’ve taken a bit of a conceptual detour (probably in the interest of popularizing the concept and making it more appealing to funding sources). But my arguments about naming conventions are getting me off track, so more on that later.

Keeping fit

Thanks, but no thanks

I got myself up at a decent hour this morning and did my morning routine — sitting and doing focused breathing for a count of 100, then riding the exercise bike for 15 minutes and doing some light dumbbell lifts. I forgot to do my leg lifts, which I do without holding onto anything so that I improve my balance (it’s working — my balance is 1000% better than it was about a year ago). But then when I was making notes on my morning routines over the past several days, I remembered it, so I got up and did my leg lifts.

About a year ago, I had to hold on tightly to the counter or the handle of the stove in the kitchen, in order to do my leg lifts. But after a couple of months, I thought I’d try it without. It was a little tricky, at first, and I had to build up to it, but now I’m able to do leg lifts in all directions — on both sides — without holding onto anything, and it feels pretty good. It’s gotta be good for me, if only for my self-esteem, which improves each time I’m able to handle it.

Some days, like when I’m sick, I’m not so coordinated, but today I managed. And it feels pretty good.

So, I’m back into a morning routine. It’s not necessarily a new year’s resolution, per se, but it is happening with the new year, so I guess that counts. The thing that counts even more, is that I started several days before 1/1/12, so I know it’s more than just a passing fad. It’s actually a really vital part of my upkeep. I lost sight of that — kind of took it for granted, got sick of it, whatever. But now I see again that it’s key and critical for me to keep at it. I’ve got to keep fit, or I pay a price.

Maybe not right away, but eventually. And I don’t relish the thought.

See, here’s the thing — over the past year or so, I have become increasingly aware of my own mortality. I had some health issues, about six months ago, that had me thinking I had less time on earth than I’d expected. And it put some kind of fear in me. But then the tests came back, and it looked like I was a-okay. Which is great. But behind it all, I still have this increasing awareness that I’m not going to live forever… that I literally don’t know how much time I have left to do what I need to do… that my days are numbered, like every other living thing on this planet.

And I’ve got to make the most of what I have, while I have it. I’ve got to be as fully functional as I can be, under any and all circumstances. It’s not enough to say, “Oh, it’s cold today, so I’m not going to go outside and do my chores.” It’s not enough to say, “Oh, it’s too hot today, so I’m going to stay inside and keep cool instead of taking care of business.” It’s not okay to make excuses for behavior and inaction, based on external conditions, because when I do, I essentially make myself a slave to those conditions, and I don’t live in total freedom.

I make myself a captive — and then I bitch and complain about how I’m in prison.

Please. What bullsh*t, if you’ll excuse the language.

Now, here’s the thing, though — there are conditions which make this kind of thinking possible — even probable. And those conditions actually precede conscious thought. I’m talking about the condition your body’s in — the condition my body’s in. When the body is not fit, when it’s not well cared-for, and it’s in a weakened state, then it drags down the brain, which then drags down the mind before the mind can realize it. Brain and body are intricately intertwined, and when they “conspire” together against the mind, then you’ve got a great recipe for trouble.

Example: A few years back, around the time when I was first realizing the issues with my TBIs, I was paying close attention to what was going on with me. And I mean really close attention — I was writing everything down, and making notes on countless little details. And in the process of recording my daily experiences, I realized that I had some pretty significant balance issues. And those issues were totally screwing with my head — and my entire life. I was so busy trying to keep upright, so busy trying to keep from falling over or falling down stairs, and I was in such a constant fight-flight-hyper-adrenaline state, that I didn’t have any energy left to pay attention to the other things in my life — like how I talked to my spouse, like how I went about my daily business, like how I interacted with the world beyond my unbalanced state.

And it was totally screwing with my life. Seriously. And I never even realized it, until I stepped back and took a look at the whole of it, as well as the minute details, and realized, “Holy crap, I’ve got major problems with balance, and it’s totally screwing up my life.”

So, I took some action. I cut out dairy, for one thing, which I’d been meaning to do for a long time, since milk always made me feel like crap after I drank it (but for some reason, I kept drinking it?) And believe it or not, after a few weeks of clearing the stuff out of my system, a ton of problems got resolved — simply because my balance wasn’t thrown off, and I wasn’t constantly putting my attention in to keeping upright and keeping focused on what was in front of me.

I’m sure it sounds way too simple and easy to explain away, this example, but think about it — with my history of concussion, I’ve got some limitations on my cognitive resources — I’ve also got a slower processing speed than I might otherwise have. I’ve got constraints on what I’ve got to work with, and at the same time, with that crazy reaction to milk and the resulting balance issues, I had even LESS to work with, because so much of my already limited resources were being tied up in handling keeping upright. Freaky and seemingly unlikely, but that’s what my experience was.

And when I handled the physical side of things — when I cut out the milk, and then later when I started exercising regularly to wake myself up and get my system moving — it helped my brain, which helped it get out of the way of my mind. So my mind could focus on getting my act together. And there you go. Much better now. Far from perfect, but that seems to be the deal here on planet earth, so I’ll take what I can get — and keep working with the rest of it.

Anyway, where was I…? Oh, yes — Freedom. Getting free of the chains and bars and shackles that I come up with for myself. Getting out from under my own self-imposed burdens. I’ve been thinking about this a lot, over the past few days. I’ve been laid up, being 75% sick, and I’ve been contemplating the ways in which I’ve made myself really miserable over the past months and years. It’s an art, you know, and I’m quite adept at it 😉 But now it’s time to move on and come up with something better, something that suits me and makes it possible for me to just get on with my life.

I was talking to a friend of mine a few weeks ago about how we invent all these ways to get ourselves “off the hook” and avoid hard situations. They were pretty rough-minded about it, maintaining that people do this because they are weak or lazy or they just don’t want to apply themselves. They had been through a self-development program, some years back, where they were trained to think of themselves and prone to slack — it was a pretty rough-minded program, which I have reservations about. And there doesn’t seem to be a lot of compassion or objectivity around their assessments – or their approaches. It’s all very well and good to make these negative, judgmental statements about human nature. For some people it can be very motivating to judge yourself and be pretty rough on yourself. But it also triggers the sympathetic nervous system, which then shuts down half of your system, so you have fewer resources to make new choices.

It seems to me that rather than accusing yourself of being lazy or weak, you could think about your need to back off from life in more objective terms, as well as more holistic terms — and put the focus on staying fit, so that you can do what you need to do, in the best way possible. And keep the focus off you being somehow deficient or having a flawed character. There’s a fundamental disrespect for the human being in that rough-minded approach, which doesn’t seem consistent with my own observations.

If we consider that physical circumstances can give rise to states of mind, then “getting on yourself” with judgment — while it may charge you up with adrenaline and motivate you to do better — actually depletes your system, and you can be unconsciously undermining yourself in the process. But focusing on keeping fit, and putting the emphasis on tweaking the physical mechanisms for your life seems like a more productive approach, overall. At least, for those of us with concussion/TBI issues to deal with.

Ultimately, thinking about it more and more, it strikes me that TBI cognitive and behavioral issues quite often have a very physical foundation to them — we can experience metabolic changes, sleep disturbances, balance problems… a whole host of physical issues, which cut into our physical — and thus cognitive — reserves in a big way. I know that I was often very tired as a kid, and that brought out the worst in me, time and again. And I know that to this day, if I’m tired and I’m not feeling very physically capable, it does a number on my head.

So, Goal #1 for 2012 for me is to keep fit. To build my stamina up to where it used to be, and to keep it there. Build some muscle to support my frame. Lose the extra weight that is holding me down. And get myself to a place where I am feeling balanced and capable. I don’t have to get ripped and buff and all that — I just need to build up my body to where it can support itself and also support my brain and mind in doing what I need to do, each day.

It doesn’t have to be a big deal, but it does need to be a regular part of my life. My life and my work deserve no less.

Stretching for more

April first. Surprise. I have a noontime appointment scheduled with my neuropsych today to follow up on some things we didn’t get a chance to talk about on Tuesday. I’ve got the time, so why not use it? Except that the weather is bad. And I’ve got things I’d like to do with the three hours it would take me to drive in, consult, and then drive home. Like sleep. Seems to me, sleep might actually help me more than driving through bad weather, sitting and talking, and then driving back.

It might shake me out of my funk. I have to admit, I’m not very good at vacations. I like my schedule, my routine. It has been good, getting out of the schedule-driven mainstream for a week, but I’m ready to get back into work. I’m ready go back to my job, my office, my roster of duties. I don’t quite feel like myself, when I’m off my schedule. I have more time, but I get less done.

Still and all, it’s been good to get out of the frantic go-go-go of the daily grind. Working in technology sets a grueling pace, which is promoted by people of a distinctly darwinian bent, who think that the better you are, the faster you’ll go. Hm. Not sure about that. Seems like speed is its own justification, at times. They just want to feel like they’re doing something. They just want to feel like they’re making progress.

Hm.

Anyway, the weather is letting up, but I think I’m going to cancel my appointment. I have a standing appointment on Tuesdays, and I’ll be closer to the neuropsych’s office on Tuesday than I am today. Time savings. Life savings. I just don’t want to wear myself out even more than I already am. Didn’t get my nap yesterday. Got busy running around in the evening. Also didn’t get things done that I need to get done.

At three years into my active recovery, I’m finding that I need to make some substantial changes to how I go about living my life. Discovering that mild traumatic brain injury was the cause of many of my difficulties throughout the course of my life was amazingly freeing and totally unexpected. It set me loose in the world, the way few other things have. It gave me a framework to understand myself and my own personal situation, and it gave me a route to follow to address specific issues I had in a systematic, common sense way, rather than the scatter-shot trials and errors of my life to that point.

Discovering the root cause of my issues gave me the means to address them. And address them, I have. Now that I’ve made all this progress, a different approach is called for. It’s about using the tools I have and the knowledge I’ve gained, to take things beyond the basic survival tactics I’ve employed for the past three years. The basics are pretty much in place — being, my understanding of my history and how it’s affected me — and I have the tools to address my issues, like fatigue, irritability, anger, aggression, and memory issues.

With these in place, it doesn’t make sense for me to keep subsisting at a fundamental level, “just happy to be alive”. Sure, I’m VERY happy to be alive. Don’t get me wrong. But I don’t want to fall into the rut that some acquaintances of mine are stuck in. They’re my “recovery friends” on the mend from histories of violence, abuse, addiction, and other things that strike at the core of who we are and what we think we’re all about. They literally tell me, “I’m lucky to just be functioning at a basic level,” and they mean it. But from where I’m sitting, it seems to me they’re capable of a whole lot more than that. They’re just not taking that chance. They’re not testing their own limits. They’re sitting in their stuff, feeling sorry for themselves or telling themselves they’re really badly off… when they’re really no worse positioned in the world than most of the other non-recovery-focused people I know and work with.

Don’t get me wrong. I don’t dismiss their troubles and their issues. Lord knows, I’ve got my fair share — we all do. But that’s the point — we all have our issues, and nobody goes through life without some measure of pain and suffering. Even the richest and most entitled people in the world experience excruciating pain — which must actually be worse than being in pain as a “normal” person. It must be awful to suffer, when you’re well aware that all of life is arranged around you to minimize, even prevent, any sort of pain at all.

But who can say why or how or for what we experience what we do? Lessons, I suppose. Just a lot of lessons.

Which is where I find myself now, on the last day of my official vacation. I’ve had a lot of time to think and ponder and examine my life, and while I’ve come away with a pretty good sense of being in a far better place than I was three years ago, something is missing. Something more. Maybe it’s in my nature, being the sort of person who is always looking for what’s next and what else is out there. Maybe I’m just naturally inclined to push the envelope. Bottom line is, I need more challenge. I need more living. I need more life. I need to get beyond this immediate situation of mine and look to the future, with my tools and strategies as a good foundation for moving forward.

More life. Different life. I’ve been spending more time stretching, the past few days, and I’m realizing that I probably need to shift my daily routine away from straight weight training and more to strength-building yoga. Lifting weights is great, but it also shortens the muscles (when you build bulk), and that may be contributing to my pain. Also the tightening causes me to tense up. I’ve been tense for a long, long time, and I need to find a different way of living in the world.

I have to say, I feel much better when I stretch. I steered clear of yoga for many years, because it was painful for me to do the stretches and hold the poses. But I’m at a point now where I’ve done enough stretching on my own to get past that excruciating pain. Stretching on my own, taking it easy, and being focused on my own movement (rather than a roomful of people) has been good. And I really need to do more of it — in a different way… in my own way.

{Pause to stretch}

Stretching… yes… in more ways than one. Physical stretching, as well as mental and professional stretching. I’ve had a lot of time this week to contemplate my work, why I do it, what it means to me. And I realize that the “career path” I’m on is less about climbing the ladder and more about having a quality experience… and sharing that experience with others It’s all very well and good for others to chase after the brass ring and climb over each other to reach the top, but that tends to be pretty debilitating for me. All that adrenaline pumping all the time — the constant go-go-go is all very well and good, but where does it eventually take you to? And once you get there, is that really where you want to be?

In the years before my last TBI, I was living that life. Fast and furious. Fiercely driven. I was a force to be reckoned with, and I was alternately feared and respected by my peers and highly valued by my employer. Then I fell, and it all fell apart. Then someone close to me died, and I sat and held their hand as they slowly slipped away from a life they had dearly loved and hated to leave. Then someone else close to me became seriously ill, and I was their caretaker for about a year. Three big hits in about three years. Even one of those would have been plenty to handle. But no, there had to be three.

Anyway… Coming out on the other side of it, now with three years of active rehab under my belt, I see how those experiences changed me, and how they have shaped my attitude towards life and my work. I know, having watched the young children and loving spouse of my loved-one who died all too young, that none of us has any guarantees in life. Even when the doctor gives you a clean bill of health and tells you to expect to see your kids graduate from college… they could be wrong. Even when you think you’ve got it all together, something as simple as a fall down the stairs can wipe out some of your most prized, cherished coping mechanisms. Even when you’re locked on target and think you’ve got your path figured out, serious illness can manifest and leave you feeling and acting like a six-year-old child, with all certainty erased.

And I realize — with the last week’s perspective — that no matter how hard I work, no matter how hard I push myself, it will never be enough. Not for me, anyway. And it will never be enough for the world. There will always be other things that need to be done, other endeavors to perfect. I also know for certain that the most important thing to me in my work is not the work itself, but the experiences I have in that work. That’s something that can’t be taken away. I need depth of experience. I need the kind of engagement and connection that makes memories for years to come. In the past, I have been so focused on getting things done, that I never stopped to fully experience what it is I was doing. I was so driven by results, that the process got lost along the way.

And that’s a shame. Because my memory is already iffy — why make it even worse?

Indeed.

The ironic thing is, when I take my focus off the delivery dates and bottom lines and pure results, and I focus on the core essentials — doing good work for the sake of doing it, and sharing the success with others to really create a working environment that, well, works — the results turn out even better, the bottom line is fed, and the actual results are longer-lived and more sustainable than ever. Getting the focus off the short-term, and putting it on the long-term, creates success not only in the present, but in the future as well. In the process of transcending the bottom line and delivery dates, those very things are fed. And it turns out better in the long run. For everyone. And I have real memories of live to look back on, later, not just a handful of deliveries and goals achieved.

Well, despite the weather, it is a beautiful day. I think I’ll step away from the computer now and have a good stretch.

Keeping up physically — and cognitively

I just got done with my second workout of the day. I’m not being compulsive (I promise) — it’s just that I really took it easy this morning, thinking I needed a break. Then I watched this great bunch of videos about how exercise helps the brain,  and I got a number of reprints of research by Arthur F. Kramer, who has done a bunch of research linking exercise with cognitive health, (especially Fit body, fit mind? Scientific American Mind, July/August) and I decided I really needed to give my brain a little more stimuli today, than I had this morning.

I have plenty of people around me who urge me to take it easy and not push myself.  They think it’s a little excessive of me to spend the first half hour-45 minutes of each day exercising and getting my heart rate and respiration going. But I don’t push myself hard every single day, and even if I did, would I be doing anything different to my body, than my ancestors once did, when they had none of the conveniences we have today, and every activity they undertook involved a vastly more involved level of effort, than the activities we follow today?

Exercising makes me feel good. And it’s good for my brain. And it wards off infection and illness. I just can’t feel badly about that.

Plus, you know, when I think about it, the folks who are most eager to see me “slow down” are pretty sedentary, themselves. And they’re not particularly healthy. So, do I take advice from them? Hmmm….

Only if I want to be like them, which I don’t — in the physical respect, anyway.

But I’d rather be like myself. And some very elderly, cognitively with-it relatives I have. I’ve got folks in my grandparents’ generation who are still mentally capable and fully competent, and they’re pushing 100. That’s more than I can say for some of my friends who are keen on me slowing down. Their families, from what they’ve told me, are not given to great longevity. Or mental acuity late into life.

Bottom line is, I just gotta be me. And if that “me” is into exercising more than 15 minutes a day and relishing the pump of freshening blood through my veins and arteries, and feeling good off the boost in oxygen in my brain, then that’s just fine.

And that boost goes a long way, apparently. Exercise, especially extended aerobic exertion over a span of 20 minutes, activates the brain to not only function better, but actually build itself back.  I was reading earlier today about how exercise among a certain aging group resulted in their brains having the mass of individuals 30 years younger. That’s pretty cool, especially since everyone has assumed for decades that once your brain starts to go, that’s pretty much it.

But that’s not the case. Not anymore. And in fact, it’s never been. But we bought into that story, so we got stuck in our crappy stories and became our own self-fufilling prophecies. Like a friend of mine who loves to blame their ‘middle-aged brain’ for every little thing that goes wrong in their life. It’s a bogus claim, especially since my very-elderly elders can dance circles around them, cognitively speaking.

So, I’m focusing on keeping up physically, so that I can benefit cognitively. I don’t want to end up like the members of my family who succumbed to dementia and other degenerative disorders. I know TBI predisposes me to greater risk of demential, but by God, I’m going to do everything in my power to prevent that from taking me out.

I do not want to go down some path of misery and decay, just ’cause of a bunch of freak accidents and being the target of stupid a-holes who thought they had the right to attack me for no good reason.  What’s the sense in that? I know, I should probably make my peace with the uncertainties of life, and just try to savor each moment, but I enjoy this life too much — with all its disappointments and frustrations — to give in. I’d much rather listen to music, work out, and read and learn and participate in my life.

With that kind of focus — rather than sitting around, waiting for my sad life to come to an unfortunate end — even if I do get taken out before my time, at least I’m pretty sure to be enjoying myself.

Triage on the battlefield of life

From Wikipedia:

Triage (pronounced /ˈtriɑʒ/) is a process of prioritizing patients based on the severity of their condition. This rations patient treatment efficiently when resources are insufficient for all to be treated immediately. The term comes from the French verb trier, meaning to separate, sort, sift or select.[1] There are two types of triage: simple and advanced.[2] The outcome may result in determining the order and priority of emergency treatment, the order and priority of emergency transport, or the transport destination for the patient, based upon the special needs of the patient or the balancing of patient distribution in a mass-casualty setting.

Some days, it seems like everyone is dying. Lying wounded on the battlefield of life and gasping for breath.

Along come the doctors to decide — who lives, who dies. Who gets to wait and see.

They sift through the sheer volume of us… separating, sorting, selecting who will receive a portion of their insufficient resources.

What is our order?

What is our priority of emergency treatment?

How and when and to where shall we be transported?

Where are we going, anyway?

Truly, it seems as though all of this country is in a mass-casualty setting.

Triage continues.

Doing it differently this holiday season

I did something quite unusual last night — I went Christmas shopping by myself at a much slower pace than usual. I didn’t manage to buy everything I set out to, but I got everything I could, and I got through the experience in one coherent piece — and I was able to get my nap after I got back.

Normally, this time of year is marked by team-shopping with my spouse. They contact everyone in the family and find out what people want… or we talk about what we think people want, and then they make up the list. We take the list, hop in the car, and head out to stores that look like good candidates, then we slog through the process of elimination, muddling our way through… with me getting so fried I either completely shut down and become non-communicative, or I melt down and fly off the handle over every little thing.

We usually spend several evenings like this, ’round about this time of year, and we’ve both come to dread it a little. My meltdowns had become more extreme over the past few years, and this year we were both really dreading the whole Christmas shopping business — to the point where we are going to be late(!) with presents for family members in other states. That’s never happened before. We were always good about it. But my meltdowns screwed everything up.

We both recognize that doing a lot of social things, this time of year (when work is actually getting more crazy, what with year-end and all), takes a huge toll on me. Even if it’s with friends (especially with friends), all the activity, all the interaction, all the excitement, really cuts into my available energy reserves. And then I get turned around and anxious… and I either regress to a cranky 9-year-old state, whining and bitching and slamming things around… or I melt down, start yelling, freak out over every little thing, and start picking at my spouse over things they say and do, to the point where neither of us can move without me losing it.

What a pain in the ass it is. Of all things, the uncontrollable weeping bothers me the most. The yelling bothers my spouse. It’s embarrassing for me and frightening for them, and neither of us has a very Merry Christmas, when all is said and done.

So, this year we did things differently.

We split up for the day and took care of our respective activities.

My spouse went to a holiday party that was thrown by a colleague of theirs who’s married to an attorney who deals with financial matters. I was invited, too, but we both realized that it would be pretty dumb for me to try to wade into the midst of 50+ actuaries and tax attorneys and their spouses who were invited to the shindig… and try to hold my own. Certainly, I can keep up with the best of them, but marinating in such a heady soup, especially with everyone hopped up on holiday cheer (eggnog, red wine, punch, etc.) and all animated and such, would have been a recipe for disaster.

So, I didn’t go. Instead, I took our shopping list and headed to the mall to stock up on what our families had requested. We had written down in advance all the names and the specific gifts we were going to get, and we had also written down where we were going to get them. That list was my lifeline. Especially in the rush and press of the mall, which sprawls out in all directions, with satellite stores on either end.

I’m happy to report that I actually did really well. I made a few tactical errors — like not parking in the first lot I came to and walking in. But that turned out okay, because if I had parked in the first lot, it would have been all but impossible to get down to the other end of the mall. I studied the list carefully ahead of time and used a highlighter to mark the stores where I’d be going. I also kept my focus trained on the task at hand — even if it was just sitting in traffic. I also walked a lot more this year than other years. I found one parking space and used it for two different stores. And I didn’t hassle with finding a space that was as close as I could get to the building. I took the first decent spot I could find, and then I walked to the store.

Imagine that — in past years, I was possessed with finding parking as close as possible, and I would move the car between stores, even if they were only 500 yards apart.  This year, I just walked the distance. Even though it was cold, for some reason the cold didn’t bother me, and it actually felt good to be out and moving.

I think that my 5 months  of daily exercise has paid off, in this respect. I think part of the reason I was always consumed with driving everywhere was that I just wasn’t physically hardy. I was kind of a wimpy weakling, in fact — though more in thought than in body, but a wimply weakling, all the same. But having a good physical foundation — even just from doing an hour (total) of cycling, stretching, and light lifting each morning — has made a significant difference in my willingness and ability to walk between stores.

It might not seem like much, but the walking (instead of driving) between stores part of the trip actually made a huge difference in my overall experience. Walking between stores — stopping at the car on the way to stash my presents — helped me break up the activity and clear my head. It got me out of that in-store madness, the crush and the rush, and it got me moving, so I felt less backed-up and agitated. And that let me start fresh at the next store.

That was good, because the first store was a friggin’ nightmare. It was one of those big-box electronics places, that supposedly has “everything” but really didn’t. It was exhausting, combing through the stacks of movies and music, only to find everything except what I needed. The lighting was awful — extremely bright and fluorescent and glaring. People kept bumping into me, or walking so close I thought they would run me down. But the worst thing was the acoustics. Everything surface was hard and echo-y and the place was overwhelmingly loud, and every single sound was at least partially distinguishable, which drove me nuts. I’ve noticed that acoustics have a lot more impact on me than light, when I’m out shopping. The store was one big cauldron of loud, indiscriminate noise, and my brain kept trying to follow every sound to see if it mattered. I couldn’t function there. Not with the place full of people — and very agitated, anxious, aggressive people, at that.

I eventually went with a gift card and got the hell out of there. I doubt I’ll ever go back when it’s that full. When the place is low-key and all but empty, I can handle it much better. But at this time of year? Not so much.

Walking back to my car chilled me out. Sweet relief.

At the second store — a bookstore — I started to feel pretty overwhelmed. They had long lines, and the place was packed — which is good for the retailer, but not so great for me. I spent the longest amount of time there, in part because I could feel I was getting overloaded, and I stopped a number of times to catch up with myself and remind myself what I was there to buy. My list was getting a little ragged, at that point, what with me writing notes in the margins and taking it out/putting it back in my pocket. So, eventually I just pulled it out and held onto it for dear life. I must have looked a little simple-minded, but I don’t care. Everyone else was so caught up in their own stuff, anyway. My main challenge there, was not getting trampled by Women On A Mission — many of them carrying large bags and shopping baskets that doubled as ramrods to get through the crowds.

One cool thing happened, though, when I was taking a break — I had a little exchange I had with two teenage boys who were talking about some book they’d heard about. I was just standing there, pretending to look at a shelf of books, just trying to get my bearings, when I hear this one young guy tell his buddy, “I heard about this book I should get — I think it’s called the ‘Kama Sutra’ and it’s, like, about sex, and it’s got these pictures… and it’s really old… like, from India or something.”

Well, I perked up at that, and suddenly very alert, I looked over at them and said, “Oh, yeah — the Kama Sutra, man… You should definitely check it out.”

They kind of looked at me like deer in headlights, and they got flushed and flustered and stammered something about not knowing how to find it. It was about sex, and they didn’t know how to ask someone to help them. I so felt their pain…

I confidently (and confidentially) pointed them to the book-finder computer kiosk, where they could type in the title and it would tell them where to find it in the store.

“Dude, you should totally look into it. It’s got lots of information — and pictures — and it’s been highly recommended… for hundreds of years.”

They got really excited and headed for the book-finder kiosk. Here’s hoping they — and their girlfriends — have a very Merry Christmas.

That little exchange got me back in the game, so I took another look at my list and managed to find the handful of books and music and calendars I wanted to get. I headed for the line and just chilled/zoned out. I didn’t get all tweaked about how long it was taking; I listened in on a conversation for a while, till I realized it was mostly about death and health problems people were having.

Oh – and another thing that helped me keep my act together, was the 4:15 p.m. alarm that I have set on my mobile phone. 4:15 is usually when I need to start wrapping up my day at work. I need to do a checkpoint on the work I’m doing, start to wind down, and begin keeping an eye on the clock, so I don’t get stuck in town past 6:00, which is what happens to me when I don’t watch my time after 3:30 or so. I have this alarm set to go off each day, and it went off while I was in the store, which was a blessing. I had completely lost track of time and I was starting to drift, the way I do, when I’m fatigued and overloaded and disoriented.

It startled me out of my fog, and I knew I still had a bunch of things on my list to get, so I refocused and started thinking about what I would get at the next store, so I could just march in and do my shopping without too much confusion and disorientation. After I paid for my books and music and calendar, I debated whether to have my presents wrapped for free, which might have saved me time in the long run. But I couldn’t bear the thought of having to interact with the folks who were doing the wrapping. They looked really friendly and gregarious — Danger Will Robinson! Warning! Warning! Even a friendly conversation was beyond me at that point.

I realized I just wasn’t up to that, and I must have looked like an idiot, standing there in the middle of the foyer, staring at the gift-wrappers for about 10 minutes, but who cares? Everyone was so caught up in their own stuff, they probably didn’t notice me. And if the gift-wrappers were uncomfortable with my staring, they didn’t show it… too much 😉

Anyway, after I managed to extricate myself from that store, I headed for my last destination. Again, I didn’t sweat the traffic getting out of the lot, and when I got to the final store, I parked at a distance from the front doors and walked in through the icy cold, which was good — it cleared my head.

Inside, I consulted my list again and headed directly for the section that had what I needed. Halfway there, I remembered that I’d meant to buy a very important present at the first store, but I’d totally blanked on it. I started to freak out and got caught up in trying to figure out how to get back to that first store and not lose my mind in the process.  Then, I slowed down and stopped catastrophizing, and in my calming mind, it occurred to me that — Oh, yeah — they probably carried that item at this store, so I went and checked, and sure enough, there it was – score! I didn’t have to back to big-box hell. At least, not that day.

I found some more of the presents on my list, and although I didn’t get everything I needed, I made a decent dent. My partner can come with me and help me sort out the other items either today or tomorrow. Or possibly when we get to our family — they usually have some last-minute shopping to do, and they can cart us around with them. And I won’t have to drive.

By the time I got home, I was bushed. My spouse wasn’t home yet, so I called them — they were on their way home and were stopping to pickup some supper. I said I was lying down for a nap, and they didn’t have to wake me when they got home. Then I took a hot shower to get the public germs off me, laid down, and listened to Belleruth Naparstek’s Stress Hardiness Optimization CD. I had a bit of trouble relaxing and getting down, but I did manage to get half an hour’s sleep in, before I woke up in time for dinner.

My partner had a pretty good time at the party, but they said it probably would have been a disaster for me — so many people, so much energy, so many strangers, and unfamiliar surroundings. I concurred, and I showed them what I’d bought that afternoon.

We’d both done well. We both missed each other terribly, but we did get through the afternoon without one of those terrible holiday incidents that has dogged us for many, many years. Like Thanksgiving, which went so well, this Christmas shopping trip actually felt normal. It didn’t have that old edginess that I always associate with holiday shopping. It didn’t have the constant adrenaline rush. In some respects, it feels strange and unfamiliar, but you know what? If strange and unfamiliar means level-headed and low-key and plain old sane, and it means I can keep my energy up and pace myself with proper planning… well, I can get used to that.

Yes, I’ve done things differently this year. And it’s good.

Muscle doesn’t build itself

I was talking to my therapist the other week, trying to describe to them the pain that I’m in on a regular basis. They were (understandably) concerned, and I found it difficult to relate the information objectively without alarming them.

I hate when I alarm people, simply by being and living the way I do. I’m not trying to shock them, but when folks become acquainted with my interior life, yes, it can be shocking.

Anyway, they recommended plenty of exercise (which I’m doing), and they suggested physical therapy might be useful.

Now, I can’t imagine that anyone is going to offer me physical therapy that can help my situation. What exercises could I possibly do, to address the myofascial all-over pain that wreaks havoc with my sanity? What specific routines could anyone recommend to ease the aching scream in my joints and the connecting points in my lower back, hips, knees, elbows… you name it…?

It’s not that I dispute it can be addresed — this pain, I mean — it’s just that I’m skeptical of the ability of others to prescribe a suitable solution for me. I’m just not that easy. Or easily explained. Besides, the pain tends to travel. Where is it today? Only today will tell.

What I do not dispute is the benefit of exercise. Daily. Routinely. As part of my waking-up ritual. I get up, and the first thing I do, is get on that exercise bike. Then I stretch. Then I lift. Not a lot of weight, but enough to notice it’s there. Enough to make my muscles burn in a good way, get my heart pumping and my skin sweating. Enough to remind me how far I’ve come, and how far I have to go.

One of the things my therapist mentioned was that physical therapy can help the knees. This I know. You help the knees — joints which can’t be helped directly — by strengthening the muscles around them. You don’t fix the joint. You fix what’s around it, what’s supporting it, what’s holding it together.

And it works. It took physical therapists years and years to figure that one out, and now we can all benefit.

From where I’m sitting, the rest of me benefits in the same way. The weak and crackly shoulders I have, the weak and crackly back I have, the weak and complaining legs I have — hips, knees, ankles — are all improved when I strengthen the muscles around them. Even my neck, which is a wreck, most of the time — pain and stiffness and the third vertebra from the top turning out to be pushed out of place every time I pay close attention to it — is helped by a good dose of concentrated lifting. In fact, when I was doing a lot of heavy weights, back about 10 years ago (and pretty much built of solid muscle, thank you very much), my neck always felt better when I did 70 lbs worth of shrugs.

You should have seen the looks on the faces of the other cubicle dwellers I worked out with, when I walked over and grabbed two 35-lb dumbells off the rack and started shrugging away. Priceless. But it worked like a charm. By the end of three sets of 12, my neck felt 200% better than it had before. And the benefits lasted for days. And the same was true of the rest of my body. I always felt so much better when I lifted regularly. And one of the things I resent losing the most, after my last fall in 2004, was the ability to go to the gym and work out without overwhelm or anxiety. I miss it. I still miss being able to go out and work out. But for now I’m doing what I can in the privacy of my own home.

I do what I can to build muscle. And it doesn’t get built on its own. It takes work and concentration and dedication to a greater cause. It takes persistence that defies logic and human resolve. It takes tenacity and a small dose of fear of what might happen if I don’t do it. Muscle doesn’t get built on its own. But when you do build it, it works for you.

Sometimes you gotta give a whole lot, before you can expect to get anything (no matter how small) in return.

I guess this is what I’m doing with my life, these days –giving a lot to get something back. Building up the proverbial muscle around the weak spots in my life — building up routines and strategies and techniques and tactics, to support the weak parts of my brain, the parts that got broken, the parts that won’t be fixed, no matter how determined I am. I’m re-routing around the burned-out shells of my old domains. I’m blazing trails through the jungle, to skirt the blown-up bridges in my neural network. I’m carving out new pathways in uncharted territory, and I’m moving what deadfall I can from the paths I must tread.

A blown-out knee, in and of itself, cannot be strengthened. It’s just bone and cartilage and connective sinews. But the muscle around it can — and should — be strengthened, and function can be restored to the leg and the body. A broken brain, in and of itself, may or may not heal. The neural connections that get shredded, are frayed for good, and nothing can return them to their original pristine state. But there are other ways of connecting disparate regions, and there are plenty of strategies and techniques available to get from Point A to Point Z in fine style.

I can sit around and bemoan my fate as an mtbi survivor with a whole truckload of residual issues… I can feel sorry for myself and worry about whether I’ll ever get back exactly the capabilities I had before… or I can take the focus off specifics and focus more fully on results — achieving the same sorts of things I did before, but now through different means.

A lot is possible, if we consider alternatives. But the alternatives won’t come out of the woodwork and make themselves known to us without our direct involvement. And we’ll never find out what does and does not work for us, if we sit around waiting for someone else to tell us what our next steps are.

It was a real struggle for me to get out of bed this morning, and I resented most of my workout with a begrudging resignation. But I did what needed to be done, and by the time I was finished, I felt ten times better than when I started. Day by day, bit by bit, I make headway and I find my way further down the path I wish to tread. Work doesn’t do itself. Workouts don’t do themselves. Muscle doesn’t build itself.

That’s all on me. And I’m glad of it.

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.