From good, to … where?

More quandary… I woke up early again today. I think I’m just jazzed about having extended time off, and all the ideas I normally don’t have the time to really dig into are pushing at the edges of my thought process.

They’re like neglected children — or puppies — all clamoring for attention.

What to do?

Well, first, I need to realize that this is a really good problem to have. A lot of people never figure out just what they want to do with their lives. I know what I want to do, and I’m doing it.

I just need to figure out how to make the most of it — and also get support from others to keep doing it. I spend a whole lot of time researching and writing and publishing, yet so far, the majority of the support has been motivational, moral support. I’m not knocking that — far from it. The “emotional paycheck” (as they call it) has been hugely important to me.

The thing is, emotions don’t really pay the bills, and I’ve gotta do that. So, I spent the lion’s share of my time working jobs that will get me money, so I can keep up this work… keep it going. And do more.

The other thing that’s kind of throwing me off, is that I’ve gotten into a pretty good space with my life. Sure, I still have issues that make my days “interesting”, but they’re manageable. I’ve figured out how to either ameliorate them or work around them or just plain ignore them and move along with my life. All the energy and time and focus I spent on identifying my issues, addressing them, coming up with new strategies and techniques, etc., etc.  …. well, it’s all paid off. And I’m in a really competent space right now (when I’m not mouthing off to police officers and managers at work, anyway).

And now where do I go?

I mean, seriously. I’ve felt like I was barely breaking even, for most of my 50 years. I’ve always had the sense that I was playing catch-up… and I wasn’t catching up very fast.

Now that I have the sense that I AM caught up, what do I do with myself?

If all you’re doing for your entire life, is trying to break even, and your whole life is geared towards laying low and minimizing risk, how can you transition to stepping out and above and beyond, when you no longer have to be chasing an ever-elusive goal?

If all your life you’re geared towards keeping things from blowing up, what do you do with yourself when you don’t have to be on constant guard? What do you do with all the energy that’s been spent on moment-by-moment damage control for so many years, when you’ve managed to achieve that level of control at a higher level?

And how do you keep yourself from imploding or going supernova from all the energy that comes up, when you’re not in constant fight-flight mode?

That there’s the question I’m wrangling with, this weekend. I have a lot of things I want to do, and that’s great. And in addition, I need to get used to the idea of moving forward into the unknown — and NOT having it all blow up in my face.

Well, this certainly keeps things interesting.

Onward.

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Just for today – every day

This is how it can be – click the image to see the big picture

Something magical happens when I quit worrying about everything before and after Right-Here-Right-Now.

I get to focus on what’s in front of me, and just concentrate my energy on that.

It simplifies things.

It relieves my taxed brain of all the what-ifs.

It makes it possible for me to put every single bit of my attention on the activity at hand, and give it my all.

And that’s a really good thing.

One of the drawbacks of mild TBI is that it can really screw with your attention. It makes you susceptible to distraction. It tires out your brain, which makes you even more susceptible to distraction.

Think about it — there are pathways in your brain that have been all messed up, like roads that got washed out during flooding, or a small town Main Street that got completely wiped out by a tornado. Your brain isn’t gone, but the usual ways of information getting around, are disrupted, sometimes wrecked. And you have to find your way through.

That takes energy. And it can be frustrating. It takes creativity and constant adjustment. And that takes even more energy. It takes self-discipline and self-knowledge to manage your moods and behavior, and not many of us have that in abundance, after our brains are injured.

Me included.

But if I can focus just on what’s in front of me, and not get pulled off in a million different directions, well then… things work much better.

And I can pick my way through the rubble, move it out of the way, and eventually build up paths that take me where I want to go. Over and over, it needs to be done. And it can get exhausting and daunting to do it. But you’ve gotta keep the faith, and keep looking at the signs of progress along the way.

Even the littlest ones.

Focusing on today, the immediate moment, enjoying the good little things, and finding ways I can address the bad little things… that’s the ticket.

At least for today it is.

Yet another way of cleaning the brain

Is there more than one way to clear out the sludge?

If you’re like a lot of people who check Google News on a regular basis, you may have seen the news about sleep clearing the brain of metabolic build-up after a hard day’s work. Sleep is an important part of every living being, across all species, but until recently (medical) people haven’t know exactly why that is. Esoteric practitioners have a lot of different explanations for why we sleep, but in terms of hard science, the importance of sleep has been a mystery.

Not long ago, researchers discovered that when we sleep, the glymphatic system (the functional waste removal system for our central nervous system, or CNS), clears out metabolic buildup (read, junk that’s left over from our busy minds’ activities), getting rid of a lot of stuff that we don’t need. It just gets in the way. Which is why we need to sleep.

Here’s a video explaining the new research:

Not getting enough sleep means not getting enough time to clear out all the sludge from your brain that comes from all the mental activity we’re engaged in. It means you’re still — literally — carrying around extra “baggage” (albeit very miniscule stuff) from before, that you should really just let go — via a good night’s sleep that opens up passages in our brains to let the extra junk pass through and out — to our livers, where it’s processed out of our systems.

I’ve been pretty excited to hear about this, especially because concussion / mild traumatic brain injury produces an abnormal and complex neurometabolic cascade that floods the brain with all sorts of extras, like potassium, calcium, glucose, and other neurotransmitters which get our brains all worked up — it can really get us pumping. And afterwards, we’ve got a whole bunch of junk in our brains that we’re not used to having there… and we need to clear out.

This combination of extra junk in your system is one of the things that makes you foggy and dull after a concussion. All that stuff needs to get cleared out, for your brain to right itself — and then it’s got to do the extra work of healing and (re)learning how to do stuff that may seem very simple, but suddenly becomes hard.

So, long story short, sleep helps after concussion / tbi, because it cleans the junk out of your brain. Lots of sleep is good. At the same time, too much sleep can be a problem, too. So, you have to find a balance.

One of the issues that I have with my long-term concussion / PCS / TBI issues is problems with sleep. I have trouble getting to sleep, and I have trouble getting more than 6-7 hours a night. If I get 8 hours or more, it’s like a jackpot. Interestingly, when I get more than 8 hours, I usually feel drugged and not quite right in the head. In some ways, it’s worse than only getting 6 hours.

But when I only get 6 hours, like last night, I definitely feel it. I’m pretty much of a zombie, feeling jet-lagged and depressed and really down. The time change this past weekend did a number on me, for sure. And now that I’ve read about the glymphatic system and what it does, now I’ve got this much clearer sensation that I’m dull for a reason — there’s too much crap still clogging the lines of my brain. It’s bad enough being tired. But having my brain full of metabolic waste, on top of it… geez.

So, if I can’t seem to get at least 8 hours of sleep a night, no matter what I do, how can I ever hope to clear all the crap out of my brain? I mean, seriously, this is a real concern for me. I have been doing daily exercises to warm myself up in the morning and get the blood flowing to clear out the cobwebs and help my lymphatic system fight off infection, but while waking, the pathways in our brains through which waste passes are 60% smaller than when we’re asleep. How can I take advantage of my body’s systems and help them do their job?

Coincidentally (or perhaps not), I got an email from Coherence.com about how coherent breathing may help to wash the brain (you can read the PDF by clicking here), in a similar way that sleep does. A steady cadence of 5 full breaths per minute — about 6 seconds inhale and 6 seconds exhale — helps to not only balance the autonomic nervous system (ANS), getting you out of fight-flight craziness, but may also help to jump-start the glymphatic system which removes the leftover junk from your brain.

I find this encouraging. While it’s not proven by rigorous scientific studies, the logic makes sense to me. And it’s something I can do, even when I’m not getting enough sleep — like this morning, with my whopping ~6 hours.

So, this morning as I lay in bed at 6:15 (I woke up a little before 6 and got to sleep a little before midnight), I relaxed and did my coherent breathing — counting six seconds in and six seconds out. I focused on my diaphragm, making sure I was breathing deeply so that my belly was rising and falling smoothly, and I just counted. I timed myself a few times, to make sure I wasn’t going too fast — if anything, I breathe more slowly than 6-seconds in-out, but I can’t worry about that. The main thing is that I’m in the range and that I’m balanced with the length of time I’m inhaling and exhaling.

I didn’t worry about how many breaths I was taking — I used to count my breaths, back when I was sitting and breathing each morning — and I just lay flat, because that helps to regulate the overall system pressures in the body, which aids the flow of fluids (as in cerebrospinal fluid, or CSF).

I just focused on my breathing, keeping myself in the count-of-6-in / count-of-6-out zone, knowing that I was doing something good for myself, and that not only was I balancing out my nervous system so I wouldn’t start the day in fight-flight mode, but I was also moving the crap out of my system.

That’s an important part of this, because it is incredibly difficult for me to just sit still – especially first thing in the morning, when my head is racing and I want to get going! Getting my system to calm down and focusing my mind is quite difficult – especially after a short night’s sleep, when I’m waking up riding a wave of adrenaline.

Focusing on the idea that I’m making myself more functional and more capable, helps me to calm my system down and keep me focused. Definitely knowing that I did not get enough sleep last night — and haven’t gotten enough sleep in months, if not years — gives me all the more incentive to clear out the sludge that comes from my brain having to work so hard, day in and day out. Heck, even if it’s just conjecture and the folks who promote coherent breathing aren’t 100% correct about clearing out the metabolic waste with that technique, the fact of the matter is, my system chilled out, and I got up feeling a whole lot better than I did when I first woke up. And that’s no small potatoes.

I probably spent about 20 minutes doing this — probably longer than I would have done, were it not so cold this morning. I wanted to stay in bed, so this was good justification. 🙂  And after a few minutes, I started to feel a lot less “jazzed” and amped up. Waking up after a short night’s sleep can be pretty rough — I just jolt awake, all systems GO, with my heart racing and the blood pumping. While it’s sometimes energizing, over time it gets to be a pain in the ass, because it wears me down, and I crash later in the morning, after the pump wears off — major let-down.

This way — as was the case when I was sitting and breathing regularly, back about a year or so ago — I can stay in my warm bed a bit longer, I can work on my breathing to calm down my ANS, and I can also help my brain get a “clean start” on the day.

It’s a win-win all around. Good stuff.

Onward.

Headache is back

So, I got a bunch of things done this morning that were pretty significant, not least of which is having signed a legal agreement with another collaborator that clears the way to move forward with one of my projects. I was feeling pretty up, as I ran my errands, then I stopped by the local high school track to have a quick walk between rain showers. I felt great, and the track has been recently resurfaced, so I did some quick sprints, which felt really good.

I was a pretty serious athlete when I was younger, and I ran a lot. It felt great to get moving again today — even just a little bit.

After that, I went home, took a shower and had some lunch, then called my collaborator, and agreed on next steps.

Then I lay down for a nap.

I had a good rest; when I woke up, though, I had one of those pressure headaches, where the sides of my head feel like they’re pushing together and pressing my brain out the top and front of my skull. Not fun. I used to get these headaches all the time. I had them for years and years, and it wasn’t until I started seeing a chiropractor that they subsided.

And then I didn’t have problems with them for quite some time. I was exercising regularly, getting adjusted every other day, and that seemed to keep them at bay.

Then I quit exercising regularly. I found I had overtrained, I was not having a balanced enough life, and I needed to let some stress injuries heal. I also quit going to the chiro, because I was out of money and insurance wouldn’t cover me.

But I never went back to exercising regularly in quite the same way. In fact, I found that when I did exercise like I used to — vigorously — I would have this headache. So, that discouraged me. I also haven’t been back to the chiro in years, so that hasn’t helped either, I think.

Now I’m back at the exercise, but apparently I need to take it more slowly. I think the sprints did not help me — too much too soon — even though I did maybe five or six 20-meter sprints, which doesn’t seem like a lot to me.

Then again, maybe it was.

So, I guess that means I rest for the next few days. That’s fine. I can do some light morning warmups and stretching, but I need to watch it and make sure I don’t kill my quality of life with doing too much too soon.

Gradual is best, I guess.

At the same time, though, I don’t want to be going at low speed for the rest of my life, and part of me is hoping that I can wean myself off my sedentary state and get back in the swing of things through tolerating the headache and not letting it dictate everything. I have heard stories about people who had post-headache exercise and worked through it. I don’t want to injure myself, and I don’t want to constantly be in pain, but perhaps this is what it takes — enduring a bit of discomfort in the short term, so my body can acclimate to the changes over the long term.

We’ll see how it goes. At the very least, this will remind me to drink water and stretch, so I don’t let myself get “out of whack” like I often do when I have days off. It keeps me honest, even if it is painful.

At least it’s not incapacitating me. That’s a plus.

Onward. Ouch. Onward.

Keeping focused

Eyes on the prize

Thank heavens – I actually got eight hours of sleep last night. They weren’t all consecutive – I fell asleep while watching a movie at 9:30, slept till 11:30, then went to bed at midnight and slept till 6:00 a.m. So, 2+6=8, and I’m focusing on that.

I am definitely doing better. I started to obsess about my boss having it out for me, then I started asking Whoever-Or-Whatever to care for and support them, so they can get the answers and the help they need in life. I started to get bent out of shape last night, then I managed to get myself back on track in a good way — and I was able to get to sleep. One of the things I tend to do is “use” agitation and anger to get me going in life — but it backfires on me because I then get all riled and worked up, and then I can’t relax.

But last night I managed to relax. I managed to let it go. And that tells me I’m dong better.

Another thing that tells me I’m doing better, is that I am returning a bunch of library books I checked out last week, intending to brush up on my skills to change jobs. I realized this morning, being rested and refreshed, that I was taking on way too much and casting too wide with my skill-building. I need to stay focused and specialize in the area that I have my greatest strengths, right now — NOT go out and try to acquire new skills where I’m starting from scratch.

I need to be smart about this, and I was not doing that, last week.

So, the library books are going back.

Thank heavens for good sleep. Even one night of increased rest makes such a difference.

So, this weekend I have to laser in on the things I need to do for my job, for my impending change. I have realized that I’ve been frittering away a lot of time doing extraneous things, and I have not done a good job of managing my time or my energy. I have been taking valuable hours out of my weekends to go do things that I could be doing during the week, on my way to or from work. I like to work out at this park that’s a half hour drive from home, but when I do it on the weekends, it takes 2-3 hours out of my mornings to go do it. It’s a least an hour of driving, round trip, plus the hour it takes me to work out, plus any extra time I spend chilling out in the process. I do want to be able to enjoy my life and I do need to work out, but I need to find a better way to use my time, than driving to and from a place that’s actually on my way to work.

Ideally, I will use the time I have on my weekends to do things I can only do at home, and I will do the things that are on the way to work, while I’m on my way to work. I just need to get up a little earlier — or get up at the same time — and focus on incorporating those workouts into my day. They have locker rooms at work, so I can shower and change when I get there. It will work out much better, and I’ll get some really good exercise during the week.

I don’t want to get too obsessive-compulsive about this and “optimize my life” down to every spare second, but some things I’m doing are really sucking up valuable time, and I need to change them.

… Things like getting books out of the library that don’t really serve my primary purpose. I have other books that are specifically about what I need to be studying, not what I suspect I may need to learn.

… Things like driving around and losing time on the road that I could be using in studying and working on my skills, and generally enjoying my life at home while I am able to be at home. If I need to work out, I can do it at home with my weights and exercise bike (which I did this morning).

The poor use of time has got to stop. Poor use of time translates to poor use of energy. So, I’m stopping it.

I can still do all the things I need/want to do. I can still find places for them. I just need to be smarter about how I do it, and I need to understand why.

Yesterday, I sat down and made a list of all the things I need to learn and become familiar with, in order to be a viable job candidate for the positions (and the money) that I want. There is a lot that has happened in my field, since I made this detour into positions that were related to it, but not exactly IT.  And I have some catching up to do. It’s pretty exciting, because a lot of this is stuff I had hoped to be able to do in the past, but the technologies weren’t all mature enough to support these kinds of things. Now the technologies are mature, and we’re able to do more and more — which means I need to learn more and more.

And that’s fine. Because I can.

This is a relatively new thing for me — I mean, it’s a relatively re-newed thing for me. When I fell in 2004, one of the things I lost (temporarily) was my ability to learn new things. Hell, I couldn’t even read, let alone keep my attention on the pages of a book long enough to let things sink in. That’s changed dramatically over the past 7 years… I’m better now than I’ve been in a long time, and it just keeps getting better. It’s very encouraging, and each day I learn even more… it builds on itself.

It’s wild, when I think back. In 2005, when I was dealing with all the TBI fallout and I was sliding farther and farther down into that black hole, I couldn’t figure out how to get from A to B to C. Let alone from A to Z. My sequencing was all messed up, and I could not figure out the most basic things, like the orders of instructions and how to use new programs. That’s a problem, when you work with computers. You have to constantly learn how to use new programs. But I was so out of it and so turned around, I was all but useless.

Even up until a year ago, I was still struggling with figuring things out — and it really showed at work. I would get so turned around and confused about how to do things, and then I would sit and struggle with them, thinking that there was something really wrong with me that I couldn’t figure things out. This wasn’t just me thinking it, either — plenty of other people gave me sh*t for not being instantaneously able to decipher new and unique stuff. It’s been very trippy, looking back on the things I did in the past two years, realizing how I just wasn’t clued into how things worked, and I was just pushing through, making the best progress I could under the circumstances, and totally clueless about why people were getting so upset with me. And they were getting really upset with me, because there were a lot of things I was struggling with, for no apparent reason — at least no reason apparent to them.

Now, I really feel like I’m doing much better. I’m more flexible than I was in the past, and I’m more actively engaged in problem-solving situations. I still have my problems dealing with a lot of my co-workers, who have their own issues (their issues are more motivational, than logistical — what I lack in native smoothness, they lack in will and desire). But I’m a lot more clued into what’s going on around me, than I was before.

It’s interesting — talking to my neuropsych, they seem to think that my issues are really based in stressing over things and being hard on myself. They tell me there’s nothing wrong with me. It’s kind of them to say so, yet I can tell a real difference between how I function now and how I functioned before. They are fond of telling me that my perception of my abilities in the past was probably a bit flawed, and I had an inflated sense of my own abilities.

Maybe, but I can still tell a big difference between how clueless I feel now, how much I just kind of muddle through, and the smoothness and fluency of my past abilities. That subjective experience is very important, no matter how much my NP tries to reassure me that there’s really nothing wrong with me. I appreciate their eagerness to reassure me. I think it’s helped me to really overcome a lot that I might have given up on, had I been convinced that I was permanently damaged and was never going to completely “recover”.

However, I have a very different perception and personal experience, and that has told me loud and clear that I have some areas to work on. My NP doesn’t seem to understand that my focus on fixing what is less than perfect is not because I’m down on myself — it’s because I truly believe that I can — and will — improve. But I can’t fix something if I am not aware that there’s an issue. So I have to keep an eye out for issues.

It’s like with Give Back – paying attention to brain injured moments, and focusing on fixing them. That’s my preferred approach, but my NP seems pretty intent on steering me away from focusing on what’s going wrong… and getting me to pay attention to what’s going right. I can see their point — it is so important to focus on what’s right and make the most of that — and replicate the experience. At the same time, though, it’s also important for me to see the areas where I’m coming up short and work through them.

I’ve gotten away from that over the past couple of years, and while it has been helping me to calm down and chill out and take the edge off… as well as improve my sense of who I am and where I fit in the world… it has also kept me from really truly improving in some areas.

And those areas are where I need to focus. Learning. Studying. Doing work properly. Completing my tasks. Delivering my work on time.

So, I still have my work cut out for me. And I need to keep aligned with the direction I’m heading. I have a bunch of stuff I have to do for work, and I have a bunch of stuff I need to do for myself. And I need to keep my strength and resiliency up. I have a plan — to strengthen my skills, find my next job (probably a contract, to start with, so I can get back into that line of work) and start looking for my next career step — another permanent job that is more in line with what I want, instead of this ridiculous treading water, just trying to stay afloat in a raging sea.

Please.

Anyway, the day is waiting and I have a lot of exciting stuff to think about. It’s time to get going, time to get on with my day. I’m feeling really good about this, and each time I sit down to work on my skills, I remember yet again why I got into this line of work — I just love it so much.

And that is good fuel for my focus.

Forget despair – I’m going to exercise

This dog isn’t going down easily

I have to admit, writing about the traumatic / PTSD aspects of TBI has got me a little bummed out. Additionally, thinking about CTE and the NFL players’ suit(s) against the NFL, and pondering the shortened anticipated lifespan of TBI survivors, hasn’t helped my mood at all.

No surprises there.

I did happen upon something interesting today, however — and it both appears to confirm what I have suspected, as well as adds a little more information to my “store”. It also lit a fire under me with regards to my exercise routine.

Check out this recently published paper from Brain – A Journal of Neurology:

Stimulation of autophagy reduces neurodegeneration in a mouse model of human tauopathy

Okay, now that I’ve got your attention 😉 what does it mean? Basically, autophagy is the process by which cells digest parts of themselves by breaking down the bits they don’t need or are trying to get rid of, and using them as “food” for other processes. A good example of autophagy is dieting — where your body consumes the fat in some places to fuel its activities. It sounds a bit strange and creepy at first look, but when you think about it, it makes perfect sense — if there’s energy or some other ingredient that’s taking up space in a cell, and it can be used for other purposes, such as energy, then it only makes sense for the cell to break it down and use it up for something else. Our cells do this all the time – and in the case of trying to lose weight, that’s exactly what we want them to do.

Since this breaking-down function is available in cells that want to get rid of extra “baggage” — and tau, the protein which is linked to CTE and other dementia-like brain degeneration like Alzheimers is definitely extra baggage that isn’t doing anyone any good, then wouldn’t it make sense for this breaking down process to be useful when it comes to clearing out tau from brain cells? Apparently, yes. Here’s the summary from the article I found (bold emphasis is mine):

Summary

The accumulation of insoluble proteins is a pathological hallmark of several neurodegenerative disorders. Tauopathies are caused by the dysfunction and aggregation of tau protein and an impairment of cellular protein degradation pathways may contribute to their pathogenesis. Thus, a deficiency in autophagy can cause neurodegeneration, while activation of autophagy is protective against some proteinopathies. Little is known about the role of autophagy in animal models of human tauopathy. In the present report, we assessed the effects of autophagy stimulation by trehalose in a transgenic mouse model of tauopathy, the human mutant P301S tau mouse, using biochemical and immunohistochemical analyses. Neuronal survival was evaluated by stereology. Autophagy was activated in the brain, where the number of neurons containing tau inclusions was significantly reduced, as was the amount of insoluble tau protein. This reduction in tau aggregates was associated with improved neuronal survival in the cerebral cortex and the brainstem. We also observed a decrease of p62 protein, suggesting that it may contribute to the removal of tau inclusions. Trehalose failed to activate autophagy in the spinal cord, where it had no impact on the level of sarkosyl-insoluble tau. Accordingly, trehalose had no effect on the motor impairment of human mutant P301S tau transgenic mice. Our findings provide direct evidence in favour of the degradation of tau aggregates by autophagy. Activation of autophagy may be worth investigating in the context of therapies for human tauopathies.

So, yeah – you’ve got extra proteins gunking up your brain cells after a traumatic brain injury/concussion, and that extra protein isn’t doing anyone any good. Wouldn’t it make sense to use the cells’ own activity of breaking down portions of themselves and flushing them out, to help clear out the tau?

In the study, they used trehalose to stimulate the process in mice, which may or may not be all that useful for my purposes. Trehalose is used in processing a lot of foods, and it’s not uncommon. I’m not sure how therapeutic it would be for me to consume mass quantities of “confectionery, bread, vegetables side dishes, animal-derived deli foods, pouch-packed foods, frozen foods, and beverages, as well as foods for lunches, eating out, or prepared at home,” especially if my body has its own natural processes to move things along. What natural processes, you ask? Exercise. Acute exercise. Researchers have found that acute exercise stimulates autophagy in the skeletons and muscles of mice, and I don’t think it’s a stretch to deduce that it can have the same effects on cells of the brain.

Why not? Okay, I’m probably being markedly unscientific here by drawing conclusions from reading a few articles (scholarly as they may be), but let’s use common sense for a moment. The human body is constantly renewing itself — every 7 years, we get a new body, because the cells have all renewed themselves. If acute exercise is worked into the routine on a regular basis, then wouldn’t it make sense that the autophagy induced by exercise would help the body rebuild itself with new materials, and with less tau?

As a TBI survivor who has a nagging concern about tau-induced dementia later in life, this gives me hope. And while “hope is not a strategy” and my scientific method leaves a lot to be desired, nonetheless, it does help me get past the pernicious, creeping depression that sets in sometimes when I get tired and start to think, “After all those TBIs, what’s the use?”

So, I’m throwing myself a bone, here, and I’m gnawing on it with all my might. I have known for several years, now, that exercise makes me feel and think better when I do it first thing in the morning. And I’ve known for decades that a good hard workout makes me feel like a new person. Researchers seem to be confirming scientifically what I have experienced, and they’re explaining it in ways that make sense to me and my systems-oriented conceptual brain (all the biochemical-speak notwithstanding).

So rather than getting hung up on the idea that I’ve gotten clunked in the head too many times, and that’s that, I’m going to amp up my exercise and really push myself to do more with it. It’s the acute stuff that apparently helps the most, so I need to do more of that. Not to the point of injuring myself, but definitely more than the easy-peasy warmups I’ve fallen into doing over the past six months or so.

Screw despair. I’m going outside to get some serious exercise.

Fighting what kills

The past few days have been pretty much of a roller coaster. I’ve been working 12-14 hour days, trying to get my work done before some major deadlines, and I haven’t been sleeping much. I have also made some changes with how I interact with my neuropsych and now when things are not good, I just go ahead and say so. If things are rough for me, no matter how much I may think I should be able to handle things, I have to speak up. And I can’t let them dismiss me and my difficulties — I can’t let them “talk me out of them” when things like sleep and balance problems, fuzzy thinking, and emotional fluctuations are kicking the crap out of me.

I guess I got back into the habit of covering those things up, telling myself I can just push through… and it’s cost me considerably. It’s cutting into my ability to do my job — and my ability to believe I can do my job. It’s also cutting into my ability to see the big picture and get up out of the mire and swamp of details and stimuli and distractions that constantly swirl around me.

It’s taking a toll, and I have to really get honest about what is going on with me and get help. Even if I do think it “shouldn’t” be that way.

Perhaps the biggest hurdle I face is recognizing when things are not going well, and then admitting that they are just not exactly in order. It’s something I just cannot do on my own as well as I’d like — and the people in my life aren’t the most helpful in this respect. They do NOT respond well to me being less than 100% ON all the time, 100% responsive, 100% engaged, 100%… well, everything.  It’s been my bread-and-butter for years — decades, really — and people are used to me being hyper-functional. So, when I’m not, that doesn’t go over all that well.

Somehow, not being 100% ON and aware and together and collected and all that goes along with that, is just not allowed. And not only in my world, but in the world in general. It’s like we have this weird all-consuming need to have no doubts, to have no hesitation, to have no insecurities or ineffectiveness or other sorts of fragmentation and partial realization of our full potential.

On the one hand, I do feel it’s a worthy thing to be constantly striving to improve and better understand and perform and excel. Where would we be, if we didn’t bother? I’m not sure.

At the same time, though, there are inherent problems with that. And I’ve been coming up against those problems over the past 6 months to a year, when I’ve been so intent on performing better and doing better and achieving and putting myself together. I’ve been so intent on coming across well around others, keeping my game face on, and proving to myself, my boss, my coworkers my neuropsych, and anyone else who is within earshot, that I’ve got it all together, that I’ve lost a lot of ground in actually BEING all together.

I’ve been slipping. I’ve fallen off on my work, I’ve fallen behind on my deliverables, and I’ve fallen behind in my sense of who I am and what I’m about in this world. I’ve felt like I’m just treading water, barely able to get from one day to the next in one piece. And I’ve all but give up on having any sense of being caught up, of being involved in my own life. It’s just one thing after another that pulls at me and pushes at me and drives me in circles.

And now Junior Seau has died.

I saw it on a news website very soon after it happened, and it stopped me in my tracks. Like many people, it was about the last thing I expected to see. And like many others, no matter how terrible this news, there was something about it that didn’t shock me, when the initial jolt had passed. Junior Seau was a football player. A professional football player who spent years of his life colliding with other massive players and in the process set the bar that much higher for his peers. I don’t know much about him, outside of seeing him play over the years, but like many others, he was the last person I expected to shoot himself in the chest at age 43.

Nobody seems to know what could drive a person to kill themself “when their life should have been great” as I heard one of Seau’s good friends describing this time in his cut-short life. Nobody seems to understand what can go on in the heart and mind of someone, which could be so well concealed from others, that their death takes everyone completely by surprise — devastating, crushing, heartbreaking surprise.

What surprises me even more, is that this should be a mystery. Those of us who are tasked with carrying the banner of top performance have this one goal — to not let others down, when they are depending on us. If that means putting aside our own well-being for the sake of the team, for the sake of others’ comfort and confidence, then so be it. If that means putting ourselves in harm’s way again and again, so that others may benefit, then so be it. For those of us who are on the Type A, self-sacrifice, take-one-for-the-gipper track, our devotion to our leading role and our protection of the ones we love — including protecting them from having to see us struggle and battle and flounder — well, that trumps everything. Including our own well-being. And we are well-rewarded for it… as well as penalized when we fall short.

I can’t speak for Junior Seau. I’m not sure anyone can. But I can certainly understand how he would go through life in the past years, possibly struggling cognitively, emotionally, behaviorally… doing his utmost to keep it together to spare his family the pain of seeing his struggles… and feeling that ground slipping away underneath him, as the memory starts to fade and fail, the storms of emotion and unchecked turmoil boil increasingly close to the surface… endangering all that he worked so hard for in his life.

I have thought many times about what I might do, if I ever get to that point — my brain giving out before my body, without any real hope of reversing the damage that’s been done, both to my brain and to my relationships with those I love the most. And in all honesty, I think I will have to remove myself from the company of those I love, if it ever comes to that. I don’t intend to commit suicide — no, something else would be preferable. Something like signing on with the Foreign Legion or signing up as a military contractor/mercenary (no joke)… or hiking into the wilderness of the North Country, and staying there, with only wildlife to witness the progression of whatever had a hold on me. I think of the Incredible Hulk movie scene where the Hulk retires to a cabin by a lake to work things out, and I think of myself.

Suicide… no, it’s not for me. Rather, removing myself from the company of those I might harm IS an option… To get myself away from those who depend on me to be a certain way… those who either have no tolerance for me being “sub-optimal” or who would be too pained to watch me become something other than I once was… those whom I love with all my heart and cannot stand to see harmed by progression degeneration of my cognitive and behavioral capacity.

I guess I’ve gotten old enough to start thinking about how “the end” will be. That thought started coming to mind, this past summer when I had some medical issues, and it’s never entirely gone away. I’m pushing 50, and in all honesty, I’m looking at the possibility I’ve got fewer years ahead of me than behind me, and it’s a strange, strange feeling.

It’s not like I thought I’d live forever, but the fact that I won’t just never sank in. Till this past year.

The thing is, when I think about “how the end will be”, I realize that I’m not past the point of no return yet. And I may never be. You never know how things will go. It could be that I end up lasting for another 50 years, and because I’m taking excellent care of myself, I stay pretty with-it and I don’t have the same level of cognitive/behavioral decline that I see others around me experiencing. (Then again, maybe everyone around me will lose it, so I’ll have to into the woods to spare myself from them). Who can say?

All I know is, I’m still here, and I really truly need to fight for what matters to me, what I want, what I need. I need to fight for myself. I need to fight what kills. I need to own up to what is not right and seek help for that as best I can. And this applies to not only the neurological condition, but also the attitude I have towards it. Because nothing makes concussion and post-concussive symptoms so lethal, as the attitude that it means there’s something wrong with *you* and that there is no room for you to develop as a person, aside from the way you’ve always been and the way that everyone around you sees you.

Nothing kills so much as rigidity and the inflexibility that comes from never exercising the different parts of your life, the different parts of your personality, the different parts of your body. Getting caught in the straightjacket of others’ expectations and the need to always live up to what others want you to do — even if that need comes from love and concern for them — can be murder. In fact, living only by others’ expectations is a great way to dig yourself a hole that you can’t climb out of… because everyone is standing around looking at you being down there, very comfortable with your position in life. Will the people who are happy with you being in that hold reach down and offer a hand for you to get out? No chance. Unless they themselves see that they are in a hole and they need to get out, as well.

And when I think of Junior Seau, I think of what a deep hole he must have been dug down into. He did a lot of good. He was a light in the world, from what everyone has said about him. He was a leader and an example, and now he’s gone. I wonder what the hole he was stuck in looked like in the past few years. He had a restaurant, yes. He was inducted into the San Diego Chargers Hall of Fame, yes. But was it enough, after the years of being at the top? And did he see the writing on the wall, with certain little things that started to go awry when they shouldn’t have? Or maybe there were certain big things, but everyone was so intent on seeing him at his best, that they never guessed…?

Who can say? Whatever the truth, I sincerely doubt that in his shoes, I would have done anything different. With a certain position to uphold in life and a role to play in society…. with family and friends you love and don’t want to disappoint… what’s the prospect for someone who secretly feels that they’re losing it? What are the alternatives? Our society does not make room for people with TBI or other cognitive-behavioral conditions. Hidden injuries are routinely mocked and dismissed. There is hardly any help for people like me, and what help there is, is few and far between and you’re damned lucky if you can find it to begin with. What are the alternatives? Really? You have to get real self-sufficient real quick, or else.

And there are tens of thousands of “what else” cases in jails and institutions and lying around on the couch watching movies and watching life pass them by, day in and day out.

I have no idea if Junior Seau was losing it. It could be that he had completely different reasons for doing what he did — business problems, money problems, family problems, all of which may have seemed inescapable. It’s pointless to guess, I know, but I’m just saying there could be a million different reasons why he did what he did. And concussion might have had nothing at all to do with any of it.

But as someone for whom concussion does have something to do with just about everything, this is another wake-up call for me to keep fighting. To not give up. To keep battling — tooth and nail — the thing that seems like it’s trying to kill me.

Yes, I did work out this morning. And had my breakfast and vitamins. And I sat and breathed. And now it’s time to get to work.

Onward. Always.

The wars we wage – of sport, concussion, and our warrior style – Part I

This series of posts comes as a response to a lot of discussion that’s been happening, lately, about concussions in football — who knew what, how they handled it, who’s responsible, and what might be done about it all… for the sake of our (and our kids’) future. I started out intending to write one post about this, but the issue is much larger, and my time is not as plentiful for one long extended post, so I’ll break it up into several. Please hear me out in the entire thing, before jumping to conclusions.

Part I – That Was Then, This Is Now

The Concussion Blog has been doing a great job of covering recent media discussions, and there have been some interesting comments there.

One thing that really sparked my thinking, was looking at the image used on the 30. January post Show Critiques (CNN and ESPN), which shows a football player from bygone years wearing a helmet that’s a full face guard. He looks more like a spartan than a “jock”… or maybe that’s the point.

And it got me thinking, again, about the nature of our concussion problem. I won’t say “The NFL’s concussion problem”, because to my thinking, it’s everyone’s problem — the NFL, the NHL, the NBA, MLS, MLB… and beyond… It’s a problem that belongs to pretty much all sports, whether adult/professional or high school/youth. ‘Cause the simple fact of the matter is, sports involve movement — often the faster the better — and movement can involve collision, which can lead to concussion. Concussion and sports pretty much go hand-in-hand, as far as I’m concerned.

Even if you’re playing tennis, you can sustain one (think, diving for a return and connecting with a pole or wall). Even if you’re playing golf, you can get one (think, an errant club or ball). Whenever things are moving, and the human head contacts something, you run that risk.

I’m not going to get into an extended discussion about how management, not only prevention, is the key to saving Sport from itself. Instead, I’d like to talk about the very roots of one of the major hurdles that — to my thinking — keeps us in a perpetual loop of denial, risky behavior, and hyper-reactivity. That hurdle, I believe, is our inability to appreciate just how much things have changed in the last 100 years, with regard to American society, American sports, and American war.

Time and time again, when I check the stats on this blog, I find people searching for “pain is weakness leaving the body” — a military slogan pulled from the Marines, which is increasingly used in connection with sports. Even youth sports. I’ve already ranted at length about the inappropriateness of using this slogan in connection with youth sports, so I’ll spare you the diatribe right now. But suffice it to say, I don’t believe it is appropriate to teach our youth — yes, our kids — that ignoring pain (even welcoming it as a sign of how tough you are) is a positive or useful thing.

But even beyond that, in a purely objective sense, what fascinates me about this adoption of an intensely military mindset, is that it is so incredibly popular, and it’s used so much.

Why is this?

What does it mean?

What does it tell us about both our kids and our parents and our society as a whole?

At the risk of over-simplifying things, I believe asking these questions can tell us a lot about the underlying conditions that give rise to our “concussion culture” — how we create it, how we sustain it, how we fear it, and yes, how we worship it.

Let’s go back almost 100 years, to the 1920’s, when football was played by lightly padded individuals.

It was a pretty rough-and-tumble (even deadly) sport, and it had been for years. Around 1905, it was so bad with deaths and life-changing injuries, that then-President Teddy Roosevelt threatened to outlaw it altogether. Rules were introduced which changed the nature of the game (including doing away with some particularly violent tactics — like the flying wedge — and allowing the forward pass)… and the sport continued.

What I think about most, when I consider the early days of football and how it was played, was the social context of it all. Back in the late 1800’s, military-driven expansion into the North American West (following the incredibly bloody and brutal U.S. Civil War) had soaked this nation in blood. World War I, with its millions of dead, again drenched the Western World in blood from 1914-1918. And the ways people made a living were largely related to how physically strong and durable they were. Life expectancy was far less than it is today — a little over 53 years for men, a little over 54 years for women. And what life you had, you could expect to be hard — either working on a farm, or in a factory, doing some sort of manual labor that most of us today can hardly imagine doing, day in and day out.

Further, the expectations were much different for individuals then, than they are today. Individuality and personal customization were hardly the norm. The norm was to conform, to pitch in and do your part, to put your own personal needs aside for the greater good. Even up to World War II, which involved tens of millions of dead, there was a different ethos at play. You took one for the team, on a small and large scale. You played by the rules. You laid your life and health and safety down for the Greater Good. And that’s just how things were. If you were cut down by bullets while racing onto the beaches of Normandy, in service to Your Cause, then so be it. Life, compared to how it is today, was… well… expendable.

And the expectations for what life you would have were considerably lower than what we expect today.

Think about it – at every turn, we have personalization and customization and convenience. We don’t work on farms or docks or factory floors, anymore. We don’t live by the sweat of our brows. We sit in cubicles and maybe go to the gym a few times a week. We don’t rough-house with each other while riding/driving farm equipment, and we don’t pass our time drinking/brawling and have that considered regular and acceptable behavior anymore, except on a playing field or an ice rink. We don’t have codes of law that people actually take seriously. It’s all about who can afford the best justice, who can connect with the most power and “engineer” their rise to the top. It’s all about the individual, our personal settings and service, our custom fit, our OWN self. It’s not about whom we serve, it’s about what we own.

Now, I’m not saying that any of these changes are good or better than how they were. I am saying that this fundamental shift in how we live our lives has turned us into very different creatures than were walking the earth 100 years ago. I’ve heard stories from centenarians about how they used to get a bunch of farm boys together and pick up Model T’s and tip them over to help dislodge a bolt that dropped into an unreachable part of the engine. I’ve heard stories from folks who grew up on farms, about people getting stuck in farm equipment when they weren’t paying attention — and managing to wriggle free at the very last minute, thanks to natural athleticism. I’ve heard stories about farm boys horsing around on tractors and falling under the wheels and living to tell the tale.

All these took place back in the day when everyday life was physically rigorous — and short. If you lived like everyone else, you could expect a relatively short lifespan, by today’s standards. Dying at 50 or 60 was usual, and if you lived to 70, well, then you were pretty unique. Life was expected to be short and hard — and at the same time that you were putting all sorts of demands on your physical frame, you were doing it for a higher purpose, for something that made you part of the greater whole.

Again, I’m not saying that any of our modern changes are better or worse than before. And I certainly don’t want to glorify the old days, when life was short and hard, and religion was your one solace in the face of seemingly perpetual suffering.

What I am saying is that the kinds of people who play football today are different from the kinds who played it once upon a time. People today are far less physically active, than they once were, and even if you do throw in a regular fitness routine, it’s still not the same as the overall movement of a physically demanding way of daily life. What’s more, today when you get hurt, it’s about you — it’s not about the team, it’s really about you. It always has been, in fact, but in past generations, our parents and grandparents and great-grandparents could make peace with their personal sacrifice by seeing it as part of something higher, something bigger than themselves. It was either for God or Church or Country or Family. It wasn’t perceived to be about them — even though every injury they sustained, every hurt they endured did, in fact, cut them to the core.

So, where does that leave us today?

It leaves us floundering in a sea of our own cultural ambivalence and indecision. We have changed as a people. We have altered as individuals. Life as we know it is infinitely safer and more coddling than it was in the last century, but we insist on persist in playing our games in a way that suited our grandparents far better than it suits us.

We want to play hard and seek out pain (because we want to be rid of weakness), yet we don’t get off our a**es long enough each day to bump up our pulse or respiratory rate. We want to be super achievers, but we don’t eat the right foods that will actually let us live our best, we don’t get enough sleep to allow our bodies to recover to keep going, and we think that a handful of pills will offset the (physical and mental) damage we do to ourselves each and every day. We want to go out on the field, to push ourselves and punish each other, but for what? For our team, or for our own individual stress outlet and glory? Our “fans” want us to beat the crap out of each other — literally and figuratively — yet they turn a blind eye when our minds go, our bodies break down, and our lives careen off the tracks.

It makes no sense. As though we’re all sleep-walking down nostalgia lane, imagining ourselves to be far more fit and far better equipped than we truly are.

Part of this illusion we’re all laboring under could be fueled by our equipment — the technologies we think make us better, stronger, faster. The pads, the armor we wear. The supplements we take. The machines we use to improve our performance and measure our progress. Those same technologies, while promising to protect and perfect us, may actually be contributing to our general ineffectiveness and increasing weakness. It’s only wonderful to have a short walk from your car to the front doors of the mall, if you’re physically handicapped and the weather is really nasty. But for the rest of us, these conveniences, these things we “have to have” are undermining the very foundation of our health — and our ability to participate in sports, even life, the way we think we can.

I realize this post has gotten quite long. And I may have gone off on tangents. Let me get to the bottom line, here, before I go off and start my day in earnest:

Many of us (myself included) — particularly athletes and Type A hyperachievers — have a warrior style or ethos, in which we often envision ourselves engaged in a sort of battle in life. Whether it’s on the field or in an office or just going about our everday business, we have this warrior style that takes challenges full-on, head-on, and with all our might. At the same time, however, the ways in which we live our lives — with the conveniences, the usually-sedentary lifestyle, the customizations, the personalizations — are undermining our ability to live as full-on as we’d like.

Small wonder, that we keep getting hurt.

Now lest we jump to the conclusion that “if we were only more physically fit, we wouldn’t get hurt”, let’s stop for a moment and ponder how things were once upon a time. Life was a constant series of injuries of one kind of another. They came with the territory. It was a rare person who wasn’t crippled in some way, be it physically, emotionally, mentally, or spiritually. The difference between then and now, is that it was expected. It was just how things were. And life was short. So why not just live with it.

As for now, we have a much lower tolerance for our injuries. Modern medicine promises to cure all our ills, convincing us that pain and suffering are to be avoided at all costs… and big pharma  can make it all better with a pill or a shot or a non-greasy ointment. And states of mind and body that were once considered “peculiar” are now full-out pathologized, ready for the next treatment (complete with insurance company billing code).

At the same time, however, we have more armor than ever, more protective equipment than ever, more treatments and solutions than ever. And with this added layer of protection, we drive even harder towards whatever end-zone presents itself to us.

So, small wonder that we now have such trouble dealing with our injuries — part of us wants to keep playing the way our forebears did, while the other part of us is having real issues with the consequences of trying to do that. We’re far less physically fit and far less tolerant of pain than our ancestors were, but we act like we’re invincible.

I’m running out of time, so I’ll wrap it up for now. Bottom line of Part I is, Times have changed, people have changed, but we don’t seem to realize it. We keep trying to do things — and play games — the way they once were done, thinking we can tough it out like our grandparents did. Except we can’t. Our changing times have made sure of that.

Most of us live too small

Facing up to it

In the midst of all the everyday chores… in the midst of trying to keep myself on track, in the midst of a seemingly endless stream of little annoyances and oversights (a check to one of my creditors was returned to me, because I forgot – of all things – to write out the amount on the line, and I just wrote in the number amount)… I often wonder how things might be, if I weren’t constantly waylaid by these stupid little things.

The thing about the stupid little things is, the sheer number of them make me think that I can’t handle the bigger things. If I have trouble handling something as simple as writing out a check (I’ve never had that problem before, that I can remember), what does that mean for my overall competence?

All the little things start to look that much bigger. And the really big things start to look absolutely overwhelming. Stuff that people do every day, as a matter of course — get up and go to work, participate in the world, and just live their lives — starts to look enormous and intimidating, and here I am — little ole me, who can’t even write out a check properly — what good am I?

But thinking about this, it just doesn’t sit right with me. One oversight shouldn’t completely wreck me. One stupid blip on my radar shouldn’t define my whole day, my whole week, my whole life. And if I let this one thing stop me, if I let all the hundreds of other little things stop me, then what kind of life is that?

Seriously.  I do this all the time, unfortunately. And so do lots of people I know. They think that because they don’t know how to do something now, they’ll never learn. Or they think that if something doesn’t come immediately easily to them, they’ll never get it, or they’ll never be able to do it and enjoy it. They think that they’re too damaged, too wounded, too impaired, too ugly, too short, too stupid, too ignorant, too inexperienced, too young, too old, too injured, too inexperienced, too _[insert reason here]_.

Sometimes they’re making excuses to get themselves off the hook, so they don’t have to extend themselves. Other times, they’re genuinely skeptical of their own abilities and potential. They think that their past determines their future, and that if they don’t know everything they need to know by now, they never will. And all that remains for them to do, is make themselves as comfortable as possible while they wait to get old and die.

Sad. And completely unnecessary. Because life holds a LOT more for us, than just that. And we’ll never know what else is out there, what else is possible, until we get up and go out and find out what else is waiting.

Okay, so there are complications. Sustaining multiple mild traumatic brain injuries hasn’t done much for my ability to deal with fatigue or uncertainty. It tweaks my anxiety and makes me VERY agitated and anxious over the littlest things. It makes my hearing acutely painful at times, as well as my eyesight and sense of touch. And the balance problems don’t help, either.

But you know what? That’s not all there is to me. There’s a whole lot more to my life, and — what the hell — I can always work around the issues I have. Like make sure I get enough sleep, or at least don’t push myself to do stupid things when I’m over-tired. Like wear sunglasses and watch my moods. Like take time-outs, if I need to.

Most of all, what I need to do is just keep going. Not let my”issues” become the defining elements of my life. I need to get enough of a structure to my life to handle all these little logistics things, that I can focus on the big picture — the direction I’m going with my life, what I’m creating with my life. What I’m meant to DO. Not what I’m meant to endure.

What if there were more to life, than “coming to terms with my limitations” and “accepting the new me” that’s a poor imitation of what I used to be? And what if the monsters that are keeping me from doing what I love to do were not nearly as horrible as my mind makes them out to be?

What if nobody noticed that I totally screwed things up and said things that were lame and strange? Even if they did notice, what if nobody CARED? What if  the rest of the world were so self-absorbed and caught up in their own stuff, that they never noticed the “horrible” things I imagine I’ve done and said?

I know I’m not alone in my conviction that there is something wrong with me. Most of us feel that way, to some extent. And I know I’m not the only one who has let their life be too small, because of what’s happened before, and what I think has become of me.

But if I live right and use my head properly, the world will have one less person living too small.

The Post-Concussion Downward Cycle

Here’s a break-out of a scenario I’ve seen happen with concussion, both in my own life and in the lives of others. (Note: Click the graphic below to take a closer graphical look.)

Post-Concussion Downward Cycle
Post-Concussion Downward Cycle

Here’s how I’ve witnessed concussion sideline perfectly capable individuals, particularly in the world of student athletics. It’s a rough synopsis, and I’m sure there are many other versions that could be created, but this hits on the major points:

1. The athlete experiences a concussive hit / fall. The “lights go dim”, which makes them nervous. They’re disoriented, confused. They’re also dis-coordinated, which they find embarrassing. They feel tremendous pressure to perform. TRY HARDER! is all they can think.

2. So, they jump back up and get back in the game

3. The result: Diminished performance. After all, they’re disoriented and confused. But pressure to perform pushes them – TRY HARDER! And they do. But they’re dis-coordinated, which is embarrassing. Still the pressure to perform — TRY HARDER!

4. During play, they’re hit again, and they just can’t seem to perform – they are benched by a frustrated coach. Pressure to perform is still there – including peer pressure from teammates who don’t understand what’s going on. The athlete is confused and embarrassed.

5. Post-Concussive Syndrome (PCS) sets in, including:

  • Headaches, which are invisible to others. “You’re milking it!” is what the other jocks say.
  • Volatile moods set in, which just looks like attitude problem. “You’re not trying hard enough” is what teachers and parents say.
  • Temper outbursts come up, which seem like behavior problems. “You’re being a jerk” is what people think.
  • Concentration problems happen. Distractability rules. It seems like willpower problem to people. “You’re not trying hard enough”.
  • Memory problems happen. Things just don’t seem to “stick” and forgetfulness rules. Again, it seems like willpower problem to people. “You’re still not trying hard enough”.
  • Sleeping problems come up – either too little or too much. Others can’t see the problem. “You’re milking it!” is what they say.
  • The concussed athlete is always tired, but nobody can see what it’s like inside. “You’re milking it!” is what people say and think.
  • Light and sound sensitivities come up — always at the worst times. Again, nobody can see what it’s like inside. “You’re milking it!”

6. The athlete is sidelined in life. They can’t do all the things they used to do, and they’re pretty much alone. On top of it, there is teasing, ridicule, ostracism. Peers don’t get it, which means they lose their support system and the peer group they turned to for their identity. They become depressed. “Who am I?” they wonder.

In school, they are underperforming. Grades suffer. Teachers don’t understand.

There are problems at home — moods and memory and temper outbursts. Parents are concerned, but nobody knows what to expect. Nobody knows what to do.

7. The only “SOLUTION” the athlete has is to Get Back In The Game, no matter what the cost. They’ve lost their peer group, their sense of belonging, their most prized activities, so what more could happen?

8. They return to play, pretending their symptoms are all gone. But things like diminished coordination — making them more prone to fall and not be able to avoid injury… diminished conditioning — making them less strong, less fast, less able to avoid/recover from hits/falls… and diminished risk assessment, which causes them to put themself in harm’s way without knowing it… it all combines for:

9. Re-injury

10. Either ‘shake it off’ and keep playing restart the cycle at 1.
OR be permanently sidelined
OR find a better way to respond to the concussion.

And there we have 10 steps to concussive issues. As I said above, there are probably many other ways to describe this scenario, but I believe that understanding the different “ingredients” that go into the recipe for concussive re-injury can help us do root-cause analysis of the situation and craft some intelligent, well-thought-out approaches for not only preventing concussion, but responding to it when it happens (and it will happen).

Education and objective analysis and the commitment to take concrete steps to address this epidemic will go much farther than fear and intimidation and punishment, in addressing these serious issues which can have long-lasting effects on this and future generations.

Together, we can break this cycle.