Driving is an important part of a person’s independent lifestyle and integration into the community. Because we take our driving skills for granted, it is easy to forget that driving is the most dangerous thing we do in our everyday lives. A brain injury can affect the skills needed to drive safely. If and when an injured person may safely return to driving should be addressed early in recovery. The injured person, family members, and health professionals should all be included in this important decision. If anyone has concerns that that driving may put the injured person or others in danger, health professionals may recommend pre-driving testing.
How can a TBI affect driving ability?
A brain injury can disrupt and slow down skills that are essential for good driving, such as:
Ability to maintain a constant position in a lane.
Having accurate vision.
Maintaining concentration over long periods of time.
I recently had to fly halfway across the country for a work commitment. I had to fly out early, which meant I had to get to the airport really early… and that meant I had to wake up really reallyearly.
Not much fun, to be honest.
But I did it.
I hadn’t been sleeping well, for several days prior to that – I was getting maybe 5 – 6 hours a night, which is no good. But that’s what I had to work with, so… that’s what I worked with.
The drive to the airport felt like it took forever.
And just getting from the parking garage to the terminal was another slog. One of the wheels on my carry-on was “wonky” and it vibrated really loudly, as I pulled it along. Not the best thing, when your hearing is already over-sensitive.
Anyway, by the time I got to Security, I was a little shaky. I was operating on maybe 2 “cylinders” (out of a potential 4), and I hadn’t had my full breakfast like I usually did. I was off balance and out of sorts, and when I handed my boarding pass and ID to the security officer, my hands were shaking a bit, like they do when I’m overly tired.
The officer gave me a look, and I tried to exchange a few words, but I was “off kilter” and my voice was shaky. I started to get nervous, wondering if they were going to alert others that I was a sketchy character. They gave me another look, and I just shut up. I sounded a little drunk and discombobulated, and my hands were trembling. That’s never a good sign, when you’re trying to board a plane. So, I did my best to gather what dignity I could and just moved on to the x-ray screener – hands over head – and then walked on through.
Fortunately, my luggage made it through without incident. At the last minute, I remembered to pack only small bottles of liquids and creams. That was a last-minute change, because I was going to take full tubes of toothpaste and a special skin cream I need to use for my beat-up hands. At least I got that right.
In the end, it all turned out okay. But I really hate that feeling, when my neurology is acting up on me, and I’m interacting with someone who can flag me as a risk, take me aside, pat me down, possibly strip search me (worst case). The worst case didn’t happen – not even close. So, that was good.
And the trip went pretty well, from that point on.
And it’s been one of the best things in my life – ever.
At the time, back in the “wee hours” of 2008, I was so confused, so anxious… and afraid. I couldn’t believe I had been injured as much as I had, in the course of my life, and nobody had ever noticed. Nobody had ever thought anything of it. I know I was good at covering things up — but was I really thatgood? Doubtful. Rather, people saw there was something “wrong” with me, and they attributed it to:
being young and “unformed”
lack of proper training
anything else you can think of that blames a person for how they’re behaving
The fact of the matter was, I’d been clunked in the head — a bunch of times. And those injuries, which were never properly recognized or treated (or even just factored in) shaped my life and personality and behavior in certain ways that made me look either like a flaming idiot, or just plain “trouble”.
Part of the problem was, I appeared to be pretty smart in certain ways. I could do some things really well — like memorize a whole sheet of vocabulary words in an hour’s time, and then not only test well on them, but also be able to use them in conversation… or be a great track team captain, motivating my teammates to do their best. But for some reason, under various circumstances (which could never be predicted by people who weren’t paying attention, anyway), I’d “fall apart”. Become a discipline problem. Become combative, resistant, defiant, and disruptive in class as well as group activities.
Looking back now, I can see how tired I was, so many times, and that fatigue flipped the switch on my issues. It was like flipping on the lights in a lecture hall — all of a sudden, my issues were lit up bright and glaring.
But of course, I was just being rebellious. Sinful. Willfully difficult. I was just being bad.
Now, I know better. And I’ve forgiven myself for so many things I did wrong when I was younger. The fights, the conflicts, the drug and alcohol abuse, the poor grades, the times I screwed up great opportunities during my youth and young adulthood, because I couldn’t put two ideas together.
Looking back over the years, I can see so many times I came up short — I didn’t live up to my abilities, or to others’ expectations. And I’ve been pretty hard on myself, all these years. And I need to keep forgiving myself, because it’s so easy to forget there was an actual reason I screwed up, when I “should” have done better. It’s a daily practice, this forgiveness business. Even to this day, I still have old habits of thinking about myself in pretty task-master-ish terms. And I need to keep practicing. Because it’s oh-so-easy to fall back into the training of my youth, and tell myself I’m just slacking or I’m taking the easy way out, or I’m being a total loser… when I’m really just in need of a good night’s sleep and a different way of tackling my problems.
I have come an incredibly long way, in these past 9 years. I’ve gotten a lot of help along the way… which is now pretty much gone, because my main supporter moved halfway across the country. But I’ve learned a tremendous amount from those years we worked together, and I am eternally grateful for their help. I’ve been seeing another neuropsychologist, since they left, but this new one is not nearly as experienced or insightful — or as patient and compassionate — as the other one was. I’m kind of on my own with this new one. But they serve a purpose, and you do what you can with what you have, so…
Anyway, since I’m now into my 10th year of active mTBI recovery, there are certain things I want to do, to commemorate the progress I’ve made. Like looking back at my past blog posts and elaborating on them. I’ve written a lot, in the past 9 years, and there’s still some food for thought there. I’d like to put that to good use.
So, I shall. And keep moving forward. Always. Onward.
I’m supposed to be shopping, right now. I intended to get up early and head out to a local department store to pick up the last of the gifts I’m giving. Then I was coming back to deal with one of the cars having a nearly-flat tire. Then I was going to run some last-minute errands, followed by a nap, followed by gift wrapping, followed by making the Christmas turkey, followed by preparing the trimmings, followed by more gift wrapping… and then finally supper.
It sounds like a lot, only because I have it all broken into different pieces. But breaking things up into different pieces and then scheduling each one in its own time slot actually makes it much easier to take care of everything.
Because it’s all got to get done. It’s not like it’s optional. The gifts need to get wrapped, and the food needs to get cooked. The car needs to have sufficient air in the tires, and I have to have my nap. It will all get done… so long as I keep my cool.
Yesterday, I talked about how I need to keep my cool around my spouse when tensions get high. And it’s true. As much because of their cognitive issues, as mine. Last night, I was feeling really rushed, and I was having a lot of trouble keeping my thoughts straight. I have not been good about keeping on my sleeping schedule. My spouse has been especially needy/demanding, this year, and they have also been having more trouble thinking things through, which makes them more emotional and more volatile.
So, to calm them down, I have been staying up later in the evening, watching television, and adapting more to their schedule, as well as their eating habits (I’ve been eating a lot more bread than I should, which is messing me up, because my body can’t handle the gluten/wheat as well as it used to). It’s great for them, but it’s terrible for me. And it wears on me, after a while.
I was feeling really pressured, and I said something that my spouse took the wrong way. They took a lot of things the wrong way, yesterday, for some reason. They’re feeling depressed and isolated and not that great, physically, so that’s an added stresser for them. And they take things the wrong way, getting all riled about things I say and do, which I’m trying really hard to not do wrong.
So, painful awkwardness ensued, and it took most of the evening for things to even out again.
Man, oh man, I cannot wait for Christmas to just be over.
Well, anyway… I’ve got a week and a half of time off ahead of me (oh, except for a few hours I need to work, next week, to balance out my vacation/work schedule). And I need to be especially protective of myself, my time, and my energy, while I’m home. We have a number of scheduled activities we have to go to — doctors and social gatherings and errands to be run — so I need to keep balanced, and keep my system in good shape.
That means exercising as usual, each morning. That means being smarter about what I eat and drink (making sure I drink enough water). That means being firm about the times when I got to sleep, and not being pressured to shift my schedule later, just because I’ve had a nap.
I felt sick all during the Thanksgiving holiday, because I wasn’t keeping on my sleeping schedule. And I don’t want to do that all over again. I’m feeling a little sick, right now, actually. I just have to get everything done. And then do it.
Could be, I have to call AAA to add air to that tire, since it might not be safe to drive on it. But I can easily do that while I’m taking care of everything else at home. I just call them, and they come. Or I may need to change the tire, period. Either way… as soon as I get back from my department store trip, I’ll have the rest of the day to sort everything out. So, onward and upward. I can do this.
I just need to be diligent about it, act like the adult I am, and keep my eyes on the prize — a wonderful week off, when I get to relax and actually do some of the things I never get to do, otherwise, while I have more than one hour of uninterrupted time to focus and concentrate.
Luxury. Pure luxury.
Okay, enough mooning about this. Time to get a move on and get this show on the road. I’m nearly there… I’m nearly there…
When we injure our brain, we injure an important part of our body. Our brains control our ability to think, talk, move, and breathe. In addition to being responsible for our senses, emotions, memory, and personality, our brain allows every part of our body to function even when we’re sleeping.
The brain can be hijacked by the Amygdala in the limbic system after our brain injuries as outlined in this source:
Wikipedia: Daniel Goleman speaks about Amygdala hiijacking – Amygdala hijack is a term coined by Daniel Goleman in his 1996 book Emotional Intelligence: Why It Can Matter More Than IQ. Drawing on the work of Joseph E. LeDoux, Goleman uses the term to describe emotional responses from people which are immediate and overwhelming, and out of measure with the actual stimulus because it has triggered a much more significant emotional threat. From the thalamus, a part of the stimulus goes directly to the amygdala while another part is sent to the neocortex or “thinking brain”. If the amygdala perceives a match to the stimulus, i.e., if the record of experiences in the hippocampus tells the amygdala that it is a fight, flight or freeze situation, then the amygdala triggers the HPA (hypothalamic-pituitary-adrenal) axis and hijacks the rational brain. This emotional brain activity processes information milliseconds earlier than the rational brain, so in case of a match, the amygdala acts before any possible direction from the neocortex can be received. If, however, the amygdala does not find any match to the stimulus received with its recorded threatening situations, then it acts according to the directions received from the neo-cortex. When the amygdala perceives a threat, it can lead that person to react irrationally and destructively.
Goleman states that “[e]motions make us pay attention right now — this is urgent – and gives us an immediate action plan without having to think twice. The emotional component evolved very early: Do I eat it, or does it eat me?” The emotional response “can take over the rest of the brain in a millisecond if threatened.”HYPERLINK “http://en.wikipedia.org/wiki/Amygdala_hijack”%5B5%5D An amygdala hijack exhibits three signs: strong emotional reaction, sudden onset, and post-episode realization if the reaction was inappropriate.
Goleman later emphasized that “self-control is crucial …when facing someone who is in the throes of an amygdala hijack” so as to avoid a complementary hijacking – whether in work situations, or in private life. Thus for example ‘one key marital competence is for partners to learn to soothe their own distressed feelings…nothing gets resolved positively when husband or wife is in the midst of an emotional hijacking.' The danger is that “when our partner becomes, in effect, our enemy, we are in the grip of an ‘amygdala hijack’ in which our emotional memory, lodged in the limbic center of our brain, rules our reactions without the benefit of logic or reason…which causes our bodies to go into a ‘fight or flight’ response.”.
Understanding the role stress plays on triggering the limbic system fight or flight response is critical for people to learn about after our brain injuries. Brain injuries are often described as either traumatic or acquired based on the cause of the injury.
Traumatic brain injury (TBI) is an insult to the brain, not of a degenerative or congenital nature, which is caused by an external physical force that may produce a diminished or altered state of consciousness, and results in an impairment of cognitive abilities or physical functioning. It can also result in the disturbance of behavioral or emotional functioning.
A TBI can affect our ability to, think and solve problems, move our body and speak, and control our behavior, emotions, and reactions.
Acquired brain injuries are caused by many medical conditions, including strokes, encephalitis, aneurysms, anoxia (lack of oxygen during surgery, drug overdose, or near drowning), metabolic disorders, meningitis, and brain tumors.
Although the causes of brain injury differs, the effects of these injuries on a person’s life are quite similar.
This is why understanding about the consequences of stress on the limbic system after a brain injury is so important.
Understanding the Sympathetic Nervous System in the brain injury recovery process is seldom talked about to us after our brain injuries by doctors or health care professionals because they only treat the symptoms.
The following information is critical to understand and has great value for people with brain injuries and their families to understand.
The Sympathetic Nervous System – “limbic system is autonomic” and creates many problems people with brain injuries face during our recovery process. If people with brain injuries don’t understand the Sympathetic Nervous System and how it works – our family members and friends react to our emotions and unwittingly create more stress for us for us to deal with.
This stress triggers the “limbic system’s fight or flight response” into action.
We do not have any control over what we are reacting to because of the stress that is being generated by our emotions shuts down the thinking part of our brain – pre-frontal cortex.
What happens next is – we react and they react, the stress builds and we lose control, get angry and have emotional meltdowns or worse.
During any stressful situation our loved ones react to our “actions” and we react to theirs – which increases our stress during those hard and difficult times.
We (family members/ people with brain injuries and friends) get caught up in a reactionary mode instead of being proactive to keep the limbic system in check.
If we set up daily routines, have structure and find purpose and meaning in our lives we have a better chance of controlling stress and the situations that trigger the limbic system fight or flight response.
If we do not control the stress, our families and friends will constantly be reacting to issues we have little control over. Learning relaxation techniques like mindfulness-based stress reduction can help to stay calm so the limbic system is managed.
Mindfulness-based stress reduction can help with this and I encourage you to look this up on the internet because there is a lot to learn about this tool that can help us rebuild or lives after a brain injury.
After our brain injuries “emotional outbursts, anger, and memory issues” are an expression of the problems caused by our limbic system fight or flight response under stress. By understanding how our emotions can get out of control we will have a better understanding of why we react to things that don’t make any sense to us.
There is a reason for all this madness and by learning the role the sympathetic nervous system plays in our recovery, the better chance we have to live full and rewarding lives again – after our brain injuries!
I am whacked. Way whacked. And very, very worried about what’s transpiring before our very eyes.
If you’re not whacked about it, you’re not paying attention. And you’re not really thinking this all through.
A lot of people are going to get hurt, because they believed a classic con man. Bait and switch. Ditching his promises, left and right. And putting exactly the people in place he said he never would.
Of course, it’s all very predictable.
People have been predicting this for months and months — much longer than anyone has been paying attention.
So, I’m back to being whacked about it.
But I’m not stopping there. I’m really taking the time and making the effort to think things through and reach my own conclusions. It’s tough, because we are in unprecedented waters, and it’s like none of the rules apply (either because people are refusing to follow them, or others are refusing to enforce them, or both). And there’s a whole lot we don’t know about how things are supposed to work, because the people whose job it is to make sure they keep working fell asleep at the wheel. Or they became corrupted by outside influences, themselves.
The most important thing, right now, is to not let my thinking process be overtaken by the slogans and the jargon of this rising gang of spin-meisters. They’re throwing around different words like “alt-right” and “unity”, to cover up the truth of white supremacy and fascism. It’s all a big thought-control campaign, as far as I’m concerned. So, I’m going out of my way to keep myself from falling into using those words.
I’m also taking good care of myself, which is really important. I have to keep my head level in these times of danger, and I’m not doing anyone any favors, letting myself get over-tired and bent out of shape.
So, maybe it’s still true that I’m not letting myself get whacked about this. Yes, the democratic process has completely broken down, and it appears that the very party that said they could do better than Trump has turned tail and run. I’m not sure they’re ever going to recover their legitimacy, after this. They’re certainly not going to get my membership. I dropped all political affiliations a few years ago, and since I live in a state where I can vote for anyone I like, if I’m independent, I’m actually better off.
But in terms of the country – this bait-and-switch scheme may turn out to be pretty painful, in the end. I’m sure we’ll learn a lot — in the short term, anyway. But long-term? Who knows? If nothing else, I hope we learn to not take for granted something we just always assumed would work: Democracy.
It’s been a week, since the election happened. And now the dust is starting to settle.
Time to get back to work, doing what I do. Writing about living life, in spite of all the hurdles that get in the way.
I have no idea what’s coming down the pike, but whatever it is, so long as I take care of myself and keep myself headed in a direction that is true to ME, I will be fine.
Case in point: Over the past week, I haven’t gotten as much sleep as I needed. This is brutal. I get progressively worse, over time.
So, last night after supper, I lay down on the couch and took a little nap. I slept for about an hour. Then I went to bed and got nearly 8 hours of sleep. Then, today, after I spent most of the morning at the dealership getting my car serviced, I took another nap in the afternoon – I got a little over 2 hours of sleep. That means, in the last 24 hours, I got 11 hours of sleep.
And I needed it.
Now I can deal with … well, anything that comes my way. It’s raining. I have to go get groceries for supper. My spouse is sick with a bad respiratory infection. It’s cold and it’s dark. But I got 11 hours of sleep, and I feel more human than I have in a week.
I’m working from home today. I started the day with a 7:30 a.m. call with someone in Germany, then another call with a co-worker in Australia, and now I’m on a four-hour marathon of multiple conference calls.
My days have gotten a whole lot longer, as well as a whole lot more complicated, over the past 6 weeks. I’m not happy about this. Yes, I’m taking on more responsibility and my role is getting more visibility with the right people, so that’s good for my job security. I think… But my quality of life has dropped dramatically. I’m in constant reaction mode – along with all the other folks I work with. We’re so behind on our collective tasks, and I’m not sure when we’ll be dug out.
Everybody’s struggling, pretty much. We’re just so swamped. For me, though, I think the cost is higher, due to fatigue. I get tired, and then I don’t think as well. And when I don’t think as well, my life doesn’t go smoothly. And it adds to my stress. And that makes it harder to sleep.
I’ve been messing up making supper. And when I went to vote earlier this week, I accidentally voted for the wrong local candidate. Oh, well. I’m sure my vote will be canceled out by somebody else. But still, it’s a little disconcerting to see I’ve filled in the wrong circle. And there was no way of reversing it, because it was in that special black ink. A bunch of little things keep falling through the cracks. But what can I do? I try to get to bed at a decent time. And I’ve been doing pretty well with that. But it’s hard to get to sleep, lately. And then I wake up early. Which adds to my stress, because I really wanted to sleep.
It’s a vicious cycle. Once I start getting pulled down that whirlpool, it can be very difficult to get out. And being at the office — first, off, driving in during peak rush hour traffic, and then being constantly bombarded by a steady stream of interactions — just makes it worse. I lose track of what I’m supposed to be doing, and I lose track of what I’ve lost track of. It builds up. It adds up. And it piles more stress on top of it. I get stressed about being stressed.
So, I’m taking the day away from the office to actually get some things done. I have a lot to do, and it will be great to have some peace and quiet around me while I do it.
I also sorely need a nap today. I’m starting to get the “adrenaline shakes”, where my hands have a tremor whenever they’re resting. My stomach is in knots, over my concern about getting things done on time.
Of course, none of this is really that visible to others. I don’t want other people to know, and in fact, I can’t go around telling people how badly off I am. That’s not how my world works. If I let on, how much I’m struggling, it will cause others to doubt me — just at the time when I have to be the most reliable. Telling people about what’s happening with me, will hurt me more than help me. So, I just keep going… keep on… and maintain my steady focus… with the eventual confidence that things will get sorted out in due time.
I can manage this. I know what the deal is with me, and I know what it takes to keep myself going. So, that’s what I’m doing.
I am very much looking forward to actually getting something done.
It’s a PDF you can download and print out. It’s 17 different versions of the circles and bars and squares training I’ve been doing. From the introductory text:
This collection of geometric shapes is designed to help train memory and attention to detail.
How does it work?
First, you fold the paper into four sides – in half in one direction, and then in half in the other direction.
Then, you study the image for a while, committing it to memory as much as possible.
Then you put the image aside and go do something else – you can think about the image a lot, occasionally, or not at all. You just get on with your life.
After an hour, or several hours, or maybe a whole day, you draw what you think is an exact replica of the image on one of the blank sides of the paper.
Then, you open up the sheet, so you can see your image beside the original, and you study it to see where you got details wrong, as well as where you got things right.
You can write down notes about your observations of your memory – what you remembered, what you forgot – and if anything “jumps out at you” about your drawing.
Repeat this process again, drawing what you think is the right image on the other blank part of the paper. Then open up the sheet and compare what you drew with the original.
Writing down notes can be a good way to train yourself about the kinds of details you missed. Nobody’s perfect, and some of the images are trickier than they seem.
Also, the images on all the pages look enough like each other that, as you do this exercise each day, you may find yourself remembering things that you committed to memory from before. This is on purpose. It’s meant to test you, to get you to really focus in on the unique and original image in front of you – not something you saw before.
At first, it may be tricky. And you may find yourself noticing things or forgetting things that surprise you. Let yourself be surprised. Learn about your mind and how it works. And learn how to memorize, one day at a time.
This collection of sheets is meant to be printed out, and each one used separately. You can re-print sheets to re-try. You can also make modifications to the original images to make them your own. You can also color in the sections of the original image and work on your color memory, too. It’s up to you.
You can use this however you want – just use it. Get better. Be better. And have fun, while you’re at it.
I hope this helps you and you find it useful. Just after doing my memory training for a few days, I was able to remember three items on a shopping list I’d left at home that morning. There were three items on the list. And I remembered them all. I was able to recall them mainly because I was able to visualize the writing — I didn’t remember the things, as much as I remembered the look of the writing of the list. But either way, it’s good. And it was such an awesome feeling to be walking through the grocery store with my other list (which was pretty long) AND remember the three items on the little list I’d forgotten at home that morning.
Obviously, I can’t guarantee results for everybody else. We are all very different from each other, and I’m a very visual thinker. So, my results are going to be probably be different from someone who is a verbal thinker, or someone who needs audio prompt.
But my philosophy is that every little bit helps, and strengthening one part of your brain can — and will — strengthen other parts as well.
So, give these exercises a try. I’ve made it easy for myself — and others — to use this. It’s not cumbersome. You have a rectangle of paper you keep around for as long as you need it. And then when you’re done with it, you can either toss it in the recycling (please don’t just throw it away – recycle, please), or you can keep it in a folder to track your progress over time.
It’s funny – when I think about my test the other day, I never even realized that the two squares underneath the bar were supposed to be separated. I totally missed that, both when I was drawing, as well as when I was reviewing. It took me a day to realize that. And then it was so obvious! Duh! But that’s how it goes with me, sometimes. So, I’ve gotta cut myself a break. For sure.
I hope you find this tool useful. I will absolutely be making more. It’s fun! And it helps! What could be better, than making life better for everyone?