Adding back coffee – a little at a time.

Kim-Sutton-Positive-Productivity-Coffee-and-ComputerI’ve been “off” coffee for a couple of years now.

Well, not entirely off, but severely curtailed. I went from drinking 3-4 cups a day (starting with two big cups in the morning) to barely one cup a day.

I’d start with 1/3 cup of really strong coffee, and then I’d have another small cup of strong coffee in the afternoon — preferably no later than 2 p.m., because if I drank it later, it would throw off my sleep schedule, and then I couldn’t get to sleep.

And in between, I’d eat chocolate to keep myself going. Because… chocolate. Caffeine. Sugar. Other tasty anti-oxidants in there to pump up my flagging energy.

But I had to give it up. Chocolate. Especially coffee.

What would make me do such a thing as give up my regular flow of dark and lovely caffeine? Well, all those cups were contributing to migraines — constant headaches that rarely went away. I had a non-stop headache, it seemed, for years. And I didn’t even realize it could be any other way. I figured it was just how my life was going to be, for now and evermore.

Untrue.

When I was told by a neurologist that caffeine (which includes chocolate) can actually trigger migraines, it amazed me. Here, I’d thought they actually reduced headaches. That’s what I’d been told, anyway. But the science is there — with some kinds of migraines, caffeine can actually make things worse. And discontinuing can help.

That’s what happened with me.

But lately, I’ve been reintroducing a little more caffeine (and occasional chocolate) into my days, without too much adverse effect. I’ve been having slight headaches, but nowhere near the intense ones that used to be constant with me. And since I notice them more, now, than when they were non-stop, those headaches are a good signpost for when (and how) I need to make different choices and do things differently.

Just the other day, someone had left some candy on the counter near the coffee maker at work. It was a kind I used to really love. Couldn’t get enough of it. I was able to walk past both the coffee maker and the candy all morning, but in the afternoon, as I was making my 1:30 p.m. 1/2 cup of espresso, I nabbed a few pieces and ate them slowly.

Sweet. On so many levels.

And then I drank my 1/2 cup of coffee. And I had another 1/2 cup a few hours later. No immediate headache. At least, not that I could tell.

I’ve been drinking a little more coffee, nowadays… and while I have developed low-level headaches (I have one right now), they’re not so awful that I can’t function. I’m keeping an eye on it, but so far, so good.

And the other good news is that with my regular daily exercise and eating a really healthy diet, I have been able to get to sleep, even if I have a little caffeine after 2 p.m. Sometimes I’ll have some at 4:00, and I’ll still be able to get to sleep. I think it’s because I’m really actively living my life. I’m “all in”, each and every day, and I also usually finish up the day with stretching and relaxing before I go to sleep.

That last bit — stretching my back and legs before I tuck in for the night — has actually done me a world of good. If I don’t stretch, I often find myself waking up at 3 a.m. in pain, and I can’t get back to sleep.

So, stretching before sleep is really helpful. As is relaxing before I turn off the light. Just consciously relaxing makes a huge difference. Until I learned how to do it (it didn’t come naturally), life was a whole lot harder than it needed to be.

Well, it’s Friday, and that’s a good thing. I’ve got a full weekend ahead of me, and I’m working from home today to get myself geared up. Relax a little bit. Tie up loose ends from the week. And get ready for what’s next.

It’s all good.

Onward.

Who am I again…? Oh, yeah… that’s who

I haven’t been myself, for the past two days. I was on a business trip, this past week, and my flight got in late on Thursday night/Friday morning. Then I needed to start work early on Friday morning. I was hoping to sleep in on Saturday, but this morning I had another conference call at 8 a.m., so that was … fun.

Kind of.

Actually, it was a good experience to have. And I held up my end of the bargain on the conference call, validating some results of a software release that happened earlier that morning.

It turned out well, which is good. Because then I had to run out and do my errands. Take the trash to the dump. Gas up the car. Go out and buy some computer stuff to keep my equipment running smoothly. That went well, too. Then it was back home to do more errands and help my spouse get ready for an event they were organizing. Everything seemed to be going pretty well, and they got on the road at a decent hour.

I got a phone call about 90 minutes later, that I had forgotten to load one of their main pieces of equipment in the van. Both of us had spaced out and completely forgotten to load it. WTF?

I never do that. At least, I don’t do it much, lately. I used to space out a lot and lose track of stuff. Either that, or I’d be so keyed-up that I’d be on top of everything and wouldn’t forget anything. Hyper-organized ‘n’ all that. But lo and behold, tonight, I did the unthinkable — seriously, it was that out-of-character for me. Then again, I was going on 4.5 hours of sleep the night before, and I’d had a full day already, on a Saturday, no less.

So, I threw the equipment in the back of my car and drove like a bat out of hell to the event. Got there before it started, which was nothing short of miraculous. I hit almost all the lights exactly right — either they stayed green, or I snuck through while they were turning orange to red.

Mission accomplished. Embarrassing, but I got the equipment where it was supposed to be. And that’s really what matters. I spaced out, but I made it right.

Times like this, I just have to shake my head. I am not “myself”, lately. Not even remotely close. I’m over-tired, stressed from work, taxed and alternating between overwrought and indifferent. It’s very strange to be me, these days. I’m pretty swamped at work and at home, so I don’t always recognize myself and my reactions.

It’s worse when I’m tired.

A lot worse.

So, the best I can do, sometimes, is just hang in there, keep plugging away till I see a signpost along the way that makes sense to me… and follow that.

Just keep going.

Speaking of going, it’s time for me to go to bed. I’m behind about 5 hours of sleep, including the hour of sleep I lost last night. Always an adventure.

Onward.

TBI S.O.S. Chapter 3. Does The Self Actually Matter?

Here’s your daily image memory test – study this image for a few minutes… then read the post below, which is a continuation of my work TBI S-O-S…  and then try to draw it from memory at the end.

Image Memorizing Test - study... read... draw from memory
Image Memorizing Test – study… read… draw from memory

 

3. Does The Self Actually Matter?

How’s your self-perception?

It’s been pointed out by commenters on my blog, as well as in certain religions and philosophies, that the “self” doesn’t really matter. In fact, it gets in the way of being the best person you can.

“The foolish man conceives the idea of ‘self.'” says the Buddha. “The wise man sees there is no ground on which to build the idea of ‘self;’ thus, he has a right conception of the world and well concludes that all compounds amassed by sorrow will be dissolved again, but the truth will remain.”

“And [Jesus] said to [them] all, If any [man] will come after me, let him deny himself, and take up his cross daily, and follow me.” (Luke 9:23)

The self is considered a form of over-inflated ego, in the world I long inhabited. It’s considered a collection of beliefs we have about ourselves that keep us from living a life of sacrifice and purpose. And according many of my teachers along the way, the most important goal in life is to do away with a Sense-Of-Self, to “die to yourself”, and even to embrace the whole of life as either an illusion or a chance to prove your worth in hopes of future reward.

That’s the tradition I was raised in — to forget your Self and sacrifice your own selfish needs for others was the highest aim of life. Individual Sense-Of-Self was unimportant. A sense of the larger community was what mattered. The most important thing a person could do, was give up the Self for the benefit of others. To avoid selfishness at all costs, was the sign of true maturity and development. Who you were, who you expected to be from one day to the next, was of no consequence. What you wanted, what you desired, with all your petty peeves and preferences… well, that all just got in the way of what you were truly meant to do with your life — which was serve the larger whole.

I believed that for many, many years. And in some ways, I think it may have made it easier for me to tolerate the losses of Self I experienced over the course of my life, thanks to numerous mild TBIs. I started experiencing consciousness-altering blows to the head when my age was in the single-digits, and to this day I can recall what it was like afterwards, to be so confused and baffled by things I said and did that — even at a young age — didn’t “seem like me”. The recollection of being so unaccountably angry when I knew that I wasn’t being sensible… teasing other kids with mean-spirited taunts, while inside my own head I was telling myself to STOP! but could not… being off-balance and woozy for long periods of time, unable to play with my new friends at a new school because something in me knew I got hurt when we were playing the day before, and if I joined them again, I might get hurt again… having my grades sink like a rock, when I was always a straight-A student before…

Even as a young kid, I keenly felt the loss of those little pieces of my predictable identity. It was like knife through me… a wide, heavy, wet wool blanket lowered over my head, slowing me down and impossible to get out from under. I knew I was not the person I was appearing to be. I knew I was better than that. More capable. More willing. But there didn’t seem a way for my goodness, capability, and willingness to get out from under that blanket of confusion and rage.

Over and over again, it happened. When I was seven… eight… ten… thirteen… fifteen… sixteen… sixteen-and-a-half. There were probably even more times along the way when I was hurt, but I cannot recall. Nobody thought much about concussion, when I was growing up. Nobody thought getting clunked on the head and being woozy or sick or confused actually mattered.

What did matter, in the world I grew up in, was forgetting the self — “self” with a small “s”. It was less important, than the collective good. Your own wishes took second place to what the community needed. I was raised by parents who’d grown up in a rural area with farming as a main source of livelihood. On the farm and in the gardens, what you wanted for yourself had to come second to what the group needed. You didn’t get to pick and choose when you would do certain things. Everything was dictated by the seasons and what needed to be done. You make hay when the sun shines. You get up before sunrise to milk the cows. You plant and weed and harvest, not when you choose to, yourself, but when circumstances demand it. And the last thing that helps you in all of this, is a dominant sense of what your Self wants, what it needs, or even who that Self is.

Training myself to forget my Self was an important part of my upbringing. It made it possible for me to do the things I did not want to do — chores, planting, weeding, harvesting, putting up food for the rest of the year. Up to my elbows in steaming hot vegetables, getting the corn off the cobs or the peas and beans out of their shells or snapping the stems off the ends of green beans, it didn’t make any difference what I mySelf wanted. It was all about the work. All about meeting the needs of the group, and putting your responsibilities first. Those who placed a premium on their own Self were a liability to the group, and everyone did their part to show them the error of their ways — either directly with discipline, or indirectly with shaming and ostracism. Many a Sunday, the sermon was about “dying to self.” It wasn’t just a nice thought. For the world I grew up in, it ensured a way of life.

Getting rid of my Self was also a form of self-protection. It was a way for me to make peace with the changes I could not explain within myself. It was also a way to avoid dealing with the troubling behaviors, the strange ideas, the distractions, the temper outbursts, the depression. If only I could stop relying on a Sense-Of-Self to point me in the right direction, I’d finally get on the proper path. If only I could escape that combination of experiences I named “mySelf”, I would be free.

But of course it never worked. And ignoring my own individual identity and Sense of who that was, led me to do things and make choices that put me in even more danger — and that danger also led to still more TBIs. I remember so clearly the determination I felt to put aside my bad feelings about an employer I worked for, for a little while. I didn’t agree with their line of business or their industry practices, but I pushed myself to go to work for them each day, in a location some distance from my home. The stress of the internal conflict took a lot of energy to deal with, and the long commute tired me out. One morning on my way to work, as I pulled out from a stop sign at a blind corner, I was t-boned by a speeding driver who was running late for an appointment. He rammed right into the driver’s side of my car, rattling me and making my car undriveable. The impact took its toll — I could not think clearly, and I could not understand what people were saying to me. It was too much for me to take, after a few days, so one day I just didn’t go to work. I stayed home and drank all day, much to the dismay of my roommate.

Here, I had been intent on doing the right thing and putting my own selfish needs aside, and it cost me.

After a couple of years, I managed to get back on my feet and managed to find a job that suited me better and was aligned with my values. Again, though, I tended to push myself too hard for the sake of keeping up, and one Friday after a long week at work, I was on my way to the train station to pick up a friend who was coming to visit for the weekend. I was late, and traffic was heavy, but I knew I had to push on — just put myself, my frustration, my fatigue, and my own wishes aside, and reach the train station in time to meet them. In stop-and-go traffic, I was rear-ended. There wasn’t much damage to the car, but again, I was rattled. I didn’t stop to see if I was okay. I checked the back end of my car and the front end of the driver who hit me, then we parted ways without exchanging information. I thought I was fine. The car certainly was. But I was not. I pushed myself to get to the train station (so they wouldn’t have to wait), putting my visitor’s schedule ahead of my own welfare,. I paid for that, too. I was confused again, addled, unable to follow conversations, and very manic. My family looked at me like there was something wrong, but I ignored them and kept on with my life, pushing myself to meet my obligations and responsibilities. Pushing myself to forget my Self. Deliberately ignoring the confused Sense-Of-Self that felt unaccountably confused… unsettled for reasons it could not fathom.

Many times over, I have been injured because I pushed myself to forget my Self. I only wanted to get away from that burden of “ego” I carried around with me. I only wanted to be free of the confusion, the frustration, the disappointment, the distraction. I longed to be released from the pain of my existence — not through suicide, but through “dying to myself”, day after day. “Train up a child in they way they should go,” says the Bible verse, “And when they are grown, they shall not depart from it.” That way of denying my Self, and fleeing from my Sense-Of-Self, was still very much with me. I had not departed from it.

And in the process of denying the fact of my Self, I have caused a great number of people a great deal of pain. There were so many destructive relationships that never would have commenced, had I listened to my Self and avoided getting involved with those people. I caused so much harm to others, because of poor choices that were more about what seemed to be the right thing to do, than what my gut was telling me. For so many years, I made choices and did things that were entirely out of character for me, because I feared that shifting Self, and I avoided listening to the still small voice that my Sense-Of-Self used to point me in the right direction. In many ways, I actually had good judgment. But I was so mistrustful of my Sense-Of-Self which drew on that, that I ignored it — and did what others recommended against my better judgment.

I thought that denying my Self and not relying on my Sense-Of-Self would save me.

But it just got me hot water. Again, and again, and again.

It’s taken me years to see that the Self is not my enemy. And it’s taken me almost as long to realize that a solid Sense-Of-Self is the one thing that can keep me on firm footing. What I’ve gradually come to realize, is that Self is more than the greedy ego. It is more than a collection of bad behaviors and peevish needs that nag at the soul, day in and day out. There is more to Self than negative qualities and needy drives to quench insatiable desires. And far from being a barrier to living a fulfilling, purposeful life, our Self — and especially our Sense-Of-Self — is what makes it possible for us to function as complete, independent human beings in a healthy, interdependent community. It’s not what separates us from meaning, purpose, and connections with others — it’s the very thing that makes it possible.

 

 

Okay, now remember the image at the top of the page? Get your paper and pencil and draw what you remember. No peeking…

Long-term neuropsychological outcomes following mild traumatic brain injury

What’s the source of the pain?

In a 2004 study of long-term neuropsych outcomes after mild TBI, it was demonstrated that “MTBI can have adverse long-term neuropsychological outcomes on subtle aspects of complex attention and working memory.” – you can read the abstract of the study here:

Long-term neuropsychological outcomes following mild traumatic brain injury
RODNEY D. VANDERPLOEG,GLENN CURTISS and HEATHER G. BELANGER (2005).
Journal of the International Neuropsychological Society, Volume 11, Issue03, May 2005, pp 228-236http://journals.cambridge.org/action/displayAbstract?aid=301460

For me, this is significant, because over 10 years ago, they were finding these results and publishing about them.

And that’s the year that I had my last mild TBI – the one that almost ruined my life.

After TBI – how do we get our sense of self back?

imageI’ve spent a fair amount of time thinking (and writing) about what it’s like to lose your Sense-Of-Self to TBI – click here to see posts I’ve written about this subject.

And it would be remiss of me, if I did not write (and think) about what can be done about it.

Because after over 10 years of being so very, very lost, having no idea where the person I was had gotten to, and being so far removed from any sense of who I was, and what I was about… I actually started to feel like myself again, this past spring.

It only took me 10 years and 5 months… but it’s here.

It’s tenuous, and some days I still wonder WTF, but I have to be honest and say, I’m feeling more like “myself” than I have in a very long time.

Maybe ever. After all, I’ve been recovering from repeat TBIs, since I was a kid.

So how do we do it? How do we get there?

For myself, consistency is the key. It sounds simple, I know, but there it is.

Consistency.

Doing the same things the same way, over and over and over again, until the wiring in my brain is re-routed to the newly familiar tasks, and it can do things by rote.

Of course, there are many thing I still have to really work at — my memory and resistance to distraction, among others — but for basic everyday tasks, and routine functioning… I’ve got an amazingly stable sense of where I’m at, and how I can get there repeatedly, each day.

I’ll be sharing more about this in the coming days and weeks. It wouldn’t be fair for me to withhold that information.

Onward.

Memory test image for the day - pretty close, actually
Memory test image for the day – pretty close, actually

And here’s how I did with the drawing today. More on this later.

 

Sense-Of-Self — what it costs us when we lose it

Here’s more from my ongoing writing about Restoring Your Sense-Of-Self After TBI

Having a fragmented Sense-Of-Self isn’t just troubling. It can be terrifying. How are you supposed to function in the world without the person you know yourself to be? How are you supposed to interact with friends, family, and strangers, if you can’t rely on the person you once were, to handle all of that? How are you supposed to function in the larger world, if all your usual reactions are gone without a trace… or just different enough that you’re never sure how you’re going to handle things? How are you going to keep a job? Pay the bills? Be the person other people need you to be?

If these issues persist over time, the cumulative results can be catastrophic. Because living your life as a stranger to yourself and having no reliable sense of who you are is more stressful than the average everyday person can imagine. It’s cumulative stress, too, each traumatic challenge producing stress reactions and hormonal overloads that never fully get cleared… one after another, the biochemical stress load builds up, the experience of stress itself produces yet more stress, and the trauma becomes entrenched. The brain becomes more wired to “kindle” (think of a pile of tinder catching fire – bursting into flame) and produces a trauma response, with each subsequent experience. And on any given day, there can be tens, if not hundreds, of these kinds of experiences. Small and large, they come and go, and they become so customary they feel like your “new normal”.

The trauma of traumatic brain injury doesn’t end with the cause of the brain injury itself, when you lose your Sense-Of-Self. It continues, non-stop, through the years in a brain-injured individual who has become a stranger to themself.

It’s no wonder that the numbers for long-term outcomes for brain injury (even so-called “mild” traumatic brain injury) tell such a dismal tale [citation needed]. Experts can’t seem to figure out why folks who experience a “mild” brain injury slide downhill and degenerate. It’s no mystery to me. Over time, without a clear sense of who you are and a confidence in what you can do, the very thing that makes it possible to get on with your life and engage with new situations – a solid Sense-Of-Self – is eroded like a canyon cut deep into the earth by a flowing river over millennia. The erosion doesn’t happen once. It happens over and over, each traumatic situation undercutting your confidence and adding to the mental and biochemical stress.

In my mind (and also in my experience), losing your Sense-Of-Self plays just as significant a part in traumatic brain injury’s impacts, as the Loss of Self. Losing your Self is confusing, disorienting, and sometimes disabling in those moments when you need to call up your Self’s abilities to deal with things. Losing your Sense-Of-Self, however, creates a far more pervasive sense of alienation and helplessness. It stops you from even attempting to reach down deep inside to find that part of yourSelf that will get you through any challenges you face. With a loss of Self, you’re impaired in the moment. With a lost Sense-Of-Self, you lose the will to even find out whether or not you have what it takes to rise to the occasion.

And it’s been my experience that restoring a stable and coherent Sense-Of-Self is in many ways as important as redefining the Self alone – if not moreso.

Why?

Because our Sense-Of-Self involves not only the brain and the mind, but the whole body. That fact is something that seems to get lost in brain injury recovery discussions. Everybody is narrowly focused on the mind and brain and what goes on inside your skull, as though that’s all that really matters.

But the body is more closely connected with the brain – and the mind – than folks like Descartes could ever imagine. To this day, there are still people who treat the contents of our skulls as separate from the rest of us. But in the past decades, we’ve learned how untrue and unfair this separation is. We know know that the body “keeps a record” of the traumas it experiences, and it creates biochemical reactions that respond to situations even before the conscious mind is aware. The body’s constant “dialogue” with the outside world – its split-second interpretation of a shadow approaching quickly from the left side of our peripheral vision as “friend” or “foe”, and the chemical messages it sends to our brains about how we should react to this approaching shadow, set the stage for our whole experience. We don’t even have to think, to figure out if the shadow is a lover or an adversary. Our bodies’ subconscious processes and directions to our brains take care of much of that processing up front.

When the whole body is involved in your lived experience (as it will always be), it affects your brain in significant ways that can precede conscious thought and hijack your best intentions even before you realize it’s happening. In fact, that’s how we’re built. The problem arises, when we have one bad experience after another – threat, confusion, helplessness, frustration – and our bodies get in the habit of kicking off a fight-flight response to every situation, no matter what the true nature of it. When your system is trained to go on the offensive as a defensive tactic against situations that seem threatening, you can find yourself blowing up over nothing. You can find yourself throwing, hitting, breaking things… getting into fistfights over a poorly chosen (or misunderstood) word… flying into a rage over what another driver did, and chasing them down the road in a fit of righteous anger… and eventually shutting down from overwhelm. It’s stressful. And because of the nature of it – involving a perceived threat to your existence, as well as elements of helplessness – it’s traumatic.

It’s also cumulative. If it never gets cleared out of our systems, it builds up and puts even more stress on our systems, which increases our sense of danger and threat and helplessness. The stress itself becomes traumatizing. And since cumulative stress has been shown to negatively impact the ability to learn and reason clearly, our thinking gets muddled and we rely more on our habits and training to interpret the world around us. Our training tells us the world is a dangerous place, and we are helpless to do anything but fight for our lives.

You see where the cycle is going? It doesn’t take much to see where it leads.

A compromised Sense-Of-Self, in my experience, produces exactly this kind of stress – traumatic stress. Not recognizing your Self, not trusting your Self to handle things, not knowing what to expect from your Self… all that puts you on edge in ways that don’t make logical sense. And unless you’re trained in mind-body techniques that attune your mind’s awareness with your physiological state and manage what you do with your physical sense of the world, that edginess gets entrenched and can be extremely difficult to dislodge. It “takes up space” in your experience… far outside the reach of conscious awareness. It’s there, but it’s just out of range of conscious detection. And all the while, it puts considerable pressure on the inner wiring / chemistry of the body, as well as the parts of the brain which are devoted to learning and overall functioning in your private and public life.

So, while brain injury is usually thought of in terms of what happens inside the skull, we don’t dare forget the injury that happens both inside and outside the skull. The injury doesn’t just happen when you get clunked in the head. It continues to happen, for as long as you don’t recognize your Self, and as long as you become less and less familiar with the person you now are… compared to the person you used to be.

So, just as the Self is the person we recognize as “who we are”, our SenseOf-Self is a “felt sense” we have of the Self that is comfortable, confident, and put at ease by the predictability of how we express our Self. That familiar feeling reinforces our understanding of who we are, when we experience our Self behaving predictably in various situations.

And that Sense-Of-Self plays a critical role in allowing us to fully express who and what we understand ourselves to be. Our Sense-Of-Self makes it possible for us to step forward into life with confidence and self-awareness. In fact, unless we have a solid Sense-Of-Self, we cannot rely on our self-awareness. Or self-confidence. Or any other sort of self-possession. We have to believe in our unconscious minds, in our pre-conscious processing, that we will be able to have or produce a certain kind of outcome or result, when we take a certain action. We have to feel confident about what we believe we’ll be able to effect, and even if things turn out differently than expected or planned, we need to have a deeper understanding of who and what we are, in order to learn and adjust.

When you’re dealing with life through the eyes of someone with a fragmented Sense-Of-Self, you can never know – for sure – what will come of your attempts. You have been trained, through one failure after another, that you cannot trust the Self you think you once had. You cannot even trust the memory of the Self you believe you once were. You have no way of knowing, for certain, if anything will actually work for you, if you try. You’ve had too many experiences with failure, too many confidence-shaking and unwelcome surprises, too many expressions of shock or dismay from others who expect you to be one way, then turn out to be another.

So, why even bother?

Why indeed?

Yes, Sense-Of-Self matters when you’re recovering from TBI. It matters very much.

How things get jumbled up

Here is what I meant to draw: Memory Test Image - study it, then draw it from memory later Memory Test Image – study it, then draw it from memory later

And here is what I drew:

imageI kind of had the right idea, but being tired and rushed… heck, this doesn’t even seem like a Real Test.

I will have to try again tomorrow, when I am more rested.

And less rushed.

My first drawing attempt after writing a post with lots of images in it

Here it is – what I just drew, about 30 minutes after posting the original at the top of my post… writing a pretty long piece with a bunch of similar pictures in it, and really trying to remember what I’d seen:

First memory drawing attempt - 30 minutes after study
First memory drawing attempt – 30 minutes after study

Now, here’s the original I was trying to remember:

Memory training test - day 3

That diagonal line on the right is… wrong. And I didn’t realize it was wrong, till I thought about the black dot I needed to draw. So, I think I need to spend more time thinking about the whole picture, rather than focusing on the individual pieces. That can probably help me.

I’m going to keep studying this — and also work on the width of that bar at the top and the placement/size of the big white dots.  I’ll keep working throughout the day… and also see if I can replicate the images from the past few days. These are quick little things I can do to see how I’m faring, overall.

Onward.

Things that get lost along the way

Here’s your image-drawing memory test for the day. This is going to be a challenging one, because there are other “competing” images in the post below. Study this image very carefully for a few minutes, then read the post, then get a pencil and piece of scrap paper and try to draw it from memory. Good luck! I’m throwing you (and myself) a curve balloon this one.

Memory training test - day 3
This is a little more challenging than the others.

What is it with my memory? Seriously, it’s just weird how things get lost…

This post is about how being tired and overwhelmed just screws with my memory — cutting into my self-control and also confusing ideas in my head. I find it fascinating how, even 10 years after my last TBI I still have these issues. It doesn’t worry me – I know what to do about it.

So, yesterday as an experiment, I re-drew the picture that I showed a couple of days back. Here it is:

3-circle-2-plank-double-slash-l-r-boxes

Later in the day, I drew the following:

wpid-wp-1436569763807.jpegEach one got a little bit better, and by the end of the day, I had it down. I could draw that sucker from memory.

Then, yesterday, I had a very busy morning — and I wasn’t feeling well, to begin with. I had been having migraine-y symptoms for the past couple of days, with Friday being particularly tough with my left side feeling like it was carved from block of wood or hardened lava… feeling like it was made of brick. My balance was really off, and I felt like I was being pulled to the left. But then when I closed my eyes, I leaned to the right, so that was even more confusing.

Saturday morning, everything was very trippy – it was like I was seeing through a filter that makes the colors more garish and all the lines separating objects were more pronounced.

trippy-sky
Like this – but not nearly as much fun

I had to work extra hard to keep my mind on what was happening, and I found myself skipping ahead in a number of tasks, and I needed to force myself to stop and back up and think things through in the order they were to happen in.

For example, I needed to get my haircut, and I needed to get there early before the rush. On Saturdays, the place is usually packed with men, women, and children, all needing to neaten up for the week to come. The thing was, when I thought about it, my thoughts immediately went to the convenience store across the street. And then I thought about paying for my haircut at the cash register.

It’s weird, when this happens, because my thoughts are not in sequence, and I have to deliberately put things in order. I have to work backwards, step by step.

  • Last thing: Pay for my haircut
  • Next-to-last-thing: Get up out of the chair
  • Before that: Get my hair cut and interact with the barber (depending on the person, it can be very intensive)
  • Before that: Sit down in the chair
  • Before that: Find a seat at the back of the store and wait my turn to be called.
  • Before that: Buy a snack at the convenience store across the street to get change (because the barber only takes cash)
  • Before that: Stop at the ATM to get cash
  • Before that: Drive to the town where my barber is located
  • Before that: Go out and get in my car
  • Before that: Gather everything I might need for the trip, remembering to take the stamped letters out to the mailbox

The thing is, it didn’t got that smoothly. My brain was jumping around from “node” to “node”, piecing together the day in slow motion, and it was a real challenge to A) put the big ideas in order, and B) make sure I was doing everything in between in sequence, so I wouldn’t have to backtrack and re-do things.

The whole morning was wild — surreal colors and weird visuals, with everything seeming to move in slow motion. But no terrible headache. That would come later, after my afternoon nap.

Anyway, bottom line is, by the time I got back from my errands, I was bushed. I figured it would be a good time to try out my image drawing exercises, so I drew the image I’d practiced in the morning:

First memory image test of the day
First memory image test of the day
Second practice of the day's memory training image
Second practice of the day’s memory training image

All good, right?

Then (at 1:55 p.m.) I decided to redraw the image I’d done the day before and had “down pat” by the end of the day. Here’s what I drew:

Image memory test - 2nd day, and very tired
Image memory test – 2nd day, and very tired

This is close, but I don’t get a cigar. That bar across the top has “snuck” the whole way across again, and for some reason, I immediately drew a vertical line in the middle. I realized after I’d drawn it, that it was wrong, but I couldn’t back up, because I was writing in pen. Also, I drew the diagonal line on the left pointing in the wrong direction, but it didn’t occur to me till after I was starting to draw the other line that something was amiss. And my squares are “off”. I can’t blame the scrap paper. I had plenty of room to write.

What screwed me up was heavy-duty fatigue, being impulsive, disorientation, and not using strategies to do the construction. I worked too fast and didn’t stop to think it through before I did the job.

The really, really interesting thing about this, for me, is that it illustrates in very plain ways, how my brain can get confused about details and come up with other ideas that are based on partial information. My brain “inferred” that there was a vertical line in the top bar, because I was using the gap between the squares at the bottom to orient the top circle. And I didn’t stop to question myself. Also, I drew the line wrong on the left side, mirroring the one on the right, partly, and not realizing till later, that they should be going away from each other, not towards each other.

As for that bar “sneaking” across the full width of the top again. I don’t know what’s up with that. It’s like my brain demands consistency and symmetry, and it doesn’t want to “allow” differences. If I get too rigid in my thinking, it’s a problem by all accounts. So, I have to remember that happens with me.

And here we have an illustration of how — even after all these years — my brain can get things turned around.

Like the other day, when I solved two problems, when I was only supposed to solve one.

On the surface, it’s a good thing, and people are deeply thankful to me for taking both those problems off their plate. But what if one of the problems — the first one I thought I had to solve — was not a problem at all, and I spent all that energy (which was a lot) working on fixing something that wasn’t broken. Then I’d have less energy for fixing the problem that did need taking care of.

I’m starting a new job in a few weeks, and I need to be strong and capable, which I am. I also need to catch up on my sleep and not let the situation in the job I’m leaving get to me. Four weeks is probably too much lead time between jobs, but there it is. It’s taking that long for them to get their act together to replace me. Of course, that falls into the category of “their problem – not mine”, but still…

Main lesson: Don’t let others’ drama get to me. Stay the course. Stay strong. Keep focused. It’s not worth the price I pay, if I don’t.

I’m not getting down on myself — this is just something I need to think about. And I suspect that these image redrawing exercises can help me improve.

Now… it’s time to draw the image you first looked at above. If you can do it, then bravo. I’ve showed you a lot of different images in the past paragraphs, which have similarities to the study image. Let’s see how you do… I’m going to draw it, too.

Another way to measure TBI impact

Here’s another Memory Training Image. Study this for a few minutes, then read the story below. After you’re done with the story, grab a piece of scrap paper and a pencil and draw this image from memory.

memory training image - memorize it and then draw it later
It’s a simple design, but it can be a challenge

From Brain Injury Blog Toronto comes this great piece of news:

Interconnected brain regions – an end to the GCS?

BY: SOPHIA VOUMVAKIS

Traumatic Brain Injury (TBI) can often lead to problems with a person’s cognitive control, affecting their attention, memory, thought, behaviour and emotion. Cognitive control is our ability to modify our behaviour and actions to adapt to the situation we are in. It provides the basis for planning, problem solving and adaptive behaviour (our ability to be self sufficient and independant, based on our age group).

person in MRI machine
photo credit: P4250960 via photopin (license)

Accumulating neuroscience evidence suggests that cognitive control functions are carried out within a network of highly interconnected brain regions. These networks allow for
communication across long distances within the brain and enable us to direct attention to important information in our internal and external environments, to plan and to problem solve. Three such networks have been identified: the salience network, the default-mode network (DMN) and the central-executive network (CEN).

Traumatic brain injury often leads to deficits in cognitive control. The salience network plays a vital role in controlling our emotions and our awareness to the physiological state of our body. Damage to the salience network produces deficits in awareness, such as difficulty with focusing and attention span.

The DMN allows for an internal focus of attention during self-reflective cognitive activity, and is responsible for our autobiographical memory (recalling events that happened to us, as well as facts about the time and place where the event occured), and social cognition (how people process social information). Damage to the DMN results in difficulties with remembering our personal histories, problems understanding time and space, and imagining the perspective of others.

The CEN supports an external focus of attention during goal directed, cognitively demanding tasks. Damage to this network results in impairment to flexibility of thought, working memory, and problem solving.

The different brain areas which comprise these networks communicate with each other via axons, the part of the cell which allows neurons to send electrical impulses to each other. Recent advances in neuroimaging techniques have shown that TBI results in damage to axons, and depending on where in the brain the damaged axons lie, damage to one of these networks, which, in turn, will result in specific deficits.

photo credit: Brain Animation via photopin (license)
photo credit: Brain Animation via photopin (license)
A New Approach to Diagnosing TBI

Since the mid-1970’s the severity of TBI has been diagnosed using The Glasgow Coma Scale (GCS). The GCS measures eye opening, verbal response, and motor response. The test is objective and correlates well with outcomes following severe TBI. It does not, however, predict the specific deficits that will develop in a brain injury survivor. In one recent study, researchers  propose moving away from using the GCS to indentifying the structural and functional integrity of each of the interconnected brain region. If damage is seen in a specific integrated brain region, then treatment can be better targeted and started earlier to deal with the specific deficits that will arise because of the location of the damage.

In a future post we will discuss new neuroscience research on interconnected brain regions and how this can be translated into effective interventions for TBI.

Since acquiring her traumatic brain injury in 2011, Sophia has educated herself about TBI. She is interested in making research accessible to other survivors.

 

Okay… now draw the image you saw at the top of this page. No peeking (till you’re done).