What happens immediately after TBI?

Find out here… http://www.brainline.org/content/2008/07/what-happens-immediately-after-injury.html

Immediately following TBI, two types of effects are seen. First, brain tissue reacts to trauma and to tissue damage with a series of biochemical and other physiological responses. Substances that once were safely housed within the cells now flood the brain. These processes further damage and destroy brain cells, in what is called secondary cell death.

The second type of effect is seen in the individual’s functioning. For those with more severe injuries, loss of consciousness (LOC) occurs at the time of trauma, lasting from a few minutes or hours to several weeks or even months. Lengthy LOC is referred to as coma. In such serious injuries, the first few days after trauma may also produce negative changes in respiration (breathing) and motor functions.

As an individual regains consciousness (those with the severest injuries may never do so), a variety of neurologically based symptoms may occur: irritability, aggression and other problems. Post-traumatic amnesia (PTA) is also typically experienced when an injured person regains consciousness. PTA refers to the period when the individual feels a sense of confusion and disorientation – Where am I? What happened? – and an inability to remember recent events.

As time passes, these responses typically subside, and the brain and other body systems again approach physiological stability. But, unlike tissues such as bone or muscle, the neurons in the brain do not mend themselves. New nerves do not grow in ways that lead to full recovery. Certain areas of the brain remain damaged, and the functions that were controlled by those areas may emerge as challenges in the individual’s life.

New day, new me

new-beginning

The start is just the beginning. Gotta keep it going…

Probably the best thing about this new job, is the fitness benefit – the gym, the pool, the free classes, and the ability to go to the gym and/or hit the pool just about anytime that fits my schedule. The pool isn’t open 24-7, but the gym is.

I don’t live close enough to the office to go to the gym on weekends, but after work is a great time to work out, when everyone else is heading for the freeway to get home.

So, on my swim days, I can work out and swim after work, when I’d normally be stuck in traffic. And the grocery store is on the way home, so I can pick up supper on my way.

It’s a good arrangement. In more ways than one.

A week into exercising just about every day of the work week, I can honestly say I’m feeling better than I have in quite some time. My back and torso are stronger, which means my posture is better, which makes me less tired. It also makes me less irritable. And I have a lot more energy and stamina than I’ve had in recent memory.

Sure, I’m sore. But I’ll hit the pool at the end of the day today, and I’ll work some of this out. Just gotta move. Just gotta keep moving.

Fitness has become a real focus for me. The gym at work is small — but it still has all the equipment and weights I need — so it’s not overwhelming, like a lot of those big-box gyms full of blaring music and hundreds of machines. I don’t know how people can work out in those places. I’ve tried, and I never last. A smaller gym, with just the right equipment, is ideal.

So, since it’s not overwhelming, I can actually get into getting into shape. It’s giving me another focus — and getting me out of my head — which is all good. Looking around my study, I’ve got all these books … so many books… and I remember how I used to spend so much time in the past, just sitting and reading. Sitting and reading.

It was great for my imagination, but terrible for my body. And because of that, it wasn’t so great for my brain.

Body and brain go together. Closely. And it’s important to really take care of both. In fact, strengthening your body and making sure it has what it needs, is critical to keeping your brain safe.

It gives you more stamina and makes it possible to keep a positive attitude. It’s tough to be chipper when you’re exhausted by life itself.

Being also strong helps you balance better and function better, so you don’t get tired and uncoordinated and off-balance. Not having enough strength introduces the risk of falling, so getting strong in the right ways can prevent a fall — and another brain injury.

The times when I fell or had accidents and got my TBIs in the past, were often times when I was over-tired and/or uncoordinated, and I did not have the strength or stamina to keep myself balanced, alert, and safe. I was worn out from working a lot, and I had a car accident. Or I was pushing myself too hard, and I fell and smashed my head. Or I was getting tired and clumsy, and I “lost it” – slipped, tripped, fell, got hit… you name it.

Although a bunch of my injuries happened while playing sports, the more impactful ones happened in everyday life. And if I’d been in better shape and had more strength and stamina, I wonder if things might have turned out differently.

Well, the past is the past, but bottom line is, I’m feeling better now, than I have in quite some time, and it’s pretty cool. Just have to pace myself and make sure to rest when I can. My body is still getting used to the fitness routine, and recovery is a critical component of any fitness routine. ‘Cause if you don’t rest, you don’t give your body a chance to recover and repair. I, of all people, know the importance of recovery.

And  with that, it’s off to my day. Onward.

After so many years in confusion and pain…

coming out of the dark

It’s been a long time coming… but it’s here

I can honestly say that life is leveling out for me, and I now have what I would consider a “regular” life. And starting from there, things are becoming truly exceptional.

The “regular-ness” is amazing and phenomenal in its own right. I have been thinking about how many years I spent in confusion and frustration, always playing catch-up, always struggling to keep up appearances of normalcy, always feeling — and being — so behind. And never knowing why that was.

Little did I know, concussion / mild TBI had knocked the crap out of me. I’m not like folks who go through their lives at a normal pace, then have a concussion / mTBI screw them up. I was always screwed up by brain injuries. I started getting hurt when I was very, very young (maybe even having an anoxic brain injury – from having my air cut off – when I was an infant, according to my mother), and I continued to get hurt regularly over the years. I never got hurt badly enough to stop me from diving back into things. And nobody around me knew that I was hurt badly enough for it to throw me off.

I kept all that pain and confusion inside, for as long as I could remember. It was just one day after another of working overtime, trying to keep up with everything… and failing. Always coming up short.

Now, suddenly, I feel like I’ve come out of a long, dark tunnel into the light. No, not suddenly… It’s been a gradual process, so my eyes have adjusted to the light. But the realization of where I am and how I am now, is sudden. It’s like I’ve at last joined the land of the living.

And I am amazed.

How did this happen? How did I get here? It’s been a slow building process, with pieces of the puzzle floating around in the air… taking their sweet time getting plugged back together again. But once they click into place, they click.

Phenomenal.

So, now I have to ask myself — how did I get here? How did I manage to do this? I had all but given up on myself and figured I’d just be struggling and battling, all my born days. But I don’t feel like that anymore.

How did this happen?

I think there were a number of factors:

  • Having someone to talk to on a regular basis – first, my neuropsych, then another counselor who has been able to talk me through stickier emotional things that I don’t like to discuss with my neuropsych. Having someone to just listen and then get to interact with, has had a hugely positive impact.
  • Deciding that I needed to get better. Even when everyone was telling me I was fine, and I didn’t seem at all strange or brain-damaged, I could feel that something was off. I just wasn’t myself. Nobody else seemed to get it. But I did, and I was determined to do something about it.
  • Getting my Sense-Of-Self back. This was the biggest piece of things, by far. It’s been the key, because restoring my Sense-Of-Self makes everything else possible. It absolutely, positively, is the biggest piece of the puzzle.

How did I do that? I’ll be writing about that in the coming days and weeks, as time permits with my schedule. But basically it’s this:

  1. Find a small but significant way I am struggling — a day-to-day required activity that “shouldn’t” be difficult for me, but which is a huge challenge. Getting ready for work each day is a perfect example for me.
  2. Develop a system and a routine for doing that small but significant thing the very same way, each and every day. Making this system into a routine not only makes it predictable and comfortable, but it also keeps my brain from being overtaxed by having to reinvent the wheel each and every day.
  3. Really pay attention to that routine, and really dive into it with all I have, sticking to it like glue.
  4. That routine then “rewires” my system — brain and central nervous system and autonomic nervous system — with familiar and recognizable patterns.
  5. These patterns become something I can then rely on, to know who I am and what I am about… and what I can reasonably expect myself to do under regular circumstances.
  6. In times of uncertainty and insecurity, I can go back to those patterns and find comfort in their familiarity. So that not only gives me confidence in myself, but it also gives me a refuge where I can find some self-assurance again — even in the smallest of ways.

It’s all about building confidence over time.  Predictable patterns. Predictable behaviors. Predictable reactions. And that can lead to predictable outcomes.

Our brains are pattern-seeking by nature, and when we don’t have predictable patterns, we have the sense that we are in chaos — we are threatened. Building in predictable patterns is the key, for me, to a healthy recovery from PCS / mild TBI / other brain injury issues. And anybody can use this. Anybody can do it.

That includes you.

Gearing up – got my bag packed, and ready to roll

I wrote this early this morning.

Checked my calendar, put my necessary paperwork in a folder to take with me, got my numbers to call, once I’m all set, got directions to the place where I’ll have orientation. And I’m running pretty much on time. And yes, I do have clean socks.

So far, so good.

It’s a new chapter to a new day.

Onward

Then my computer froze. G*dd@mn Google was trying to update Chrome in the background again. I  *&)#$(%* hate when they take liberties like that. Just sail right on in and take over my system, like it friggin’ belongs to them. Makes me want to uninstall Chrome, actually.

Bad things come to mind, when Google hijacks my system. I think very uncharitable thoughts about that pack of 20-something ignoramus nincompoops in Palo Alto.

No, I didn’t get to post that note.

My first day went really, really well. The one thing that went wrong, was that I ducked out of the room to empty my bladder at the time they were wrapping up and doing a group photo. So, I didn’t get in the group picture. But that’s okay, I guess. I hate getting my picture taken. Still, it would have been nice to be involved… Bad timing, but not the sort of thing that should ruin my day.

My head is full — so full — of a lot of stuff. I’ve got to get to bed early tonight. I’m incredibly excited about this new job. I’m being introduced as the new “resident expert”, which is phenomenal. I’ve worked for this. I’ve earned it. I’ve saved my past — and my future — from being permanently ruined by TBI. I have another chance. It’s taken me 10 years to get to this place… no, 40-some years, considering all I have been through.

And I’m owning this. Because no doubt about it, I have earned my place.

I have earned this, for sure.

Getting the Gunk Out – Again and Again

Here’s your memory training image for the day (sorry I have forgotten to include these in the past days)

memory training image

Study this image for a few minutes, then read the post below… and then draw it afterwards.

Get that gunk out of the gears

So, I’m starting my new job tomorrow, taking it easy today, catching up on my rest, and not going too crazy with everything. I had some errands I intended to run, but I went to bed, instead.

Just as well. Those errands can wait.

I’m pretty excited about my new role, and I can’t wait to find out how it’s going to go.

I got myself some really nice, fresh food for dinner, and I’ll start cooking that up in a little bit. I need to get my things together — make sure I have clean socks, as well as a formal suit to wear. It’s my first day. I want to look my best. I’m sure it will prove to be a lot less formal than I’m dressing for, but I’ll just take off my jacket. Roll up my sleeves.

Problem solved.

I’m trying to drink a lot of water, so I’m clear for tomorrow. The last few weeks were pretty action-packed, and I need to settle my system. Yesterday I ended up being pretty busy and active, which wasn’t my ideal. I really wanted to have yesterday off, but that’s not what happened. Oh, well. That’s what Sunday’s for, right?

I spent a lot of time, this afternoon, relaxing and stretching and breathing. I did that after my nap, while I was lying in my warm bed, feeling comfortable and easy. I am having more trouble with my upper back, shoulders, neck, and trapezius muscle. I’m really stiff and sore, and not feeling great. All that lifting and moving yesterday didn’t help. Oh, well. I stretched, rolled on a tennis ball to work out the knots, and I “breathed into it ” as my chiropractor tells me to do. In the end, I felt better than when I started, but it’s still tight and painful to move at times.

The main thing for me is to work on clearing out the stress sludge from my last job. Let by-gones be by-gones, and also help my body clear out the biochemical leftovers from all the ridiculous dramas and conflicts that people seemed to dream up to keep themselves entertained. It’s not a small thing, clearing out the sludge. We have to do it, in today’s world, because nobody else will do it for us. We live in very stressful times (especially as the new political season picks up), and our systems are deluged with all kinds of conflict and strife and perceived threats.

If we allow it to build up and stay there, it takes a toll. It puts additional stress on our systems, and it drags us down. I dunno about you, but I don’t need anything else dragging me down. Especially if I know how to clear it out.

So, I’m breathing – steady as she goes – count of 5 in… count of 5 out… nice and even, relaxing all the while. It balances my autonomic nervous system and gets me out of fight-flight mode. It backs down the stress response and makes it possible for me to clear my head, so I can think properly.

This is important. This is critical. I know how to do this, and I must do it. It’s no longer optional for me. Not just some interesting thing to try out, here and there, but a discipline I need to regularly do.

Like the image memory exercises.

Both help. In different ways. They really help.

 

 

And now, get your pencil and paper and draw the image you just looked at above. No peeking. It’s important to see where you come up short. If you succeed each and every time, you’ve learned nothing. Good luck.

Do we really need ALL our brains?

Dude, where’s your brain? This image is of a 44-year-old civil servant with average IQ and normal social functioning… and a ton of fluid in his brain. Dark areas are fluid. Like… everywhere.

I’ve been thinking a lot, this morning, about how people get derailed by neuropsychological exams. In the past few days, other folks whose blogs I follow have talked about their difficulties coming to terms with test results that “show” they are more impaired than they would like to be — or even that they think they are.

It’s a tough one, for sure. One of the hallmarks of TBI is that brain injury survivors are unaware of how impaired they really are. Take, for example, Charlie Elsmore, from the documentary Me And My New Brain (click here to watch it), who adamantly insists that she no longer has any issues from the TBI that nearly killed her only four years before. Just watching her in action, it’s clear (to someone familiar with TBI) that she continues to be affected. It’s not terrible. It’s just there.

On the one hand, you want people to be realistic about where they are. You want them to make good decisions and not put themselves in danger.

But you don’t want to kill their hope.

In the category of keeping hope alive, I keep coming across stories about people who have either functioned throughout life with significant brain impairments (or pieces just being missing). Take, for example, the Chinese woman who was born without a cerebellum. She went in for testing to deal with some dizziness, and she found out through imaging that he has no cerebellum, which

“is estimated to contain half the neurons of the entire brain. Experts used to think its function was purely to do with coordination, balance and controlling the body, but in the last decade or so they’ve realised that its role is far more varied and includes language, emotion, memory and attention.”

So, she’s literally walking around without a very important part of her brain.

Although this woman with no cerebellum apparently started walking late (at age 7), walks unsteadily as an adult and has slurred speech, it’s amazing that she is able to walk and talk at all. The authors of the case study say she has mild intellectual impairment, but they also note that she is married with a daughter, had normal word comprehension and was “fully orientated” by which they presumably mean she had a normal sense of time and place.

So, yeah… It actually is possible to live out your life without everything being perfectly in place — or even, apparently, having a cerebellum.

Huh.

So, for a fun Sunday mental romp, take a gander at this:

From

“Is Your Brain Really Necessary?”, Revisited

By Neuroskeptic | July 26, 2015 7:40 am

According to British biochemist Donald R. Forsdyke in a new paper in Biological Theory, the existence of people who seem to be missing most of their brain tissue calls into question some of the “cherished assumptions” of neuroscience.

I’m not so sure.

Forsdyke discusses the disease called hydrocephalus (‘water on the brain’). Some people who suffer from this condition as children are cured thanks to prompt treatment. Remarkably, in some cases, these post-hydrocephalics turn out to have grossly abnormal brain structure: huge swathes of their brain tissue are missing, replaced by fluid. Even more remarkably, in some cases, these people have normal intelligence and display no obvious symptoms, despite their brains being mostly water.

Here’s Forsdyke’s illustration: a normal adult brain on the left, alongside two striking adult post-hydrocephalic ones. The black spaces are nothing but fluid:

forsdyke_brainsThis phenomenon was first noted by a British pediatrician called John Lorber. Lorber never published his observations in a scientific journal, although a documentary was made about it. However, his work was famously discussed in Science in 1980 by Lewin in an article called “Is Your Brain Really Necessary?“. There have been a number of other more recent published cases.

Forsdyke argues that such cases pose a problem for mainstream neuroscience. If a post-hydrocephalic brain can store the same amount of information as a normal brain, he says, then “brain size does not scale with information quantity”, therefore, “it would seem timely to look anew at possible ways our brains might store their information.”

Whereas the orthodox view is that “information relating to long-term memory is held within the brain in some chemical or physical form”, Forsdyke says that we need to consider the possibility that memory is stored “in some extremely minute, subatomic, form, as yet unknown to biochemists and physiologists” or, maybe, that it is stored “outside the body—extracorporeal!”

Forsdyke refers to this latter possibility as ‘cloud storage’, suggesting that perhaps “The brain [is] as a receptor/transmitter of some form of electromagnetic wave/particle… of course, when speaking of extracorporeal memory we enter the domain of “mind” or “spirit” with corresponding metaphysical implications.”

You can read the rest of the article here: http://blogs.discovermagazine.com/neuroskeptic/2015/07/26/is-your-brain-really-necessary-revisited/#.VbTnRbVBnW1

Who knows what else the world has to teach us?

Last day on the job – and a few thoughts on TBI recovery

It’s my last day on the job, and I’m getting my act together before I leave for the office, so I can concentrate on finishing up there. I’m feeling really good about giving myself (and them) four weeks to transfer everything I know that will be useful to them. I’ve absorbed a ton of information, and I’ve also developed new ways of doing things, so there’s a lot to pass along.

And I’m not sure I’m going to be able to pass everything along. But I’ll do what I can. And in any case, other people have to step up and find their own ways of doing things. That’s part of the fun and the challenge, and I wouldn’t want to deprive them of that experience ;)

Anyway, there’s a lot going on in my head, right now. I’m saving off images of the projects I have worked on, for my future portfolio, and I’m trying to cover all my bases, so that I can finish up in good form.

I wish I could do more. But I don’t think I’d ever be able to do enough, so…

I finished watching “Me and My New Brain” this morning while I was riding my exercise bike. Great documentary! I was really impressed by the kids who were shown. They were very articulate, and also very brave, putting their lives on video like that. I was especially struck by the honesty — and how the folks featured were so varied in their self-assessments. One young man had such a poor memory that he had to ask his friends intimate questions. One young woman was very clear on how difficult it was for her to spend time socializing in the loud clubs and pubs that all her peers were hanging out in.

The main individual featured, a snowboarding gal by the name of Charlie, made an amazing physical recovery from her very serious brain injury — she was in a medically induced coma for about a week — and she was back on the slopes within months of her accident. I’m not sure what to think about folks who allow brain-injured athletes back into their respective form of play, so soon after their near-death experience. I know that losing your ability to do the thing you love the most can be devastating — especially for a young person growing up, who perhaps has that One Single Thing that they’ve come to organize their identity around.

And telling them “No, you cannot do that yet,” can be awful. Depressing. It can lead to suicidal thoughts and threats. So, why not just let them get back on the slopes/streets/court/field, so they can feel normal again? After all, they’ve been through so much, they’ve had to work so hard and give up so much. And you want them to just be happy again, right?

This is one massive gap in TBI recovery and rehab that I think needs to be addressed. Parents and caretakers and friends of kids (and adults) who sustain brain injuries need to be taught about the effects of TBI / concussion on your ability to judge, assess risk, assess your own abilities, and make good decisions about what to do — or not to do. If they don’t know how brain injury impacts your thinking and ability to judge, how can they know how dangerous it is for recovering folks to do what they so desperately want to do?

Allowing kids to make up their own minds and let them have their way after they’ve been brain-injured is a Russian-roulette proposition. You just don’t know what’s going to come of it. But that information seems to get lost with parents and friends and guardians who let brain-injured kids go right back to the thing that got them in trouble, in the first place.

But it’s not enough to educate folks about these things — we also need common-sense strategies and tested techniques to give to parents and friends and caretakers of brain-injured folks. I definitely think that neuropsychological assessments should be included in every single rehab program — or faulty decision-making can put the survivor right back in rehab all over again.

Seriously, who releases someone into the world without doing an assessment on their thinking capacity? That’s one area where I believe Charlie was failed by the system. They never did a neuropsych assessment on her, till four years after her accident.

That, in my opinion, was a huge mistake. She could have been killed in the meantime, by her decreased ability to plan and judge and make wise decisions.

More on this later.

For now, I’m off to my last day at work. Should be interesting.

And then, on to the next chapter.

Onward.

Me and My New Brain – Watch it On YouTube

Lots of good food for TBI thought, lately

I’ve been spending a bit more time on Twitter, lately, and I’ve found a steady flow of information about late-breaking TBI / concussion news… as well as some pretty good pieces talking about the personal experience of TBI.

And that’s great. Really, really great.

It’s a lot to take in, and it’s a lot to process. One of the things that concerns me, is that we can end up with so much information that we cannot possibly process it all. Even the bits that we can take in comfortably often don’t get their due from our noggins.

Heck, most things don’t get their due.

So, I think about what I can, and I sure have a lot to consider. And a lot to write about. That includes a story I read recently in the Washington Post about how headers are not the main cause of concussion in soccer. Well, alright, it appears that statistically speaking, contact with other players (68.8%) or contact with (13.3%) a playing surface together account for a lot more than the heading itself.

But there in the article, it says (my bold),

“Previous researchers discussing the safety and risk of soccer heading may have been asking the wrong question,” they wrote. In fact, they argued, the “ball striking the head during heading has less of a role in soccer concussions than the athlete-athlete contact that occurs during contested or challenged heading opportunities.”

So, the ridiculous thing about saying that “heading the ball isn’t the main cause of concussion” in soccer is that — by their own admission — heading-related contact accounts for a lot.

Whether or not you actually contact the ball is only part of the story. The main point is that

Players Are Playing Soccer (or Football, if you will) With Their Heads

I honestly don’t see how it’s possible to make a meaningful distinction between the instances where heads hit a ball, or they hit something else. The point is, Heading Is The Root Cause.

Well, anyway, so much for researchers. Kind of like what they were telling us a few years ago about not turning on the light in the bathroom when you wake up and need to empty your bladder. Having the light on can disrupt your sleep patterns. Of course, so can stepping in a puddle of pee that your significant other left on the floor because they couldn’t see the toilet.

Researchers got a lot of ridicule for that one – especially on the radio. Hahahahaha.

Anyway, tomorrow is my last day at my current job. I have to call the HR folks to make sure I have everything in order for my first day on Monday. Gotta figure out where to go, what to take with me, etc.

They have rules, as I understand it. Gotta keep to the thin line and keep myself together.

I had planned to buy some new clothes ahead of time. Maybe Sunday, as Saturday I’m supposed to be joining friends for a gathering at the beach. Not in the mood. Want to keep to myself. I’ll probably beg out of it, one way or another.

We’ll see.

Lots to think about.

Onward.

Me and My New Brain – watch it on the BBC site

From the BBC program – check it out!

In the UK – Watch it on the BBC website here: http://www.bbc.co.uk/programmes/b063h17m

Outside the UK, watch it on YouTube here: https://www.youtube.com/watch?v=0iKKMUsaVRU

About the program: Charlie Elmore suffered a brain injury in a snowboarding accident four years ago. Now she’s going to retrace the steps of her dramatic recovery and meet other young people adjusting to life after serious brain injuries, including 19-year-old car-crash survivor Callum, avid skier Tai and fashion buyer Hannah, who has to re-learn how to walk and talk after she collapsed whilst out shopping and hit her head on the pavement. With their help, Charlie embarks on a courageous journey to improve understanding of this ‘invisible’ disability, which is the biggest cause of acquired disability in young adults in Britain, and discovers the hidden ways it affects her own life too.

If you’re in the UK, you have 29 days from today (July 22) to watch it – I plan to, very soon. Hopefully, my browser and internet connection can handle it.

On YouTube, you can probably watch it indefinitely.