Author: aforrest

Optimizing my brain functioning — my new monitor!

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Because of my training and work as a PhD economist prior to my injury, I think about things like how to optimize my brain as best I can.    Prior to my injury, I worked on issues that are now called “sustainability”  or “sustainable development”.  I did research on U.S. development and made suggestions for improvements for other countries hoping to leap frog past the mistakes made in the U.S.

After my injury, I have learned abit about how to harness this prior training and research to help me get better (in other words, develop and improve) after my injury .

When I can, I try to think (and I seek help to think about) better ways to optimize my brain functioning.

And, I also think (and seek help to think about) next steps to re-optimize my brain functioning each time my slow but steady improvements in my abilities take me to a higher level.

My new, bigger, monitor that we bought this week has helped me tremendously.   I cannot believe what a difference it is making!  It is opening up space for me to think better.

And in being able to think better, it is opening up new horizons for my recovery.

Let me take a step back.   When my head swung from side to side and front to back during my accident, connections in my brain were either stretched or broken.   It’s like the telephone wires could no longer pass signals across them.  I never knew how many telephone lines there were connecting parts of my brain, until they no longer were passing signals to keep parts of my brain connected!

I did not have damage to my eyes.  My eyes are fine.   However, connections between my eyes and brain were disrupted.   And I have learned first-hand that those disruptions affect my vision.

To improve my vision and thinking,   I have worked with optometrists who understand how to help me recover these connections (often called development optometrists or visual therapy doctors).  The hard work I have done has helped me tremendously.   I believe this work has been instrumental to fostering neuroplasticity and I believe its why I do not experience the type of lengthy plateaus that many people talk about with persistent symptoms.   More on that later.

Dr Franke, OD in Washington DC (now retired), Dr Judy Hughes OD in Austin, Dr Denise Paquin OD in Northern Virginia, and Dr Denise Smith OD in Austin have helped me alot with exercises, daily living suggestions and recommendations about optimizing my functioning on the computer (versus my increased cognitive fatigue from working on the computer) that have helped me tremendously with my recovery.  I have made alot of progress.

Buying a bigger monitor is following through on a recommendation made years ago by Dr Franke.   At the time, I wasn’t in a position to make the change, but I kept it on my list of things to do in future.

With our move to Austin, I have been using my laptop monitor on my computer.   (So, I have used a smaller screen than my previous home computer).   I have had lots of improvements with my eye-brain connection in past two years through my vision therapy exercises, my physical exercise and some chiropractic therapy.    With the new purchase,  I have gone to a monitor that is 24 inches wide by 15 inches — so a big change compared to the laptop.

What I am still surprised to experience each time I use my computer is how much clearer I can think with the big screen!

My non-technical explanation of my experience is that my brain can better organize what I am taking in visually.   And once I have written that description, I realize that that is a good description of what my visual therapy exercises do for my brain, in general.   It seems like the monitor is enhancing my brain’s organization abilities when I use the computer, rather than un-enhancing or not enhancing them at all.  This means that I am giving my brain practice at better organization when I use the monitor or at least not making my brains organization worse each time.

Amazing!  Just thinking about the improvements from the new monitor gives me new energy and hopes for more continued improvement for my brain.

Is it possible that the monitor will help me improve brain-functioning at a faster rate?

 

 

 

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The Power of Reflection — revisited, at a deeper level

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I love it when I am in a reflective place where I am appreciating how my life has improved during the year.

I was thinking about that improvement this morning.   I was heading out for my walk and I was cued by seeing my sun block so that I could use it BEFORE I started my walk. I have consciously looked for, and found, a place to put my sun block so that I see it on my way out the door. When  I see it, I am reminded to put it on.  The “cue” — seeing my sun block on my way out the door — means that I can get the sequence right (put sun block on before walk). The cue frees me up so that I am more likely to get sun block on either because I remember to do so (sometimes) or because I am cued to remember it. Either way, my life is better with the sun block on for my walk, and because I am training my brain about the sequence.

As I was putting on the sunblock this morning, I remembered what the pattern was like on my almost-daily walk in Arlington, Virginia before we moved to Austin, Texas. I would often have already passed by several houses when I realized I did not have sun block on, if I realized it at all. So I noticed that and tried to improve upon that. And over the years, I have. In Texas, wearing sun block is much more important than in Virginia because the sun is so much more intense here.   And I have made alot of progress on getting it on.

Like I have said, small things make big differences in my world.

I realized the other day after I posted on reflecting about my “rehab” accomplishments, that I had a lot more to say about the improvements that I have had this year in the continued “re-training” my brain department.

Why do I need to re-train my brain still? Because I have persistent symptoms from my concussion/mild traumatic brain injury that I am still working a way on and, in working on them, I am improving my quality of life and functionality. The kinds of persistent symptoms that I am working on are mostly in the executive functioning category. What is executive functioning? My non-technical definition of executive functioning is the more advanced brain functions like getting a process in sequence, getting things done in a certain time, determining what activity has priority over the others and accomplishing it, getting more than one thing to happen by a certain time and taking in new information into the process.  I will have to look up the more technical definition in a future post, but that is the working definition that I remember from my formal rehabilitation.

What I have learned is that the more often I can combine rewiring activities with another activity that I am already doing during my day, the better.  That way, I don’t have to find separate, extra time in my day to do the rewiring work.   Since I have to do the activity anyway, if I can work on rewiring at the same time,  then the rewiring work will be done on a regular basis. And the more I practice, the more I train my brain with the new habit.

The trick is that I often have to be conscious that I am doing a training activity — and that means doing it more purposefully to imprint it on my brain.   Doing an activity more purposely, sometimes can mean doing it slower.    I remind myself that I am training my brain the way I want it to work in the future and that slower will make it better in the long run.  (No multi-tasking allowed!)

Raising my son is the best example of a daily life activity that has also pushed me along in my rewiring.    As a mom, I have to think ahead — so that exercises my planning skills.   I have to think ahead about how to direct him and focus him on what he needs to know about and learn.   And I have to look for effective ways to encourage behaviors in him that are good for him and away from behaviors that are unsafe or are not age appropriate or that I don’t want to encourage.

My doctors have been very encouraging that I am at the point in my recovery where taking care of a child is beneficial to me.    There definitely was a long period where I couldn’t even take care of myself, much less another.  I have had a lot of help on learning about child raising and have been taught how to build a support system around doing it.   But my point in this blog post is that raising my child is rewiring that is mostly fun to do and that I am able to take advantage of during my day.

My son is 5 years old and thriving in his preschool class.   He’s doing well, loves school and loves his friends and family.    His progress is amazing.   And when I reflect on my accomplishments this year in my rewiring, I can count the progress in his growth and development as rewiring work and progress for me also.

If you would like to read ahead about motherhood and my injury:

www.brainline.org/content/2011/10/bringing-up-baby_pageall.html

 

 

 

 

 

 

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The Power of Reflection before welcoming in the New Year

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I usually end the year by exercising my reflection skills.  I find it very powerful to reflect about how my life has gotten better during the last year and to write these down.

I find reflecting on how things have gotten better makes me be more appreciative of my accomplishments.

Many of my accomplishments happen at a very slow rate.   In fact, at a much, much slower than I would like.

By practicing things I want to accomplish over and over, I do see progress.  My brain does eventually reorganize around a habit after I have practiced it over and over.

I find that sometimes that forward progress is easy to miss or sometimes its easy for me to take the end result for granted when it finally happens because I can finally do it and its just suddenly there.

So remembering where I was at the beginning of the year and how my life and my functionality has gotten better provides useful perspective and good feelings about my persistence and my hard work.   I am still getting better.

Here are a few of the accomplishments in developing new brain patterns (or what I refer to as continued rehab) that I have had this year:

–I am driving my own car now which means more freedom for me.    I also no longer need to schedule sharing a car with my husband which has made my life as a mom to our son much easier.    I have the car when I need it and I know that what I put in the car for our activities will be there.

–Being comfortable on some of Austin’s  bridges and expanding my range are now two of the new challenges I am working on with my driving.

–I am finding time several days a week to work on my eye exercises.  I am seeing progress from that.    I am finding that there is a shift in my eye-brain connection on my right side.  This is the area where my headaches can originate (when I am not able to rest from a cognitively-intense activity before I get a headache).   I cannot quite translate the shift  into increased function yet, but I can feel that something is changing for the better.   My hope is that this shift will eventually lead to new pathways on that side and eventually no headaches.

–I am walking twenty minutes  a day and using my arms to exaggerate the motion of going from one side of my brain to the other.   I meditate for 20 minutes a day (4 or 5 times a week).    The meditation mat “draws me to it” when I am not able to make the time to meditate.     Both the exercise and the meditation help me get through the day and make my life better.

Those are some of my reflections on ways my life has improved this year.    I do this same reflection in all parts of my life.

What are the new brain patterns you have accomplished in 2013?

Where were you when the year started and where are you now?

How do you feel when you reflect on the changes that are improving?

 

 

 

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’tis the season

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A friend who is also a mom told me the other day that she realized that if she didn’t get on top of things Christmas was not going to happen at her house. She said she stayed up late that night and used Amazon Prime and other online shopping to help her become less behind.

Her comment focused for me why December is such a challenging month for me. Because I need to keep up my sleep and cognitive rest in order to be able to manage my persistent symptoms as best as possible,  I am not able to use her strategy of staying up late. If I stay up late to do all that I think I am behind on, it only sets me back further. I must take on less in December and simplify as much as I can, in order to take on the increased tasks of preparing for and being present for celebrating Christmas.

My very wise Visual Therapy Doctor taught me a lot about slowing down in December. He did not hold our vision therapy classes  in December at all. He said there’s enough stress with the season and to teach his patients to reduce stress, he gave them time by not holding class.

He also advised against taking on anything that could be done in January in order to clear out time to do increased holiday activities like get together with friends and family.

I have followed the strategies he suggested for years and I am grateful to him that he taught me this.

TisTheSeason

I also pick which events will make me happiest and then choose among those. I have to work very hard not to over do it. Once I have picked what I would like to do, I have to be flexible about whether its good for me to do it and cancel if its not. And I focus on enjoying the things that I am able to do.

Another “strategy” for managing my life that I was taught in my rehab was to write everything down. Doing this is especially important during December. I write everything down in my calendar  in order to free up as much room in my brain as possible so that I can use as much of my brain as possible for problem solving the things that come up during the day.

If my brain is too cluttered with things I want to remember, then that clutter impedes making all the decisions that I need to make on an everyday basis — decisions so simple as which key is my door key and what to eat for breakfast or how to get from my house to the grocery store and what to buy. In December, there are so many extra details to remember and kept track of that I find I really have to be as vigilant as possible about getting things down on paper and out of my head. Presents, extra grocery shopping, trying to keep structure when everyday routine changes with the holidays  and finding good conversation topics can take up a lot of room in one’s brain if its not written down.

If Thanksgiving is my the Olympics of cognition, than Christmas is Mega-Olympics. It’s beyond what we have a term for.

Tis the season.  Enjoy!

 

 

 

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I did not know how damaging concussion/mild traumatic brain injury could be

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You would hardly think that I would be the person telling you that getting the best treatment for concussion is important and that not everyone gets appropriate treatment for concussion in the U.S. (or Canada and other countries for that matter).   When I had my concussion, I had the life that I loved to live.   I didn’t have time for a concussion and I really did not have time for persistent symptoms.

Frankly, I didn’t know how damaging a concussion/mild Traumatic Brain Injury could be when I first had my concussion, and neither did those around me.   I was in a car accident by the Lincoln Memorial in Washington D.C.   I was driving and trying to merge onto Rock Creek Parkway when I was hit from behind.

I was coming off a ramp from the Memorial Bridge across the Potomac River and the road I was merging into runs very close to the path of the ramp.    To merge, I had to move my head as far to the left as possible to look over my left shoulder at the light on the road I was merging into to see the cars.   When my car was hit by the jeep behind me, my head went from side-to-side and then back to forth (called a coup-contre-coup).

My brain was shaken inside my skull.  Neural pathways were either stretched or broken.    I may have  lost consciousness briefly.

I did NOT hit my head on the steering wheel or the windshield.  I did NOT have a coma.   There was NO blood.

I did have headaches when I went to work on Monday, so my colleagues suggested that I do to the doctor after I told them I had been in a car accident.   I was not making that connection myself.   When my symptoms worsened, my doctor sent me to a neurologist who diagnosed me with mild traumatic brain injury.   I did not understand what “traumatic brain injury” meant or could mean to me.   I felt comforted by the word “mild”.   At least I knew what mild meant–short lasting and not very bad.  Or so I thought.

When I first saw the primary care doctor and then later the neurologist, I was fully expecting to continue my life as I knew it.   I loved my work and had exciting research to do.   I had my sports that I loved (coaching kids soccer and playing volleyball) and I had an active social life.

I remember being bummed at the thought of waiting for a couple of weeks to return to sports.   When I first saw the primary care doctor, he said he wanted to keep me under observation.   He said not want me to play volleyball until he cleared me for it because he was concerned I might jostle my head further.  I was bummed because sand volleyball season had started on the Washington Mall and I had already been waiting until the kids soccer team’s season ended before I started it.   The previous year, our sand volleyball team won the trophy for the league and I was looking forward to playing again.

But my life did not continue as I expected.  In fact,  far from it.

And so here I am telling you, about 15 years later, about my experiences with trying to recover from concussion/mild traumatic brain injury.

My experiences have led me to know first-hand that:

–there can be persistent symptoms from concussion/mild traumatic brain injury,

–that it’s really important to get the best treatment possible to minimize the possibility of long term symptoms, and

–that it can be quite difficult to get appropriate treatment for concussion/mild traumatic brain injury around the world.

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Why guidelines for treatment after concussion/mild traumatic brain injury are so important to me

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Back to guidelines for concussion/mild traumatic brain injury this morning.

I have been thinking about what is the most important thing to me personally as a survivor about the updated Guidelines for Concussion/Mild Traumatic Brain Injury and Persistent Symptoms developed by the Ontario Neurotrauma Foundation (ONF).   I introduced the guidelines in my blog a couple of weeks ago.    They are the first guidelines for the treatment of civilian adults with persistent symptoms in the world.

They have been updated recently to include the latest research and clinical knowledge.   I worked with a group of other experts on these, including several experts from the U.S. and Australia as well as experts from Canada.

I know that the ONF guidelines may be difficult to read and understand since they are written for Health Professionals.   So I want to talk about what they mean to me and explain them in a way that can be understood for people with concussion and mild traumatic brain injury and those who love them.   Here’s the link to the guidelines posted on the ONF website: www.onf.org/documents/guidelines-for-concussion-mtbi-persistent-symptoms-second-edition

Before I go further, I have to say alittle about my ability to prioritize what the most important thing about the guidelines is to me.   Prioritizing is definitely not my strong -suit post-injury.   In fact, what I have come to learn is that prioritization requires some higher level executive functioning skills that I am still consciously working on to improve.

I will say though that my ability to prioritize has gotten better with practice.   In fact, I remember that people would ask me what’s the most important thing  about this or that for you?   And it would stump me.   I couldn’t answer, especially in the time that they expected me to answer it.    I learned to compensate by learning to ask — “Could you give me a yes or no question?”

Later, I learned to try to say it with a little humor — “Could you give me an easier question for less money?”

Practice in awareness has also helped me recognize that even without my challenges in prioritizing, it might be difficult figuring out the most important thing about the concussion/mild traumatic brain injury guidelines.  I say that because there are many important parts of the ONF guidelines that affect me as a survivor very personally.    And,  I know that many of the parts are important to other survivors because I have had many conversations with survivors and their loved ones who have had big difficulties finding the help they need after concussion/mild traumatic brain injury.  And the guidelines address many of the questions that I and others have taken weeks, months or years trying to resolve  for ourselves.

As I sat down to write this blog this morning, I realize that  the first thing I really need to explain is why I think Guidelines for Doctors and Health Professionals for treating patients with concussion/mild traumatic brain injury are helpful to survivors and their families and why I would like to see them for every country.   Then I will talk about specifics in the ONF guidelines.   I think they could be used as a basis (or jumping off point) for the development of guidelines in other countries.

Guidelines are important because, quite simply, many people with concussion are (still) not getting the best advice on appropriate treatment after concussion/mild traumatic brain injury.   So, again quite simply, better information to Health Professionals will lead to better outcomes for people with concussions/mild traumatic brain injuries.

 

 

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Thankful for Thanksgiving and the cognitive challenges it requires

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I am torn between blogging about what’s going on in the moment with the Thanksgiving Day holiday and saying more about the Guidelines for concussion/mild traumatic brain injury from the Ontario Neurotrauma Foundation that I started introducing last week.

This week, Thanksgiving wins.

Its my favorite holiday from way back because I love food and its a time to share good company and appreciate what’s good and what I am thankful for.   I am thankful for my family, for good food and for a roof over my head.   And I am thankful for continuing down my path to finding my voice through my blog and the self-expression that its giving me.

Thanksgiving can be a very challenging holiday for anyone.   I find I have to work much harder to manage my persistent symptoms during the holiday, so its more challenging than it was before my injury.

There are many reasons why the holiday is so challenging for me and why I have to work harder.

Here are a few examples:

— Routine helps me manage my daily life and so any holiday takes me out of routine.    When I am out of my routine, I forget to do things that I would be more likely to naturally remember or have cues to remind me, if I were more in routine.   This means that going into holidays I have to increase my planning in order to compensate.  And when I forget to increase my planning, my life can be very chaotic.

–I have to manage my energy on a daily basis so that I don’t get too tired and overwhelmed.   Thanksgiving can be a tiring holiday for anyone.   When I don’t manage my energy well, I get irritated and snappy and that makes things harder for me and for my family.   So I need to get cognitive rest to build up my short term energy reserves going into Thanksgiving and take more rest and downtime afterwards.   I also need to limit my activities that take energy and make sure I engage in activities that are uplifting and give me energy.

–In my rehab, I am practicing hard to get things lined up in sequence so that I can do them easier and better.   I work on this on a daily basis.   Getting things in sequence is pretty natural to many adults and certainly was for me before my injury.    But post-injury, I have to learn to consciously think about sequence until it becomes automatic again.    Getting things in sequence is a component of what’s called “executive functioning” skills.   Preparing for and living through Thanksgiving is the Olympics of sequencing in my mind.

What do I mean by the Olympics of sequencing?   Well, first, I only practice at Thanksgiving once a year, so its hard for me to access what I learned from last year to do this year better.   And typically its easier for me to learn tasks that require doing things in sequence when I can practice the task over and over.   If I am practicing the task often then I am more successful at using  information about where or how I misstep in order get closer to getting the sequence right.

Here’s a very small and practical example.  Pumpkin pie is the dish that is always mine to make and I love trying to make it.   I have been taught many steps to simplify making it — one is by using a store bought pie crust.  Another is to re-write the recipe instructions so that I can follow it as best I can and to make parts ahead of time.    Several years ago, my husband found an easier recipe that has a crushed ginger snap crust and that made it even easier.    But this year I forgot about the new recipe and it was not until I was trying to cook the store bought pie crust that I realized that I did not have the new easier recipe (and the ingredients for it).    This may seem like a very small thing.  But what I have learned is that a small thing can make a huge difference with managing  my persistent symptoms.   And this example, of forgetting what I did to improve things in a previous year will happen in about ten or maybe 20 times during the holiday week.   Rather than letting it get to me, I have to practice letting it go and being okay with it so that I can continue on.

 

Second, Thanksgiving is the Olympics of sequencing because in order to buy groceries (that I am not used to buying on a routine basis) I need to plan out what groceries we need to buy or that we are taking to someone else’s house.   Then I have to work backwards and get it all on the shopping list.   And I need to remember to adjust the list for how many people our family is cooking for.  So those are three or four discrete steps that I need to be conscious of and try to keep straight:  plan what we need to make or take, make a list, adjust list for how many people will be eating what we make or take, then update list at least once when people are added or subtracted.    Keeping the steps separate and keeping them in order takes me alot of time and energy. And I have to set low expectations for the results.   All these steps may be unconsciously done by most adults, but I have to remind myself to do them as they aren’t automatic for me.

And those are examples of only a few of the reasons why Thanksgiving is the Olympics of sequencing.   Thank goodness, I love the holiday so much that its worth taking on the challenges!

 

 

 

 

 

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Helping others has led to my participation in developing guidelines for symptoms from concussion/mTBI

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Starting last October,  I participated with other experts on concussion/mild traumatic brain injury on a consensus panel to update guidelines for Health Professionals about how to treat adult patients with short-term symptoms and persistent symptoms after concussion/mild traumatic brain injury.

It feels great to be contributing to guidelines that will improve care for patients with mTBI/concussion.   It gives me hope for the future.  And it makes my difficult experience with finding appropriate resources for recovery alittle easier knowing that I can use my knowledge and experince to help others.   I worked on the first edition of the guidelines, starting four years ago, and and now the update or second edition.

Ontario Neurotrauma Foundation (ONF) in Canada has sponsored this work.   As far as I know, these are the only systematically developed guidelines (in the world) for general Health Professionals on how to treat persistent symptoms for adult civilians.  It also contains information about how to treat symptoms right after they occur that have been developed in Australia, New Zealand, Canada and the U.S.

The second edition of the guidelines were published in September 2013 and can be found here:

http://onf.org/documents/guidelines-for-concussion-mtbi-persistent-symptoms-second-edition

The guidelines are written for Health Professionals, but you can read them too.

As a PhD, I am trained to understand the importance of high quality research versus other evidence and thus I am able to use some of my pre-injury skills for this work.   As a patient I am able to contribute from my experience and from the many mistakes and pitfalls that I have either experienced myself or heard about from other survivors and their families that I have met in my journey.

Guidelines

Here are five reasons why these guidelines are important for patients (consumers) and their families and friends.

1) The guidelines take concussion/mild TBI seriously.

2) They are a compilation of current knowledge about what to do in the short term after a concussion for civilians.  In other words, they educate and provide guidance to Doctors about how to take symptoms seriously.

3) The existence of guidelines about persistent symptoms from concussion/mTBI is acknowledgement that some patients (consumers) have persistent symptoms and that appropriate treatment can be helpful to these patients.  Not everyone gets better from concussion immediately and those who don’t get better need treatment.

4) They are a compilation of current knowledge about what to do for patients with persistent symptoms.

5) The guidelines can be used in any country although they are written for the Canadian Health Care System.  They can also serve as a model for the development of guidelines in every country.

The guidelines were just presented last week at the American College of Rehabilitation Medicine annual conference in Orlando, Florida.   Hopefully we will be hearing more about them.    I have alot more to say about them in the next posts.

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Helping others by providing the information that I wished I had gotten when I had my injury

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I had written a draft post earlier this week about what I would have wanted to know after my injury that I was struggling with.  Then some things came up that grabbed my attention.  It occurred to me this morning that perhaps the best thing I could do was let that draft post sit and eventually it will come to me how to say it.
I wanted to post the following statement that a new friend wrote about me for my website because it introduces my advocacy well.  In fact helping others with their journey to recovery, one-on-one, has taught me alot about what people need to hear following a concussion.
Here’s what my friend wrote:
“I first met Anne several years ago when she moved back to Austin and joined
the church where I am a member.  Anne is smart and outgoing and she became
an instant friend.  When I learned more of Anne’s story, I was even more amazed
by who she is as a person.  Several months ago, our nephew had a serious closed
brain injury.  Anne was one of the first people I called.  She was a wealth of good
information and she shared numerous helpful resources.  However, what I most
appreciated about our conversation that night were her encouraging words and
positive outlook and her emphasis on hope.  Our nephew thankfully is well on the
way to a full recovery.  I am grateful for Anne’s friendship;and I am especially thankful
for her continued sharing of her gifts and experiences researching and working with closed brain injury patients.”
                                                –  Martha Richardson
Martha had called me because her nephew had had a concussion during a bike accident.  She told me that the family was concerned by what they had heard from the MD whom they saw.   They heard that there was a 50/50 chance that their nephew might be permanently disabled by the concussion after two years.   I was hearing what had been said third hand. So I don’t know what was actually said.   I do know what they heard and how much it concerned them.
And, I knew that I wasn’t hearing about any recommended treatment.    In listening to survivors and family, I know that its often missing.
When I probed about it,  I heard that the patient and family hadn’t been told about what  treatment would be helpful NOW to improve the odds that the patient would get better and wouldn’t be disabled two years from now.
I know firsthand the importance of early treatment for concussion.   I didn’t get what I needed early on.   I will always wish I had.     So I gave advice to my friend based on my experience.   I suggested to her that the family might want to get a second opinion with one of the doctors and/or programs that have helped me here in Austin.
It makes me feel good to hear that my friend’s  loved one is “well on his way to recovery” having followed my advice.
And, there are two other resources that I always tell people they should consider further for information:
The information line and website at the Brain Injury Association of America:
1-800-444-6443,
The second one is a book call “The Brain That Changes Itself”   By Norman Doidge.  This is a tremendous book on neuroplasticity our brain’s ability to rewire and grow.

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My “Ah Ha!” moment — What I wanted to know about how to recover and rewire after my injury

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I had an “Ah Ha!”  moment about my posts this past week.    With my brain the way it is now, I have to learn more by doing as opposed to thinking things out ahead of time.   Often,  I just have to get going on trying something new, like writing this blog.   Once I have have practiced at it abit, it comes to me where I am trying to go.

My “Ah Ha!” moment was that all my posts have been about trying to describe my “new normal” from the perspective of many years out after my injury.    You can go back and look at them.   Some are about some of the gains that I have made long after my injury–like driving and speaking to the media and how practice has helped me.

Others have been about some of the work I still have to do to stay on balance.

These have been descriptions of different aspects of my “new normal” !

So far, I have talked about how I have hope because I know how to rewire my brain and recover more functioning.  This is called neuroplasticity (and I will come back to it).    Overall, I know that neuroplasticity is working for me —  I am still getting better and the evidence that I am still getting better gives me hope that I will continue to do so.

I also know that I have persistent symptoms following concussion/mild TBI and that I am not “well” and that I need to work hard using my self-awareness, using the compensatory strategies I have learned from doctors and professionals  (in and out of outpatient rehabilitation (which it took years to get receive)).   I have also learned from self-care, from managing and respecting my limitations, and all my strategies to cope with my injury long after the initial “acute” injury–the actual swinging of my head from back to forward and from side to side (referred to as the coup-contre-coup).

And when I am on top of my game, I have to work at it very hard, but my life goes okay and is meaningful.  And my life is getting better at a slow, but overall, sure rate.  I have had long-term recovery and rewiring and it continues (although at a slower rate than I would like, but better than no rewiring at all)

And when external things come up (like they do in life) or I get sick  or I get out of balance for whatever reason, then I need to step up my work to get myself back in balance.    Sometimes I am unaware that there’s too much on my plate or I need “to be cued” to compensate for them and sometimes, it takes me awhile to recognize that I am off balance and I fall “off my game”.    This is part of life.

When I am off my game, my life can become intolerable and I am irritable and cranky and I can get down and depressed and at some times, when it gets really bad, I simply don’t want to go on.  So I know I want to do everything I can to avoid getting in to that “trough” or valley or even getting near it.    At this point in my recovery, I have learned alot about how to manage this downward cycle that I would describe like an airplane in a tailspin.   I know I need to use all my strategies to keep me from getting in a tailspin and if I am unable to avoid getting in a tailspin or do not recognize the tailspin until fairly late, then I must use them to get out of tail spin as soon as I can.    I have a list of things to do to pull me out of a tail spin and reminders to be patient because it takes time.

I think everyone’s life has its ups and downs that may need to be managed abit.   With persistent symptoms following my concussion/mTBI,  I have learned that my issues may just be more extreme.  Some of the strategies that I use might have been helpful for me prior to my injury.  Now they are critical.

And that is a rough description of some of the things that come to mind in describing what my “new normal” is like.

 

 

 

 

Read More - My “Ah Ha!” moment — What I wanted to know about how to recover and rewire after my injury