vision therapy

Automaticity Part 1

aforrest Leave a comment

Last week, I wrote my first draft blog post about a term that I have learned called Automaticity.

I wanted to write about Automaticity because I knew that I was expereincing a huge increase in it, and that it was automaticity that was allowing me to do much more than my “previous normal” would allow.

I had titled the post from the week before “I did it!” because I was so amazed that I had been able to do so much and knew it was because my brain was changing and allowing what I previously could not get done in a given time period.
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Automaticity Part 2

aforrest Leave a comment

I introduced the word Automaticity in my last post.

According to Wikipedia, learning, repetition and practice eventually allow the brain the ability to automatically respond.   An automatic response means that the mind is not trying to figure out the how to do it part (any more) of doing a task.   The how to do it part becomes automatic.  The mind just responds or acts out of habit.

You may not have even known that there is a procedural part and an action part of doing tasks. That is because by the time we are adults, most of the how to do it part is automatic.   When who to do something becomes automatic, its called procedural memory. When I had my brain injury, I learned that one of the connections that I had lost was procedural memory for a lot of everyday tasks.   I have had to relearn a lot of procedural memory in order to do daily tasks.
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I did it!

aforrest Leave a comment

On Monday when I walked, I realized how glad I was that I had developed some awareness last week about my vision and integration, how my brain is changing right now and how to help my brain change during this transition through my vision exercises and walking.

And in reflecting about my increased awareness, I realized that I had more challenges on my plate this week then had even recognized that I had the week before.

It wasn’t just that I had more tasks to take on as a daughter, but also I needed to figure out how to increase my communication with my siblings and brother and sister-in-law in our collective tasks to help each other work together to help my father.
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Integration, Vision and Neuroplasticity

aforrest Leave a comment

A dear friend from Washington DC who knew about my setback this summer called last weekend to see how I was doing and offer her support.  She left a kind and supportive message on my voicemail.

While walking that next day, I wondered how to describe concisely how I was doing when I got back to her.  In many ways I am better, my functionality is very improved and I feel well enough that I have begun the daunting task of seeing the doctors that I was not well enough to see this summer for followups.

In other ways, I am still struggling after the setback.
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Neuroplasticity and Resilience

aforrest Leave a comment

In the last couple of posts, I have been writing about my experience of neuroplasticity.  I am going to emphasize that I am writing about it, at an experiential level.

In other words, I am aware that my experience is anecdotal evidence for scientists and social scientists because to my knowledge, neuroplasticity has not been studied in a systematic way for as long as I have been living post-injury.  (According to Dr Allen Brown at the Mayo Clinic.   He presented the evidence from studies that have been done at the Mayo Clinic on Neuroplasticity after brain injury at the Brain Injury Awareness Day 2011 panel that he and I participated on as well as many other government, military officials and the wife of a wounded warrior.)

I am particularly interested in how vision therapy increases neuroplasticity.  I got to vision therapy relatively quickly after my concussion/brain injury because I couldn’t process what I was reading and because I was not getting help for this issue from my primary care doctor or my neurologist.  I wanted to get back to work and, even with my injury (and little overall self-awareness about its consequences or sequalae), I knew I had to be able to read.

In response to my last two posts about neuroplasticity  I am feeling following my 3 1/2 month unexpected setback this summer, I reached out to Sue Barry, a neurobioologist at Mt Holyoke for information about what’s actually happening in my brain.  I wanted to understand what’s happening.

Now I realize that there is value to me (and others) in trying to map my experience with what some scientists understand is happening in my brain.

In response to my question to Sue Barry PhD about the role of vision therapy and neuroplasticity, she wrote:

“Vision therapy changes the way we process visual information, and this can have dramatic effects on how well we function as both Anne and I have discovered.  In chapter 6 of Fixing My Gaze, I describe some possible ways that vision therapy techniques alter synaptic connections in the visual cortex.  In addition, our mental outlook  and mood alters the release of neuromodulators onto cortical cells and synapses from certain regions of the brainstem and basal forebrain.  These neuromodulators then alter the strength of existing synapses.  I cover some of this in the last chapter of Fixing My Gaze.  Thus, mental outlook and mood have powerful effects of brain function and plasticity.”   (By email, October 28, 2014)

So I have been reading and and re-reading her book, Fixing My Gaze: A Scientist’s Journey into Seeing in Three Dimensions by Susan R Barry with a foreword by Oliver Sacks. (It was copyrighted in 2009 by Basic Books in New York, USA)

And then this week, I went to an amazing panel at SXSW-Eco on “Networked Resiliency and Sustainability”.  It’s a long story about how I got to the panel, but the short answer is that much of my thinking about my brain and recovery is influenced by the research and work that I did on the broad topic of sustainability that I did at the Environmental Law Institute pre-injury as a senior environmental economist.   Post-injury, to the extent and when my cogntive function allows me to think abstractly,  I try to apply what I learned about sustainability and the economy to running my everyday life as an individual.   I learned alot about resilience when I finally got to rehabilitation after my brain injury, although it was not called that.  So I was attracted to the panel title “Networked Resilience and Sustainability” and wondered if it would apply to how I think about my post-injury medical problems.

It did.  It was fascinating and stimulating to see how the work on sustainability has been continued by others after the end of my career (due to the difficulties I had getting comprehensive post-injury treatment and possibly by the injury itself).

It was fascinating and stimulating to see the societal context for the work on sustainability that is being done around the world in 2014.

And it was fascinating to see how what I have learned about resilience and building networks to support optimal recovery from my injury is being done by cities to support optimal recovery after weather shocks such as hurricanes and tornadoes and other extreme weather incidents that we now understand the societal benefits of planning for on many different levels.

After listening to the talk, I understood that perhaps some of the euphoria I am attributing to neuroplasticity is really from the resilience I feel after getting past a setback that I know I am lucky to have cut as short as I did.

So I wondered how much of what I am describing as how I feel when I feel neuroplasticity is really how I feel when I feel resilience.  Probably some of both!

More on all of this in my next post.

Here’s the link to the “Networked Resilience and Sustainability” Panel at SXSW-ECo

 http://schedule.sxsweco.com/events/event_ECOP29859

 

 

 

 

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A week of possibilities

aforrest Leave a comment

I have had an amazingly clear and instructive and stimulating and exciting week!

Like I described in my blog post last week, I brain feels “clear as a bell.”

Given all that I have gone through this summer with my setback where my thinking was so confused and so disorganized and had to work so much harder than normal to try to function, having my brain feel “clear as a bell: feels great.

The vignette that I will always remember about this summer was when I unawarely blended a metal spoon in my blender.

I think I wrote about this blender incident in an earlier blog post.  And, I am going to write it again, for the emphasis.  I had noticed that I had put the spoon with peanut butter on it in the blender and told myself to remember to take it out before I turned the blender on.

And then I did not remember the caution to myself because my attention was so terrible this summer.

Instead of remembering to take the spoon out, I put the top on the blender which meant I could no longer see the spoon in the blender.

And then I turned the blender on.

And when I couldn’t process the information that I was getting from the sound of the metal blender trying to blend with the metal spoon, I turned up the blender speed thinking it was ice that needed a higher speed to blend.

Ah, me!

And now, my brain is processing quite well again and my thinking feels “clear as a bell”.

You may imagine that I feel like I can do anything!

My week has also been instructive because the clearness of my thinking is reminding me of my brain’s ability to change (in response to my eye exercises and my hard work to help it get better) means to me at an experiential level.   I feel clear.

And I can even feel connections being made inside my head that I was not able to make previously.   And that feels great!

Its been an instructive week because I got knowledgeable feedback from Maria Romanas MD, Larry Shutz PhD and Sue Barry PhD about my last blog post and the conversation that Maria and I have about my brain before I wrote the post.  Their feedback about the mechanics of what is actually happening in my brain right now was tremendously helpful.  It made me realize that I am describing the changes in my brain but that I don’t really understand the mechanics of the neuro plasticity very well other than I know its happening to me.

It was exciting to get the feedback from an MD and two PhDs–people who have studied this issue and are very knowledgeable about it –on what’s physically happening for me.   Sue Barry, a neurobiolgist helped me understand that the vision therapy (and potentially other things I am doing) are strengthening the connections in my neural pathways.

I hope to re-post the input that I have received from these three because the discussion with them on neuroplasticity this week has been  a fascinating to me.   I need to ask for permission from them first or to ask them to post their comments directly on my blog.

You see, as an economist, I have been trained to think about how an economy changes and post-injury, I have begun trying to apply my training to try to characterize who my brain changes.  Linking the changes that I can describe to the actual physical part of the brain is another step.   With the feedback this week, I have learned that I have a lot to learn about neuroplasticity, what it is and what it is not, before I can begin to make that step for myself.  The feedback sharpens for me some increased awareness of what I don’t understand about neuroplasticity.   Improving my understanding of neuroplasticity will help me refine my thinking and help me match my experiences to the science better.  Yahoo!

So I read the medical definition of neuroplasticity this week for what seemed like the first time and I looked for the research that the Mayo Clinic has done on studying neuroplasticity after brain injury to find the definitions that they used in their study.  (I will post these definitions on a latter post and I must work harder to find the Mayo work.)  Exciting stuff!

There was another opportunity this week, that I want to describe because it was so meaningful and poignant for me.

I volunteered to read to my 5 year old son’s kindergarten class this week.

As I prepared to go to his school to read, I realized how far I had come that I could read to his class.

One of the symptoms of my brain injury was that I had difficulty processing what I read.   My eyes looked at the words, but I did not know what I had read–I couldn’t take it in and trying to do this was exhausting for me.

I first became aware that I couldn’t read when trying to read Time Magazine at the Neurologist’s office.  However, this symptom was not understood, or treated, or even recognized as a problem by my medical doctors.  I was lucky in that it was diagnosed (and hence validated) by a vision therapy doctor, Dr Franke.  He treated me by giving me eye exercises, diagnosing prism glasses for me temporarily, and helping me develop compensatory strategies.

In preparing to read to 5 year olds this week, I recalled a difficult moment for me early on when a friend’s friend had asked me to read to her 2 year old while she got dinner started.  Books written for two year olds are about as simple reading as you can get.  So I thought I could read to my friend’s two year old.

However, it was the end of the day, and I was tired, and after reading two or three pages, I realized that I just couldn’t read the book to my friend’s 2 year old.

It was difficult to come to terms with that for myself.   But I had no choice.  I couldn’t do it.   I had to tell my friend, I couldn’t do it.   It brought me to tears.

And years later, look at me now!   I am the mom that is reading to my son’s class.   What a joy!

 

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More on Neuroplasticity

aforrest Leave a comment

In last week’s post, I talked about how experiencing and believing in neuroplasticity gives me hope and helps me be optimistic about my continued recovery.

But neuroplasticity gives me so much more than that.

So I want to say more about what the changes that I am still experiencing are like.

I have had several exciting conversations about the neuroplasticity that I am experiencing this week.

One with Maria Romanas, an MD, who was interested in the neuroplasticity I am experiencing and how my vision therapy promotes that.

And another conversation that I had was with a friend from Thatcher Freund, a memoir writer.  I have known Thatcher from Junior High on as he is the brother of one of my best friend’s and the three of us did a lot together–in fact people used to ask if we were triplets.  Thatcher has been researching vision and neuroplasticity and what is known and utilized  in the dyslexia community.

I have been telling people that ask me how I am doing after my setback that I am in the midst of experiencing intense neuroplasticity and this week I feel full of energy and “clear as a bell”.

When I told Thatcher that I was experiencing neuroplasticity and felt clear as a bell, he almost jumped out of his chair and said “I am so excited you said that.”   He said, he could “see” how much clearer and more articulate that you are compared to the last time we had lunch (in December).

So we had a very animated conversation about what was going on for me.  Because of his research and interests and background as a memoir writer, he asked very probing good questions that I had a difficult time answering.   Its hard for me to get to concreteness on describing how my brain is changing sometimes and what I am feeling and how the neuroplasticity is changing my thinking right now.

But one thing I have learned in my journey to recovery is that if you give my brain good questions, it will eventually come up with answers.

My brain cannot come up with answers, quickly, so I don’t expect it to.

But I know that my brain will come up with them if I am patient and let it come up with them on it’s own time.

So my brain will give me the answers later.

Answers may come up when someone says something to me that “cues” me.  (And with a brain injury I have certainly learned how to look to others for “cues” to help me think or to help me stay on task.  So I know how to cultivate stimuli received from others to help me think.  I have been practicing doing this for a long time.  More on this later.)

And I know that answers may come when I meditate, so I cultivate a meditation practice.  And I know that answers may come up randomly during my day.   So I know to look for them to cultivate and harvest.  And I know to just let one of these processes happen and to be patient with my brain.   And they may come up as I write my blog.

A couple of things to say that I have harvested since these conversations about the neuroplasticity that I am experiencing:

1) The gains that I am having right now are specific to the deficits that my brain has been having.

I realized that its probably that since ” if you have seen one brain injury, you have seen one brain injury”, my gains are about me and are not necessarily true for others.  In other words, every brain injury is different.  In my mind, it follows that the experience of neuroplasticity will be different for everyone, which is why its important to hear how others experience neuroplasticity also.

2) That my gains from neuroplasticity are specific to the deficits I am experiencing right now.

Earlier, when I was getting treatment for attention and concentration issues, I was experiencing neuroplasticity around attention and concentration and by conquering those problems, I was able eventually to have more abstract thinking because my brain had changed to support more abstract thinking.

When I realized that my current neuroplasticity is specific to my current deficits, I figured out more about how to describe it more concretely.

This summer, I was sleep deprived and was getting head aches from muscle tension and thus I was at a lower level of functioning.

Now that I have resolved those issues from my setback, I am experiencing repair (neuroplasticity) around my “executive functioning” (which I was having before the setback).   Or at least I think its my executive functioning.   Someone described executive functioning as the “executive” in ones brain making decisions about priorities and what to filter out and what to filter in and how to do decide to do things in order and figuring out the steps to line things up.  A researcher at the Smithsonian in DC called it the ability to “get the trains to the right stations on time”.

So one way I am experiencing neuroplasticity right now is about categories and my ability to categorize.

Over the course of my brain injury, I have had a difficult time sorting things into categories.    An overly exaggerated example might be, if I were to sort out red and blue sock, post-injury I would inevitably sort some red socks into the blue and some blue in the red.  This happens because I wouldn’t notice that some red are in the blue and vice versa.  I just couldn’t see what keeps the category pure or in tact.  And it also happens because I may forget my sorting rule in the midst of the task (and not be aware that I have forgotten it).

I would compensate for this issue, by taking a second pass at sorting the red and blue socks, and I would notice some of the red in the blue and the blue in the red.  But I would not notice all of them, because of the same problems above.

So suddenly, I experience neuroplasticity around my sorting, and I can look at the red and blue sock piles, and suddenly see that oh!  there are still more blue socks in the red sock pile and still more red socks in the blue sock pile and I can “see” the things I couldn’t sort before and consequently make the piles more pure.  So suddenly I want to reorganize so that all the reds are together and all the blues are together.

The reason I used the example of red and blue socks is because its exaggerated.  You can imagine how unorganized my house looks after moving, if I cannot organize something like blue versus red.  In reality, its a little more subtle than that– its beige versus white or kids bowls mixed in with kids plates or its papers that belong in one category versus another.  So its not just my house, its my writing and its my organization of my day and its organization of my projects and on and on.

And the irony of it is, is the less distraction I have, the more I can focus and be efficient and think better and more efficiently. But my injury means that I have a lot of distraction going on in my brain that I don’t yet have the skills to filter or the procedures to filter out.

And when I experience neuroplasticity, I suddenly can see how to filter things into better categories.  Since I have better categories, I can do things more efficiently and because my brain can do things more efficiently I both have more energy to use toward problem solving and I can solve more problems (because my brain has more energy to solve problems.)   Both the energy and the increased abilities bring a sense of accomplishment and a kind euphoria.

(And, not to mention, I don’t have to spend time employing the compensation strategy of going back and doing the work again,  I am more likely to get the categories right the first time, and thus save time doing the task.  That is if I am aware enough that I can drop the compensatory strategy. More on this later too.)

And another more on this, later catagory too.   I need to add briefly that the neuroplasticity isn’t all good.  It comes with “costs” that I have to be willing to tolerate in order to embrace my brain’s ability to change  and get the benefits of the neuroplasticity .

There is a down side of the sense of accomplishment and euphoria of the neuroplasticity.   It can be depressing to grasp just how poorly my brain was functioning before.  So I have to be able to take that in without judgement.  And I have to be able to let myself cry and grieve and feel the losses that I now suddenly am aware of that I wasn’t aware of before the neuroplasticity stage kicked in.   Sometimes its too much to take in, so I have to take it in slowly.  Sometimes when I experience the neuroplasticity and the new “seeing” it makes me feel vulnerable and unsafe because I am suddenly aware of how others could take advantage of my deficits or in some cases, how I actually was taken advantage of with my deficits.   Or it makes me realize places where I couldn’t stand up for myself as a result of the fact that I didn’t have the brain skills to do it, and I have to be easy on myself, and know that I did the best I could then, and that in the future, with increased skills I can do it better now.

Do you know when you are experiencing neuroplasticity?

Can you describe it?  Or begin to describe it?

Does it make you feel euphoric and optimistic?

Or do you feel scared or frustrated?

Do you feel losses with it?

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Making the most of technology while my brain changes

aforrest Leave a comment

This has been a crazy good and crazy bad week for me.

I both want to write about it, but haven’t processed it because the wide swings that I have expereinced this week are just hard for me to integrate.  I am very aware of how slowed my processing is this week.  Even slower than its been with this setback.

And as I reflected about my experiences this week in order to write my blog post, I realized that part of what’s going on is that visually I am trying to learn how to organize increased “space”.

I have talked about the reorganization and neuroplasticity that I am having right now in my last posts.

It feels like my brain can now support taking in more space in my peripheral vision.

 

So it is taking in more space visually.

But my brain has to learn how to integrate that space.

And so the wide swings that I have experienced this week and that I cannot integrate well yet, are consistent with what’s going on in my brain, also.

I am taking in more, yet my brain has difficulty prioritizing.   And so my brain is trying to take in more which means to me that it is trying to prioritize more information when it cannot prioritize information well.

Prioritizing what to take in and what not to take in is part of executive functioning skills and its something my brain does quite poorly post-injury as compared to pre-injury when I wasn’t even aware that prioritizing information to take in and what to ignore was part of what my brain did!

Since I am having a harder time dealing with the big screen of my computer this week, I am going to stop writing and post-this and then come back to it later.

I am limiting my computer use in general to get cognitive rest.   When I need to use the computer, I am using my iphone which is some easier than the big screen right now.

I don’t know how to post my blog on my iphone yet, and I know that trying to learn new things right now is ill-advised for me when my brain is undertaking so much change.  It takes too much concentration and too much energy.  I need to use the energy to help my brain change right now.

I have so much to say but the computer technology is an even larger limitation for me in saying it right now!

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Cultivating Neuroplasticity

aforrest Leave a comment

I having been writing about the big setback that I have had following a dentist appointment to fit a new mouthguard and what its been like to go through this setback with the increased awareness and insights that I have developed from my previous recovery journey.

I am clearly in the final stage and I am experiencing the neuroplasticity that I hoped I would get coming out of this.  Goind through what I am going through is “not pretty”– in that my brain is making mistakes and going through some growth pains right now.   But its exciting.   I know beyond a doubt (from my previous experiences with neuroplasticity) that I am going to come out of this better than I was before June 2 when this setback started.

My uncertainty about the outcome of all this is gone!  Yahoo.   I still don’t know when this final stage will be done, but my job right now is to cultivate, entice, do everything I can to allow my brain to change in the ways that it wants to.  I want to get the most benefit I can from this neuroplasticity phase that is finally happening for me.

In other words I need to get out of the way of my brain’s ability to change for the better!

That may sound a little dispassionate.  Who ever heard of getting out of one’s brain’s way before (!)

I have learned from my years of recovery to separate myself from my brain and what my brain is doing.

Before my injury, my brain was who I was.  My brain could support me being a Phd Economist and that was my identity.  I was what I did.

After my injury, I did not have the skills to do my job anymore.  I didn’t know who I was because it felt like I was no longer me.

Having learned a lot of the tough lessons of recovery, I know that the more I see my brain as separate from me, the better I can be dispassionate about what my brain is doing, and the better I can not take what my brain is doing personally!

And not taking my brain personally, means that  in this case that I can step out of the way and let things happen for my brain, so that I will continue to experience long term recovery.

Here are three ways that I know that I am in a period of neuroplasticity, right now:

1) I can feel my brain reorganizing.  What that means is that I suddenly start seeing all of the disorganization that I could not see around me before.  For example, I will look at my clothes drawer, or any drawer, which has previously been as well organized as I could get it.  Suddenly, looking at the drawer I can see a better organization.  I can also see that my shirt drawer shouldn’t have pants in it, for example, or that like shirts can go together, so that I can find them easier.   Since this is happening all over my house, it feels good to start taking advantage of the better organization that my brain will allow.

2) I get a burst of energy.  I assume that this comes from the fact that I can see how to reorganize things that were previously poorly organized despite my best efforts.   It suddenly takes less energy to do a task because all the steps to do it are now obvious to me, suddenly.  Because I can do things more efficiently, the energy I have can go farther in my day.   The increased energy makes me want to take on more things that I am noticing should be organized differently.  (In fact, I have to work hard not to overdo it and get too exhausted from this surge of energy that I get.)

3) My vision is inconsistent, along with reorganization and the energy burst.  I can see well far away with my current level of correction for my contact lenses.  But my near vision isn’t good and  my vision is not very stable. It is changing.  But, that is okay.  I am learning how to integrate more space, and it is what it is.  I want to use the brain injury strategy of “riding this out”.  This means, tolerate it until its over.  (And I am limiting my driving in order to keep everyone safe. I am only driving when I need to and at low speeds to familiar places nearby that I cannot walk to.)

Dr Franke, OD, my vision doctor extraordinaire told me what to expect with a transition and it is indeed happening.

Have you experienced neuroplasticity?

What do you experience when you are experiencing neuroplasticity?

How do you know when its happening?

 

 

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My proposal for a panel at SXSW Festival

aforrest Leave a comment

While I have been trying to get cognitive rest and rest and trying to get better from my setback, my dear husband, Michael, has put together a proposal for a panel at SXSW festival.  (If you are not familiar with SXSW, its a local festival here in Austin and I have more info about it below.)

This week, I have been helping send that out to get votes for my submission.  Its been an interesting week of trying to minimize my computer use to help me get better and at the same time connect with others through my husband’s online mailings.  I have managed it pretty well by only being on the computer for 20 minutes at a time and then coming back to it again later after cognitive rest and doing that off and on during the day.

I have found that the small iphone screen is actually easier for me to get feedback than my wide screen monitor right now, so I have taken advantage of that learning too.

Here’s my request for help to be selected for SXSW Festival and info on my topic.

The voting stops on Sept 5, but anyone can access the first link to see what I am proposing and background info.  I think my husband did a great job with this!

Please vote (voting instructions detailed below)  if you like it by Sept 5.

Otherwise, check out the panel description (by clicking the link posted below) and give me feedback about my panel on my blog!

I will post it on the blog if I am selected to do the panel.

Help Me Get Selected For SXSW Festival!

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I need your vote!

I have submitted a panel for SXSW Festival about concussion and the brain.

Your vote for my panel will help me get selected to present at the Festival.

It’s a very competitive process. There are 3000 panels submitted this year and only “a small percentage” are accepted.

Please take 5 minute to register and vote to help me.

http://panelpicker.sxsw.com/vote/41233

Thank you!

Here are the details:
Some of you are familiar with the SXSW Interactive Festival already.

SXSW stands for South by SouthWest and the Interactive part is the fastest growing part of the festival. Interactive is the technology part (interactive=different kinds of media).

SXSW is an international festival and a global audience comes to Austin in March to hear speakers and see demonstrations.

Festival participants are interested in all kinds of subjects and how they can be improved through technological tools.

SXSW is a pretty amazing concept and the Interactive part has gotten a lot of media attention in the past years.

I have proposed a panel called:
Welcome to Your New Brain: Lessons from Concussion.

At this panel, I will talk about the learning I have had to understand how my brain functions, how my brain changes over time (neuroplasticity) and how to overcome cognitive deficits and diversity.

The lessons I learned and tools I use are useful even for those without an injury. In fact, I wish I had had them before my injury.

Here’s the link for the full text of my panel including supporting info like my cameo on NBC News and The Washingtonian article:
http://panelpicker.sxsw.com/vote/41233

Voting Instructions
So here is how you vote for me:

1. You register to vote here:
https://auth.sxsw.com/users/sign_up
Once you have done this first step, you have done the hardest part

2. Then you vote (vote = thumbs up)
http://panelpicker.sxsw.com/vote/41233

Thank you for your help! I will let you know how this turns out for me.

Anne

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