TBI and Cogintive Function

In May, I underwent a battery of tests in regards to the impact the TBI has on my brain.  The testing included an EEG, a contrast MRI, and neuropsychological testing.  I received a mix of good and bad news.  

  
The good news is that my EEG showed no seizure activity.  The epilepsy specialist did not recommend changes to my current treatment.  It appears that my seizures are controlled.  I might get my driving privileges reinstated in 4 more months.

The MRI (with contrast) showed changes in my brain indicative of brain injury.  Thanks, I knew that before.  On the other hand, I’m happy something finally showed up on my physical testing.  It was extremely frustrating to know things weren’t right but have no medical confirmation on testing.

  
The neuropsychological testing was brutal.  It consisted of 6 hours of testing over 2 days.  It was totally mentally exausting and aggravating.  It was designed to push me and it did.  The testing looked at overall intellectual functioning such as language usage and comprehension, memory, visual spatial function, problem solving, math, and reading.

  I did well on basic knowledge and vocabulary.  However, on the rest of the testing, I scored between the third and tenth grade level.  I have a Masters in Social Work.  This is a significant drop in function.  My IQ is now low average , close to below average.   It used to be much higher.  This result wasn’t unexpected but it was hard to hear.  I still haven’t really accepted it at all.

I also showed low levels of frustration and stress tolerance. I have no idea where that came from.  I only told the examiner to F off once.  And broke a pencil.  And was 15 minutes late coming back from lunch because I had no intention of continuting.  My sister managed to get me to return.  

It was noted that I cognitively fatigue and perform much worse in the afternoon.  I also have focus and attention problems.  And, gee, I have issues with depression and anxiety.  Go figure.

The overall recommendation was that I do not return to work at the VA in any capacity.  This is both good and bad for me.  I enjoy working with veterans and being a social worker. I want to return to work. On the other hand, work is extremely frustrating and I am unable to perform much of my job responsibilities.  It’s both sad and a relief.  My prognosis is that there will be no significant improvement at this point.

On the positive side, the information provides my cognitive therapist with target areas for treatment.  She thinks I can have a limited amount of improvement, enough for me to do some volunteer work in the future.  She also thinks it may be worthwhile to do vocational rehabition after I’ve done more cognitive therapy.  

The outcome of Traumatic Brain injury varies greatly between patients.    Some brain injury victims end up in vegetative states or have extreme difficulties in mobility and even basic functioning.  My outcome is much more hopeful.  There may be more optional for me in the future.

Be well, friends.  Take nothing for granted in your lives.  It can change in a second.

  

Gourmet?  No.

In the military, our food is often presented as Meals Ready to Eat aka MREs. Frequently, these meals are all we have for days on end. Other times, we get hots or a combination of hots and MREs.  At times, it,was hard to know which was worse.

MREs consists of a main course and a variety of other foods: things like crackers, bread, peanut butter, some sort of desert, and the absolute prize…tobasco sauce. There is also an MRE heater.  Just add water and you can warm your food.  If you’re more creative, the heater can also make an impressive “bomb.”  You also get 6 sheets of toliet paper.  Save up four or five sets and you can actually have a bowel movement and have enough to wipe.  Fortunately, the MREs tend to stop up that particular function.  But, when you do go, it’s like crapping bricks.

  
                       (Example of MRE)

The MRE menus have improved since I joined in the 1990s.  Still, there are some absolutely nasty ones.

Perhaps the worst I had the misfortune to encounter was “Chicken ala King.”  Or, more accurately, Barf ala King.  Looks, smells, and tastes like barf.  It did make a good tool for practical jokes.  Leave a pouch open under a rack or in a locker.  Set it up so someone steps in it barefoot.  Good times.

There was always trading of meals or parts of meals.  No one would touch Chicken ala King.  Currently tobasco sauce is in every meal.  In the 90’s and early 2000s, it was only in some meals and very highly prized.  One of my experiences with Chicken ala King demonstrated the absolute hatred of the meal.  I received the meal two times in a row.  The second time, I tried to trade it for something, anything, even the second place in digesting meals, the omelette.  I saved two bottles of the tobasco sauce.  I offered them in trade for someone’s spaghetti.  No.  I sweetened the offer.. Both tobasco and the cake desert.  No.  All I mentioned previously and $20.  No.  I gave up.  At least there were peanut butter crackers in that one, 

I often miss being in the military after my medical retirement.  One thing I don’t miss are MREs.

  

Summer Running

running woman

Runners often workout in less than optimum conditions. Summer running provides it’s own challenges.

1. Wildlife.
A. My workout Monday called for sets of three minute hard intervals ran just under full effort (full sprint), followed by a set of 6 core and upper body resistance exercises. Repeat 3 times.
The first two sets went well. On the run starting the third set, I had a less than pleasant wildlife encounter. I was stung three times by wasps or bees; two stings to the upper left arm. However, one wasp flew up my shorts and stung me on my left butt cheek. That hurt. Here I was, shaking my left leg, jumping up and down, and reaching my hand up my shorts to shoo away the offending insect and remove any stinger. It must have looked interesting. I am relieved there was no one to catch it on video. Being a hard charger, I finished my sprint, got home, took some Benadryl and completed the workout. Runners are crazy.
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B. Snakes. In the world of running, any stick is a snake until proven otherwise. This summer, I ran a gravel path around a lake. Part way, I heard a hissing rattle. I looked forward and saw a rattlesnake pulling back into strike position. I never stopped so fast in my life. I slowly backed away and watched in relief while the snake disappeared into the grasses off the trail. I crossed on the far opposite side of the trail from the snake. My heartbeat didn’t slow down for another mile. I love adrenaline.

C. Possums. They’re ugly but tend to leave people alone. Still, having one hiss at you is a rather startling experience.
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D. Skunks… Oh, crap. Fortunately, it wasn’t interested in me and just went into the downed tree limbs.

E. Ferrets. Well, they’re not wildlife but they are involved in anything and everything in the house that looks interesting. It’s hard to do pushups with a ferret climbing up your arm- or into your shorts/ pants.
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Watching someone run in the summer heat generally brings questions to people’s minds. The primary one being “why.” Runners often ask themselves the same question. What goes through a runner’s mind during summer workouts?
1. Man, it is freaking hot.
2. Do I have enough water?
3. Crap, it’s hot
4. Why do I run anyway?
5. My socks are wet and I’m getting a blister- My shoes are squishing
6. Damn, it’s hot
7. My Garmin must be broken. It says I’ve only run two miles.
8. Only 5 more miles to go. Crap.
9. My shorts are wet. Must look like I peed myself.
10. Keep going… Only 4.5 miles left.
11. Really it’s time for a surge again?
12. I want a beer.
13. Make that two.
14. Just run to that tree… that stop sign…. that telephone pole, etc
15. I need more water.
16. Am I leaving drops of sweat on the sidewalk?
17. Yup I am.
18. I hate running
19. I will never run in the summer again- or at all.
20. I hate running.
21. 2 miles left.. thank heavens.
22. Damn, I need to poop
23. Yes! Endorphins!
24. I love running- endorphins
25. I’m tired.
26. I’m done- I have to find the toilet- NOW!
27. There’s not enough pickle juice to fix this. Pickle juice tastes weird.
28. I feel beat. Maybe I’ll take tomorrow off.
29.. Ten minutes later… I LOVE running! How far am I going to run tomorrow?

Yes. Runners are crazy.

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Hope, Courage, Determination

quotes-about-life-dont-look-back-in-regret-but-move-on-with-hope

Hope. Courage.  Determination.  Without these three qualities, I would have quit striving for healing and improvement.

Hope is elusive.  There are dark spots in life where it seems nothing will ever get better.  The road of brain injury recovery is filled with potholes and valleys.  Yet, there are also the mountain peaks, where I see how far I have come.  Hope allows me to see the possibilities I still have in life.  It allows me to dream of the future instead of only seeing my past and what I lost.

Courage is facing fear and adversity without retreating.  Fear:  constant anxiety that never quite leaves.     It’s a backpack of rocks, weighing me down, but it can’t be dropped or left behind.  I can only work to reduce how much it affects my life. If I want to continue to function and have any sort of meaningful life, I have to ignore or work through the anxiety of being. Just being is anxiety.  I face it every day.  Some days are harder than others and there are days I hunker down in my house most, or all, of the day because I just can’t face being outside.  Yet, I still run and complete life chores.  It’s exhausting but needed.

Determination.  When I was first injured, I faced a long and uncertain recovery.  No matter how much I wanted to quit, I kept moving forward.  I still move forward.  I don’t want to stay where I am right now.   Running marathons before I was injured developed a strong sense of determination.  There are times in training and the race that the body is spent.  What is left is determination to complete the run.  Now, it’s determination to live life to the fullest, not allowing fear or uncertainty to trap me in the quagmire of fear.

I may never improve beyond what I have now cognitively and physically.  Hope.  Courage. Determination.  I may come out the other side stronger and wiser than before.

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Ferrets Go figure

I have been owned by ferrets since 1999.  They are strange critters.  We spend money on toys for their enjoyment.  And this is what happens:

They climb Christmas trees.



They play in the box



They play in inappropriate places



They explore strange places



They “help” with cleanup



They explore gravity



They steal things



There are some things even a ferret won’t steal





But they’re so cute we love them anyway



My ferrets have made me smile at times life was at it’s hardest and I wanted to quit.  It’s just not possible to feel sad when a ferret is around.

Relationships and TBI

TBI changes everything.  My old self died in the car accident that led to my TBI. I am walking wounded, the injury to mind and soul invisible.  

My relationships with others changed.  Some do not want to accept that I am not able to be who I was before.  I struggle with tasks that used to accomplish, I frustrate easily, I have to spend more time thinking about how to answer questions or solve problems.  For me, daily function depends a lot on routines.  Same tasks, same time, same order.  Change something and I don’t adapt. 

It is frustrating when people assume I have the same abilities as before.  It’s worse when they think I am unable to do anything correctly.  For example, my sister and I arrived late for an appointment.  She insisted we were on time.  I am still capable of reading a digital watch and analog clock.  Another appointment, I was to blame for being late because I “was upset and couldn’t communicate” when I told her we were walking the wrong way.   Both times, I “freaked out” on her. I admit that I was angry and losing my control over it with her verbally.   Her response was to walk away from me.  She expects me to be who I was before.  Or to be so broken I can’t do basic things.  We don’t connect anymore.   



It is hard on both sides. New relationships have to develop with a familiar stranger.  I’m not who I was, in intelligence, cognitive processing, energy, emotional  stability.  Friendships and professional relationships need to be formed by who I am now, not who I was before.  This is difficult for both sides.  It seems easier to connect with people I either knew for decades before or people I met after the injury. I understand .  There are times I don’t like myself (or how I act) either. I suppose it takes patient people to stay in relationship with someone radically different. It is so much easier to relate to my friends, past and present, on FaceBook.  They don’t see me day to day and have to endure my temper issues or other problems.  Interacting with my ferrets and cat is so rewarding.  They accept me just where I am and love me anyway.  They’re also easy for me to understand.  



This article explains some of the changes in relationships after brain injury.  I experience many of the emotions and changes.  

Brain Injury and Relationships