Concussions Can Be Serious-- Ya' Think?

     After my traumatic brain injury, I used to think frequently that "Not so many people give a crap about concussions or about t.b.i." That changed. First there was some news about our veterans returning from the battlefields with brain injuries. [I do have several relatives involved with the Wounded Warrior Project]. Then people decided to get excited about concussions in professional sports and in high school football.

     Attention can be a good thing. Awareness gets raised that way and suddenly one community passes a law about bicycle helmets. Another implements guidelines for high school athletes who get their heads banged in the field. 

     But attention can also be not so good. When the populace is not exposed to original research-- and don't know how to interpret it if the data was made available-- articles written for common folks can be mystifying and contradictory. In the references below, articles have maintained that either location of impact has little to no impact upon outcome or that top of the head impact is worse than other areas and is more likely to cause unconsciousness. Or that high school football players are most at risk for permanent cognitive effects. 

     Do you want to believe the professional athlete who has had three concussions and is not fazed by the idea that a fourth can end his career? Or do you want to believe those folks who are no longer able to work after what was initially diagnosed as a "brain bruise," "a concussion," "post-concussive syndrome," or nothing? Or the guy in the sailboat race who was hit hard by the boon in an accident, gets hospitalized for several weeks and almost dies, can return to work but is told he cannot ever sail again? Another injury to his head like the last one may well be his last one.

     The thing is, every head injury looks different. Whether it is a concussion-- a brain injury with no lasting effects-- or a brain injury that is judged to be a traumatic brain injury (which has lasting effects), or an acquired brain injury (from stroke or brain tumor removal etc.), every single head injury looks different. The t.b.i. survivor who did not lose consciousness at all may in fact be more permanently disabled than the survivor who arrived to the emergency room unconscious. Add to that, the reluctance of the adolescent to admit to having cognitive symptoms or how badly his or her head hurts and the denial of the professional athlete who figures the glory of the game is of higher priority than the integrity of the brain.

sapphoq healing traumatic brain injury says: Those of us who have had brain damage know how serious any injury to the head can be. We also know that repeated concussions can alter brain functioning permanently. 

     

References:

http://www.woundedwarriorproject.org/


http://www.steamboattoday.com/news/2014/aug/10/monday-medical-concussion-tools-help-recovery/
        The article that I liked the best.



http://www.empr.com/for-concussion-outcomes-impact-location-has-limited-effect/article/365564/

http://www.designntrend.com/articles/17823/20140811/football-concussions.htm

http://www.reuters.com/article/2014/08/11/us-concussions-football-high-school-idUSKBN0GB07C20140811

http://www.medicalnewstoday.com/articles/280869.php



http://www.cdc.gov/concussion/HeadsUp/index.html

http://www.winnipegfreepress.com/arts-and-life/life/health/blasting-away-at-concussions-270711161.html?cx_navSource=d-tiles-2



http://espn.go.com/blog/nflnation/post/_/id/135137/lowery-no-reservations-after-concussion

http://www.thefalcoholic.com/2014/8/9/5987021/dwight-lowery-returns-to-practice-saturday



http://en.wikipedia.org/wiki/Concussion_grading_systems

http://post-concussion-syndrome.com/
         From an attorney website, sorry.

http://www.mayoclinic.org/medical-professionals/clinical-updates/general-medical/diagnosing-treating-sports-related-concussion
         Guidelines from the Mayo Clinic re: sports-related concussions in schools.

If It's Worth Having, Then It's Worth Working For

     Out of all of the professionals and specialists that I've dealt with in respect to my traumatic brain injury, there was a grand total of one-- and only one-- who told me that I was capable of learning how to control my impulses and harness my dis-inhibitions. Let me explain further:

     Go to any brain injury unit and you are likely to find patients who curse fluently. I'm not claiming pre-injury innocence. What I'm saying is that cursing originates from the more primitive, reptilian part of the brain located deeper in than language is. Hurt a brain, you will probably hurt communication but the cursing may remain more fluent than language skills for a time.

     I was talking with a friend who is eighteen months away from his stroke. He told me that he was having trouble with just blurting things out. He was astonished when I said that he could learn to govern that. Blurting things out and cursing both have a similar emotional component to them, to my way of thinking. 

     I also had experienced those sorts of demands from my fractured brain. I learned that when I was feeling a pressure to "Say it, just say it!" that was when I almost certainly should not "Just say it." And the cursing thing? I found out that it was easier for me to strive not to curse at all than it was for me to give myself permission to curse at some times and not at others. Learning not to insert the f-bomb into every other sentence and learning not to blurt things out were two things that helped me feel some semblance of control during a time when the world was still wobbly and rotating slowly to my left.

     Was it difficult and challenging to develop some self-discipline? Yup. But I worked on it and I continue to work on that because I have found the results to be rewarding. Not feeling driven to tell my very proper mother-in-law filthy jokes over dinner in a restaurant made the meal go better. I was happier being able to blend in a bit. And m.i.l. certainly was happier too.

     Do I curse now? Yup. A lot less than post-injury and less than my pre-injury days too.

     Self-discipline is something that I found to be worth working for. I tell myself daily, "Get up, clean up, walk the dog, go to the gym. Your brain damage is not an acceptable excuse for your laziness." And so I get up, clean up, walk the dog, and go to the gym. I still have to rest during the day however I am getting stuff done now. And that feels good to me.

     There are bunches of stuff that is no longer automatic for me. I have to think through some tasks before I am able to do them. I have to concentrate on where my feet are going as I walk so I don't fall. I have to have things put away in the same places today so that I can find them again tomorrow. Supplies for cleaning the floors go on one shelf on the back porch. The laundry bag lives next to the washing machine. The stationary, bills, check book, stamps, and pens are kept in the desk. I still struggle with organizing today but not as much as I used to. I can get more done because I am not stumbling around the house in a blind rage unable to find the vacuum cleaner bags.

 sapphoq healing t.b.i. says:

If It's Worth Having, Then It's Worth Working For.

If It's Worth Having, Then It's Worth Working For.

If It's Worth Having, Then It's Worth Working For.

Aphasia, I Haz It

     The second neuro-doc told me that I have mild expressive aphasia, or more specifically a phonemic paraphasia [N.B. which some professionals characterize as being entirely separate from expressive aphasia] with pragmatic and substitution errors.  I also have the associated right-sided weakness that a physical therapist recently pointed out as still being evident a decade after my head trauma.

     I am conscious of my speech errors.  I know when I've substituted a sound for another sound at the beginning of a word.  I figure that if the person that I am conversing with understands what I am endeavoring to convey, no correction of my pronunciation should be forthcoming.  A few other people appear not to agree.  Sometimes I've said to them, "Do you understand what I mean?"  After their response in the affirmative, I've told them to s.t.f.u. about it then.  I've become less defensive about this than I used to be.  Now I will repeat the correction out loud and visualize it cementing itself in my brain.

     I also get irritated when I cannot think of a specific word that I want to use in conversation.  That appears to be an anomia and anomia is central to almost all aphasias.  [Note to testers:  Many of your test subjects know that if you point to the thing on your wrist, the correct answer is "watch" and when you point to the writing implement, the correct answer is "pencil."  Just so you know that, I thought I would tell you that].  Fortunately, I am able to hunt through my brain for a similar word.  Although the substituted word is not exact to my intended nuances of meaning, I get my point across.  The vast majority of people that I interact with do not recognize this sort of thing when it happens unless I point it out to them.  I despise the blank that happens when my brain blocks a word from me however I do know that my ability to pick a different word is evidence that my cognitive slowing has speeded up a bit. 

     Another difficulty that I have appears not to be part of expressive aphasia or of paraphasia.  When people talk too fast-- and I think this chiefly happens when a store clerk or someone on the phone wants me to agree to something (like "buy this object" or "agree to this contract")-- I lose the gist of what they are saying.  I've learned to tell them to slow down.  If they don't, then I tell them that I have a brain injury and that if they want me to understand them, they must slow down.  A second failure to slow down results in my termination of the interaction, or less frequently a request to speak with someone else like a manager.  I've resorted to taking someone with me to a store or having someone listen in on an important telephone call if contracts are involved.  I describe the second person as "my disability advocate" because it then becomes more difficult for the other party to dismiss the presence of my helper-friend.

     Like all of the complications that I've had due to my traumatic brain injury, I continually work on improving those difficulties that I can identify.  Movement is especially important to me.  I substituted my [severely lacking] motivation with motor-vation.  Social interaction [including interaction with other folks on the web], adequate rest and nutrition, and challenging my brain on a daily basis has become a lifestyle.  I do not believe that the majority of improvement after a traumatic brain injury occurs during the first year.  I've had significant improvement throughout because I keep practicing everything.  That which cannot be fixed [and with a t.b.i., there are things that cannot be fixed] can be worked around.  My philosophy is not one of "attitude" or "surrounding myself with 'positive' people."  Action is the word that sums it all up, with periods of rest so that way I have the energy to take repeated action. 

sapphoq healing brain damage says:  I would have gladly settled for a less-challenging life.  I am not "better off" because of my brain damage.  Certainly, I am financially much worse off and my career (that I fought so hard to have) ended.  I have not found any evidence that a god "did it" or even "allowed it to happen."  I have found that it takes courage to dream new dreams and even more courage to take action on the stuff that I say I want.  Anyone can make a list for Santa Claus.  Very few people will want to even attempt to drive a sleigh hooked up to a bunch of grumpy overworked reindeer.


A few links:

http://www.aphasiahope.org/

http://www.aphasia.org/

http://preview.tinyurl.com/n8r6zc6    [Neuro-psych Central, a pdf on aphasia assessment tools].