Anger

Many specialists will wade in on this issue with confusing double talk that might explain it but could simply confuse the hell out of you and leave you more enraged.  I made issue with the show “Golden Girls” and Stella back in my signs and symptoms section for a reason.  It is now common knowledge amongst the scholars that the last part of the brain to develop and often the first part of the brain to go as we age, is located in the frontal region.  This part is responsible for many things, behavior being one and another is planning.  We often wonder why our children act brain dead and take such dangerous risks that could kill them and the reason is that the wires have not fully developed where they start to take stock in the right and wrong of any given situation.  An example is staying out late on the dangerous streets at night because it is cool or skate boarding without helmets and making the bold statement that it’s my body and if I want to do it then I will.  They do not factor in that if they fall on their head and become incapacitated then society, the distraught parents pay the ultimate price by having to care for them forever.  They do not factor in the cost to their parents, of possibly wiping out their savings and retirement all for the selfish reason of it’s my body and I’ll do with it what I want.  This is normal behavior and fortunately it too does pass and as parents we give a big sigh of relief if they along with us survive until those neurons finally connect and a decent young adult emerges.

            Now think about this for a moment.  If you were to meet me I would look like an average guy.  There are no telltale signs that I am brain injured.  Most psychologists would aptly diagnose my anger as easily managed with some basic coping skills.  If he was not aware of my previous brain injury he would apply the same treatment on me as he would a non-brain injured individual and that would be his first mistake.

            My anger is not an issue that comes from the norm of a bad upbringing where I was beaten but rather because the pathways that once led to my frontal brain have been altered or completely severed.  Many problems are happening simultaneously to a brain injured person and the caregiver needs to fully appreciate this.  Those coping skills of life have to be re-introduced and rewired in many cases.  The time it takes a non-injured person to learn new coping skills will be a great deal shorter than that of a brain injured.  It is a Pandora’s Box of emotions from crying, to depression, to despair, to elation and of course anger.  All of which need to be addressed and it is no easy task.  One cannot separate anger from the rest of the issues.  Anger is a result of the many internal problems that a brain injured is facing.  He/she is angry because they recognize that they cannot speak properly, can’t find the words quickly enough, forget constantly, their balance is lost and the list goes on.  The caregiver has no coping skills to deal with this scenario and may accidentally remark, why can’t you remember and that triggers an anger outburst the likes you’ve never seen before.

            My point is this, the brain injury and anger is very complex.  One cannot separate anger without identifying all the triggers that bring on the outburst in the first place.  This will take months of testing and rehabilitation.  We have to rebuild the pathways and re-educate the brain injured so that he/she has an understanding of what the triggers are and how to better deal with them.  It is imperative that the care giver learn as much about the brain injury as possible if they are to survive this ordeal in tact.  You will employ the same techniques for dealing with the brain injured as for the non-injured however if the instructor is not familiar with brain injury he or she may alienate the TBI patient.  Remember the TBI survivor may be dealing with memory issues or permanent damage to the frontal lobe.  The anger may not be easily controlled as a result and therapy may take many months and not just a weekend retreat that might be prescribed for non injured counterparts.

Half Full is a great starting place

I may have been hard hitting in my last blog with regards to fellow TBI survivors who feel they can make it on their own.
Allow me to clarify my position for you.
In life we do not get to where we are without feedback and help.  We start with our parents guiding us, enrolling us in sports, school, music and from there we begin to network.
We gain employment through our efforts and referrals.
From those referrals we learn of better career choices and climb the ladder of success.
We also have setbacks along the way from scraped knees to broken hearts and someone is always there to help us back onto our feet.
Why should we think it should be any different when we are suddenly brain injured?
After the brain injury it should not matter why or whose fault it was but rather how we can overcome and what resources will we need to tap into to ensure the best outcome for me.
Why in your time of your greatest need would you abandon all that have used in the past, your networking skills, and choose to go it alone?
Yes, it is a new endeavor and yes it is frightening or even embarrassing to admit you need help from the last place you thought you would ever be, however it is a resource and you will benefit.
Let's face it, brain injury will conjure up the "One Flew Over The Cuckoo's Nest" mentality in some less educated people.
Mental health in general has some pretty negative overtones that can frighten some people.  This is born from a lack of understanding.  Some friends may abandon you out of this reason.  Not to worry because throughout life you will gain some friends and lose others. Why would you think it would be any different now?
The new friends will understand your needs and stand by you rather than toss your aside.
You are not a freak show.  You are simply brain injured.  You may have speech, memory or mobility issue but you are still you and are desperately important to your family so you owe it to them and moreover to yourself to at least give it your all.
It is in the end, a new career choice, fraught with all the uncertainties, like riding the bike for the first time or the new job or getting your driver's licence.  Look at it like it is, a challenge, one you will overcome, and most important it is one you will master to the best of your ability.
Is your cup half full?
It is incumbent on you to see that it is because so much is riding on your recovery and your loved ones are counting on you to have great hope for the future like you did before the accident took place.

Help! I have a TBI!

The sooner you can get help for your TBI survivor the better.  I have rarely met a survivor who jumps at the opportunity to join or attend a Brain Injury Group.  Ego being the mother of missed opportunity, will cause your loved one, time when it comes to recovery.

If he, and I mean he because 9 out of 10 times it is the male who will argue, I am not as bad as them why do I need to attend?
This bravado is a defense mechanism.  I actually joined in hopes to help other survivors because it had been 15 years since I had been injured.
To my surprise I learned more about myself in the process and enjoyed my time so much I eventually became President of our Brain Injury Society.
It offers support for the caregivers and lets you know that you are not alone.  The society will also have resources both locally and provincially or state wide, that you can tap into.
Things like attorney's who specialize in brain injury.
Why do I need an attorney trained in TBI?
Some lawyers will settle a case from an MVA, and state that the person will be healed up in 2 years and so you are compensated for 2 years and no clause for long term disability was considered.
What if scar tissue builds up and another surgery is required?

So help is most crucial at every turn.

I found that it was so nice to attend a group where I could contribute to with suggestions like the ones on this blog and in turn receive suggestions that might just work for me.
Yes there are people in the group that are far more injured than yourself and there are those who are less affected. The great thing is you will feel like you belong.  It is a place where we don't mind if you stutter, have mobility issues or anger issues.
The mere fact that when you arrive you are accepted as is, will make you feel at peace.  You don't have to explain yourself each and every time you forget. It's understood.

For the caregiver, it will be a place to network and a shoulder when things get tough.  Our group has assisted from giving food and clothing to getting the right medical assistance for you or your loved one.

If there is not a group in your town then check online to see where one is.  You might even decide to start one.
Ours started out of a home with a handful of people and now has hundreds of clients and is partially funded by the provincial government.  The only thing I can warn you about is that when you decide to start one get ready to be overwhelmed by how many respond.

What if my TBI survivor refuses to attend?

Well there is nothing from stopping you.
Second:  Get him to read this page.
MY SPECIA;L NOTE TO MR. TBI.

I like you are brain injured.  You have everything to gain and nothing to lose by attending your local brain injury support group.  If you truly want to heal, have a productive life, not lose your wife, avoid the 90 percent divorce rate that your fellow brain injured survivors enjoy, then if that is nothing for you to lose continue on with your head in the sand and have a great life.
If you can appreciate the fact that your wife is standing by you trying to help you back on your feet, don't you think you owe her a little respect for all she is sacrificing for you?
Don't hesitate and Join today! It may just save your marriage let alone your life.

Did you know that now that you have suffered from a brain injury you are twice likely to suffer a second before someone suffers their first?  Lets keep it to one and learn how to cope.

Brain Injury...Forever....

The title sounds like a death sentence, but in fact it doesn't have to be.  It is a matter of is your cup half empty or half full?
Obviously there will be many challenges and there will be many triumphs along the way.  Here is my question to you, Does this last sentence define life itself?   We all have challenges we must overcome.  We all have moments of great elation and those all come with a dose of cold hard reality that sometimes have us gasping for a reprieve and then the cycle repeats itself.
I stated in previous writings, that is is how we train our brains to keep our expectations in check that help us mitigate the more challenging moments in our life.  If we set the expectation bar just a little lower then obviously the reaction to not meeting that expectation will be easier to accept.
We have to build up our tool box of coping skills.  In the last blog I mentioned this along with anger management being one of those benefits along with accepting your new limitations.

It is not to say that your limitations will be permanent because there will be healing over the first couple of years.  Re-assessment is crucial as you travel the path of recovery.
I couldn't write a full sentence back in 1977, however I now have overcome that obstacle.  Most of my writing skills returned after the initial surgery along with my spelling.  The part that has remained a challenge is my short term memory which I can say without any hesitation is permanently damaged.
My recall of memory is also challenged and some days I remember or recall an event or a name immediately and on other days it is a write-off.
Yesterday started like any other for me.  I got up at 5am tinkered around the house and while I was shaving heard the phone ring.  When I went to see who called I realized it was the Physio Therapy office informing me that I had missed that morning's appointment.  I called them and was raked over the coals because this was the second time in a row that I had forgotten.  What they do not appreciate or understand and I forgive them for it, is this is normal fare, for me.  It is a new event.  I suck at new events because they are not a part of my daily routine.
I had forgotten to add the appointment into my cell phone calendar and was not warned at a timely manner as I usually am.
I left there and got home.  I took my truck to the repair shop and my wife and I walked the dogs, grocery shopped and returned home.  I had an appointment with my boss and went to the meeting that ran a little over and though my alarm sounded about my new afternoon appointment I ended up being about 8 minutes late.  Again I was scolded by the Therapy staff.
I left and went home for a nap as my brain was on overload.
I awoke and decided to go to the store.  I got to the store and low and behold my wallet was back at home.
I usually place it in my hat when I nap and when I got home I realized my hat was still at the physio office.
This explained why I had forgotten my wallet. A simple step or coping skill failed when I left my hat elsewhere and things began to snowball as a result.I have several hats and so I replaced the lost one with a new one.
The point of this exercise is to inform you the reader and possible TBI survivor, that this is a regular occurrence for me.  I am 34 yrs past my injury and still with all good intentions aside, with the memory  prosthesis (cell phone), I still forget.
I am far beyond the point where I let it get the better of me but it still pisses me off when, the medical staff have no understanding (physio), and I spend money in the form of fuel to only have to repeat the trip because my wallet was left behind.
The lesson I want you to take from this is rooted firmly in the title, brain injury is permanent.
How you deal with this new reality will determine whether your trip back will be easy or hard.  In fact you will determine by your action on how tough you want to make it on yourself.
Your cup will have to be half full if you want peace of mind.
The sooner you adopt this attitude the healthier it will be for you.  you stand to drive all your friends, loved ones away which will only go the enhance a negative outcome for you.
I kind of think you do not want a divorce added to your mounting problems.  I am sure you do not want to be alienated  by your friends.
You have so much to gain by a positive attitude.
Will it be easy?
Of course not.
The antithesis of a happy go lucky approach however is a lonely, frustrated and dejected person who has alienated all those who loved and supported him.
Slow and easy helps to win the race.  Next I will explore the area of Help.

Where do I begin?

There are the obvious steps from initial brain injury to when all the fanfare ends and everyone abandons you figuratively, that you soon discover yourself left to your own devices.  This happened to me right after surgery when my Neurosurgeon signed off on the case and said have a nice life.  That of course was in 1977-78.
I was told not to go to school for one year and take it easy and allow the brain to heal.

I was not referred to any other facility, nor were my parents educated on what to expect of their brain injured son.
To them, (my parents), I was cured.  It was like I had a broken arm and in my case it was a broken brain that I had survived, I should be blessed and carry on with life like nothing had happened.

Was that ever a narrow minded view.  Fortunately we have become more aware of the complexity of brain injury and have some techniques in place to assist those suffering from such a tragedy.

I wish to cover the latter scenario, of after you have discovered you have multiple injuries to your brain and what you personally can do or not do to enhance your situation.

I say multiple brain injuries like I am some kind of expert.  Considering that my case is 34 years old and as I muddled through my life discovering several key injuries, I think I am qualified enough to share my findings with you.  When I say multiple, I truly mean more than one and in fact I challenge anyone living with a brain injury to prove to me that they only have one such injury or disability.
The brain like a computer is complex.  If you delete a little code from the hard drive chances are many programs will be affected.  The same can be said with the brain.  Alter speech and see if the the recall ability is not altered.

A brain injury is complex however the way we approach it can make a huge difference in how the disability affects our daily life.

I had the surgery.  My speech was reduced to one syllable words.  The speech came back quite quickly but my spelling took a lot longer.  I also found it hard to keep up with a conversation because I would forget what I was about to say.  My patience took a major blow.  I became easily frustrated and would "lose it" and frighten people by my volatility.

Little did I know that this was directly to my short term memory deficit.  When you are working on assembling a BBQ or installing a ceiling fan and as you fumble for the tool that you forgot where you put it, you start to get annoyed at yourself and then the colorful language appears.  You may toss the tool, punch a wall or even worse take it out on your loved one.

This is why I am writing this installment.

Where does one begin?  If you are brain injured, I highly recommend an anger management course.  I have recommended this before but lets face it.  Even if you do not have an anger management issue yet, you just might and even if you don't there is a greater issue that Anger Management courses will teach.
Coping skills.
When you become brain injured, you are in another world.  What once worked for you no longer holds water so to speak.  You need to learn to analyze yourself when you act or react to a situation inappropriately and learn to find a better response when that same situation occurs again.
Believe me, it works miracles.  You become calmer and better in control of the outcome.

The next tool is acceptance.  Boy is this a hard one to overcome.  I still catch myself getting frustrated at my "incompetence" for forgetting.  I have to remind myself that I am not incompetent but rather I am and will be forgetful so get used to it.
I inform my co-workers of my memory and we get a good laugh at how short it is.  So rather than getting down on yourself, the sooner you can accept your disability or should I say your limitations the sooner the world will accept you as you are and not what you ought to be.

Coping tools.  This is an important one and can play on your ego especially if you are a male where you should be able to perform simple tasks such as installing a light fixture.
I tried this time and time again, whether a light, or assemble a bike or BBQ, I soon learned that the family would head for the hills because it was going to become a gong show.
What did I do.
I surrendered to my limitations and hired someone to do it for me.  It was great!  He could build the deck, he could install the dishwasher, he could install the light or paint the house and I had more time for myself and family.
Sure you can argue the cost but believe me it costs more to lose a family, it costs more to replace that light that you broke out of frustration then it does to have an expert come in and do it for you.

Try it some time you might just like it.  Simply park your ego at the door, invite the repair man in and go outside in the back yard sit back have a beer and watch the grass grow.  It is quite relaxing.  Did I mention that it helps with your sex life too.  Have you ever approached your wife after a day from hell and ask her for some nooky?  It doesn't go far now does it?  It might if your are calm and relaxed.  She might just appreciate you a little more.

Look, the simple fact is, you are still you.  If you have a cast on your foot, you are not going to play soccer anytime soon.  You are not going to run a marathon.  The same goes for your brain.  You may never run the brain marathon like you did before the injury.  If you can accept a cast on the foot and know that there are certain thing you can't do and will need help with,  like cutting the lawn or cleaning out the gutters, then take that same approach to your brain injury.  The only difference is that you may be wearing that cast on your brain forever and not just a few weeks.
It is amazing how helpful people are when they understand your limitations.  My clients call me to remind me to key in an order for them.
I use my cell phone to key in appointments so that I can be reminded on the day of and it alerts me.
This is a good start.  I will examine this and more in my next blog.