Acceptance

At my Traumatic Brain Injury education/support group my Neuropsychologist told us that many of his clients return within a couple of years with pretty severe depression. I told him that I think perhaps that part of my brain must have been altered by the accident, because most of the time I feel just fine. I feel I'm coping fairly well, but he gave me a sort of pitying look and told me, "Heather, your brain is still so stunned right now that all it can really do is concentrate on one or two things at a time. It's years later, when the brain stops showing signs of improvement, that people look back at their lives and start missing the things they were too injured to take note of." 

Despite his rather bleak sentiments on this occasion, the doctor is a delightful man. He's recently moved in both of his parents because his mother has dementia and his father is failing physically. He calls me personally to answer my questions any time of the day, but often long after work hours have ended. Some of the people in the group have been attending for longer than twenty years, and often the doctor knows the names and occupations of all their family members, and asks after their children by name. For S---- (who once was the fastest female Corvette racer in the state of Michigan!), he attended her husband's funeral, and he never fails to tell all of us what a wonderful man her husband had been. Whenever he starts to explain a specific brain function using a former patient/client as an example, he will say, "Oh! I haven't called or written Sarah in a while!" and make a note on his stenopad reminding himself to drop a line and see how she's been doing. I'm told by the Brain Rehab that this individualized, personal approach is rare in Neuropsychologists, so I lucked out in getting such a good one. 

I've received the results from the Insurance Company's Independent Evaluation from the Neuropsychologist they had hired. The results are mixed and rather incongruent. 

Although I scored in the 23rd Percentile for auditory attention and concentration, in my spacial organization and visual-motor processing speed  I tested in the 99th percentile.

The speech language pathologist is assisting me in learning coping skills to counterbalance my deficits. 

I have to learn "self-cuing" strategies, and other things that are very similar to what I'd do with a struggling reader or a special needs student. Oh, how the mighty have fallen! Speaking of which, 

I also have a hard time doing all this typing, although I am loathe to relinquish this form of communication because I find writing about what's going on in my life enjoyable and often quite therapeutic. It helps me to organize my thoughts. But my right hand has lost some dexterity because the left side of my brain was damaged, which causes me to miss a lot of keys on the right hand side. I know to proofread everything, particularly words like "you, mom, ploy, yum, hop," etc. I am from the generation of students who were still taught good touch-typing skills, and I learned in college to type words just as quickly as they came to me. Recently I was disconcerted to discover that my hands haven't been keeping up like I thought they were. I'd actually miss a lot of words without even knowing it, because my brain overcompensates by trying to behave as if there's nothing wrong, so my fingers are at work the entire time but many of the words aren't actually being typed, like "I ran the and thought was fine." Another function of the left side of the brain is sequencing, which aids in spelling. Once again, thank god for spell check.

Not addressed in the report would be the visual therapy recommended by the behavioral optometrist. Of all the things that aren't the same, it's the reading that troubles me the most. My eye muscles were damaged in the accident and the therapy is to help redevelop them so that they converge and diverge smoothly together again. They are also not anchoring well, so when I read I skip lines all the time and have to use a bookmark to follow. This is discouraging in a woman who used to be able to read something like Don Quixote, listen to my sister telling me about her day, and compose a grocery list in my head -- all at the same time, without missing anything. Then, even a year later, I could pluck Don Quixote off the shelf and find the exact passage where he first attacked the windmills. Now I have to look at words like ordinary people and have a harder time concentrating and visualizing what I read. I have to read lines over again. If someone interrupts me it's harder to find where I left off. It's like torture. The insurance company is sending me in for another independent evaluation specific to address these symptoms, because of course they always need a second opinion on everything.

If all goes well, I might be allowed to drive again before the end of the year, although I do wonder how that's possible when I get distracted and overwhelmed in busy places where I have to pay attention to more than one thing at a time, and there's the right hand dexterity issues in addition to the eyes. Right now the brain rehabilitation center is playing a waiting game to determine if the insurance will cover a road test with an evaluator who specializes in brain injuries, and there is also some question of whether or not they're going to cover the car service that's been taking me to and from all my appointments. I have vision therapy, speech therapy, speech and language pathology, vocational therapy, yoga, and they want me to have a therapy for eye-hand coordination skills that I'd need for successfully returning to work, but it sounds likely that I won't be getting it.

Sometimes I feel as if I could just google most of this therapy and do it myself, though. It involves a lot of worksheets and computer games to challenge my diverse attention and concentration skills.

I've also got a Vocational Therapist now whose job it is to help me find a part time volunteer position that will lead into a part time job, and within six months, a year from the original accident, I'll be working full time again. The Therapist thinks she can get me a job in an assembly line at a factory, where the work is steady and predictable and my moderately impaired diverse attention and focus won't prevent me from achieving vocational success. They say I should be able to transition into some basic entry-level position without needing any accommodations. Apparently they know of a corporation that hires people with disabilities part-time. 

They don't tell me as much, but it seems to me like no one but my Neuropsychologist believes I'll ever go back to teaching in any classroom. Or at least they don't see it happening any time in the next year or two. It doesn't mean I'm going to quit trying. How can I stop? This has been my whole life, trying to get there. I don't feel I have to let this stop me.

 Still, I was in Cognitive therapy last week trying to do a worksheet beginning with one sentence, and running underneath down the sheet there was a row of twenty-five simple directions (Ex: "Switch the first vowel with the fourth consonant from the end"), and when I got to the last line it was supposed to spell out a completely new sentence, but when I finally got there it was just garbled. I used to give worksheets like that to my eighth graders all the time as a warning to them to pay close attention when reading the directions of any given assignment, and right now I can't even do it myself. The Therapists are teaching me to take careful notes and ask clarifying questions to compensate for this condition. 

Then today they gave me a map with numbers instead of street names, and read directions to me that were meant to help me guess which road had which name, such as "Harrison begins at Brookview but ends running North-West along the third intersecting street. Which road is Harrison?" and I can't listen to directions like that and reason them out in my head anymore. I would forget "Harrison" but remember "Brookview," and I would forget which direction the road was supposed to be in, so I'd ask her to repeat the entire question so I could focus on that. Then I would remember North-West but forget the names of the roads. Once I combined them and asked if street number 9 was the "Harrisview" I was looking for. 

I played a board game with my family for two hours on Saturday, and then suddenly it was like my

brain shut off and the generators kicked on, but I didn't want to be the one to stop all the fun, so I hung in there for nearly another hour as the game wrapped up, until my head was falling forward and my eyes were closing involuntarily. I was struggling to keep them open without being too noticeable, but when I felt forced to bring it up, my sister sent me straight to bed. 

My Neuropsychologist told me that I have to pay close attention to how I'm doing, because this is going to keep on happening to me for the rest of my life if I don't learn how to pace myself better. My sister said sarcastically that he should come home with me then and follow me everywhere, because I can sit and read that long just fine, or write a marathon email, but apparently I'm always one more involved board game an hour away from being as bad as if the therapy had never happened. Too much physical activity can bring on fatigue, or too much mental activity, and I'm having a hard time figuring which activities are going to cause it.

I feel a little discouraged today. Being out of commission for an entire year feels like yet another setback for me. Still, I am a lover of words of wisdom, so whenever I feel defeated by the bulk of changes in my life and despair of anything ever working out, I defer to this quote:

 When I was watching Family Ties in the 80's,
I never would have guessed that Michael J. Fox
was ever going to be such an inspiration to me.