Brain Injury Journal

Reconciling Lies and Truths

A few weeks ago, I was catching up with my aunt when she asked whether I got down or depressed by my brain injury. My response was something like, “No, I have such a good support system, I feel so loved that I can’t feel bad about things.”

WHAT?!? I’m a pretty happy, even keeled person by nature but the most unthinkable thoughts have passed my mind since I had encephalitis. I’ve also had moments of extraordinary love and joy. As it turns out, these ups and downs are clinically known as “emotional lability” and pretty common with brain injuries. I wasn’t familiar with the term until I saw it in my doctor’s notes and asked what it meant. In the span of 10 minutes, I’d laughed, cried, and laughed some more so I couldn’t deny my mood swings. And I giggle typing this now, but as if my doctor needed more evidence, I started crying and using profanities that I didn’t want to be like this. The point is, I have had all the expected emotions for a person who’s gone through trauma and grief.

So hours after that call with my aunt, I’m in my jammies and sobbing because the pain in my head is unbearable and I am helpless to stop it. That’s when I realize the dissonance in the reality of my emotions and what I told my aunt. In fact, I’ve told everyone who has asked that I’m doing remarkably well generally leaving out the ugly parts. Maybe I’ve told half-truths because I’m trying to assuage other people’s feelings about my illness?  Or, maybe because it re-directs us from the ickiness of my health?

Well, context matters. My aunt wasn’t just curious, she’s now a caregiver. My  uncle suffered a grave brain injury three months after mine and his family is in the early stages of the aftermath. It’s serious. I am rooting for him though I know his journey is not an easy one. My aunt deserved the full truth. Really, everybody does, but this part of my family especially needed honesty.

This realization made me want to know why was I lying about not being sad?  Two truths emerged.

1) Because I don’t like being vulnerable. As it turns out, being in pain makes you vulnerable. Since I experience pain every day whether from cognitive or sensory overload, nerves going haywire, or ferocious headaches, I’m as vulnerable as I was as an infant. I. DO. NOT. WANT. TO. ACKNOWLEDGE. THIS. TO. ANYONE. It’s been twenty-two days since I can remember a day that I didn’t have a headache. I keep a daily health journal monitoring my physical symptoms noting things like, what was my fatigue level today? Was I dizzy? Did I have hand tremors today? Any nerve pain? Did I have difficulties with my words? If so, what were the circumstances? Did I stay on task or did I have attention issues? Did my thinking seem clear? How was my light and noise sensitivity?

On better days, I succinctly write notes like “at work for three hours, 2 meetings, rest of time spent writing. Snacked apples and carrots. Pain in right temple and eyes tired after meeting. Put ear plugs in and closed eyes for a few minutes at desk” But the last few weeks, my notes have slipped into the repetitive, “BAD headache,” “OMG headache,” “terrible headache” and on October 28, I just wrote “headache headache headache headache” as if repeating the word would reflect that we’d moved past a 1-10 pain scale to the Richter scale. I don’t remember writing “hurts head” and “bad head” but there it is, the pain so overwhelming that I lost my command of grammar along with the power to precisely describe my experience.

2) To motivate myself. One of my favorite quotes is D.H. Lawrence’s brutal and startling truth,

“I never saw a wild thing sorry for itself. A small bird will drop frozen dead from a bough without ever having felt sorry for itself.”

While laughter and love usually propel me, when things are tough, I never feel more powerful than when I cowboy up. That’s what a girl from the country does – she makes a plan and starts moving. In practice, my “be strong, be happy” coping mechanism requires me to ignore the full spectrum of my emotions and wholly embrace Lawrence’s maxim. Keeping myself emotionally psyched up is why I never wavered from my exercises to work my coordination, my balance, and my memory. Following my plan saved my life this summer. But, it’s time to let my guard down.

So if I could do that conversation over with my aunt, I’d say this:

Yes, I am depressed as I go through the reckoning that I had a brain injury. I am scared because I don’t know what the end state looks like. I am even more scared because this wasn’t a fluke, my autoimmune system caused the encephalitis and it could happen again. I get Eeyore sad when I think I “should be able to” do things but can’t because I have sensory overload or I’m too tired. It’s unbelievably lonely when you realize that people close to you don’t get what you’re going through. Some days I get really down by what feels like a glacially slow recovery.

And yet, I have more contentment in my life than I can ever remember. I’ve never loved myself more or been more proud of myself. I’ve experienced unbelievable generosity of spirit and kindness from friends and that fills me with joy. I’ve never felt so close my family. And, in the darkest moment of my life, I experienced transcendence and knew that my life was in God’s hands. So, I’ve had good days and awful days and you know what, the spectrum of all of this has never made me feel more alive.

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Brain Injury Journal

Working hard

It’s been a far longer gap than I intended between posts but there’s a very special reason for this. It’s because I started back to work! Even though my part-time schedule is taxing me far beyond anything I expected both cognitively and physically, the satisfaction I’ve felt at earning my livelihood by my very own brain – brain injury and all – is indescribable. I’m just so proud of myself.

What I couldn’t imagine before my injury is the hard work that would go into barely being able to put in the equivalent of two work days in a week. The months of occupational, physical and speech/cognitive therapy plus my home program.

From time to time, a well-meaning person has asked me, “how are you spending your time?” I don’t like admitting these sorts of things but my inner judgey self would translate that as a back-handed way of saying, “it must be nice to have all this time off.” I’ve always known there was no shade intended in the question, just a conversation starter for people who probably didn’t feel comfortable probing for the latest on my health. Still, the question would make me wonder, was I using my waking time well? Was I doing all that I could to heal, to rehab and exercise my brain and body so that, with the grace of God, I could recover from the far-ranging effects of my brain injury?

The truth is I’ve never worked harder in my life and I was raised in a family who believed in the good ol’ Protestant work ethic and got by on the hard labor of railroading and whatever else  might put food on the table and warm the house through the long stretch of winter. “What you put in is what you get out” ranks as probably one of my parents’ top 10 life lessons for me. That’s why I was incredulous when my occupational therapist told me she didn’t see a lot of people with my perseverance. Doing my rehab plus more is a given to me. This is my life. The rest of my life.

While I was seeing my physical therapist, my occupational therapist, my speech/cognitive therapist and my neuropsychologist weekly, I’ve now graduated to every three weeks for OT and PT but am still weekly for the others. I usually have a doctor’s check-in or two somewhere along the way. I had acupuncture to treat symptoms but let that lapse in favor of doing something called hyperbaric oxygen treatment. It’s the same treatment given to people with the “bends” and there is evidence, though not conclusive, that it helps with brain injuries. Frankly, I’m not willing to wait on the science to prove that it’s helpful or not so I’ve embarked on it and think that I generally feel better after my treatments.

And besides my part-time work week and therapy schedule, I now sleep ten hours a night up from six to eight before the injury. This is no luxury. The best way for the brain to heal is to let it do its work while resting. And while I don’t like the insane need for sleep I have these days, I know the side effects are worse. My speech starts to go, I get blazing headaches and I do very absentminded and sometimes, dangerous things. I take about an hour nap every day. Again, not optional. So while the old me bucks against these unfamiliar limits, the me today knows that trying to go, go, go is just not a good choice.

So I’m unashamedly sharing that I’m proud of myself. Life gave me a different song than I wanted but it was my choice to dance rather than sit this one out. I’ll save for another day the story of my dear friend who helped me build my home program and my gratitude to her. Right now, I’m just celebrating this milestone!

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