A No Joke Medical Disclaimer

This isn't some legalistic thing, but I would greatly appreciate it if you took a moment to have a read:

While a good deal of thinking goes into the ideas and information on this site, their relevance must relate to recoverers' own personal health and qualified medical help. When it comes to brain injury, so much is case-dependent. There is never ever (!) any substitute for sound medical advice.

To get the maximum benefit from this site, please use it along with help from a qualified and empathetic therapist knowledgeable about brain injury recovery. Physicians and neurologists may also be a great help. You can't beat a good team approach!

My Starting Point

A comment on my post, TBI Recovery - Not About Restoring the Old Me, But Improving the Current Me, led me to think about yet another aspect of acceptance - what I use as my starting point when I talk about my recovery. Early on, many recoverers (and I definitely include myself here) compare themselves and their abilities to how they were before their accident. It is very easy for others to see how pointless such a comparison is, but, for the one making it, it can be remarkably difficult to break!

For TBI recovery, it is very common for the recoverer to have no recollection of either the accident or the time immediately following it. My accident must have been such a shock and I was in such a bad way for weeks following it, people often ask, would I really want to remember that time. The only reasonable answer would have to be a definite no!

There are also other reasons for strongly remembering the time before my accident. Chief among them is that I really used to enjoy that time. My accident brought it to an end, but I really want to get back to it!

There's one small problem with focusing on the time before, though: I had a TBI in between now and then. The jolly thing came very close to killing me and I've been incredibly lucky to pull through. I've came to feel a lot better about that - about where I've been - once I came to accept I'd had my TBI. Once I learnt to accept it, it's so much easier to see my starting point not as my pre-accident days, but as the day of the accident, which I ended near death, laid out in a hospital bed!

In terms of remembering better days, acceptance means I'm better able to think of what I enjoy about my current, post-accident life. Yes, it lacks some of the things of my old life, but it has other stuff the old life didn't. I can now accept I've had my TBI and focus on the stuff I enjoy of my new life.

Cheers,
Mike

Phrases for Mike to Avoid: Again and Back To

In the post, Mike's Path to the Third Level of Acceptance, I put parts of two phrases in bold: "when I start doing this again" and "once I get back to that". I did so because these have become words, even now - over three years since my accident - I need to work to avoid using. I try to avoid them because of what I'm learning about accepting my TBI. When I use 'again' or 'back to', I imply that, because I used to do it, I'm certain I'll once again do it.

Yet part of me accepting my TBI is accepting that I might never again do what I once did. So I might never again do what I did previously.

I'm never able to stop being careful to accept my TBI and not use these words. Most recently, I've been tempted to use them when I talk about my running and swimming pace. I'm relearning how to be a triathlete (I wrote a little about it here). As I restart training, my mind quickly turns to my pace and how it compares to my pre-accident pace.

Before my accident, I could run a kilometre (about 0.62 of a mile) in four minutes and swim it in 15 and I used to be able to do both kilometre after kilometre. Now, I'm recovering from a TBI and, despite an amount of training, I can only manage about 70-80% of that pace.

I think it's a technique thing more than a fitness thing; I can only maintain that pace for a single kilometre before it starts dropping away and I'm not much faster when I try and sprint over shorter distances. Since it's a technique thing, the cause is very likely my brain injury; the brain is unable to perform what's being asked of it. Deep down, I have to admit that that means the brain may never relearn proper technique.

It took awhile for me to accept that I might never reach my pre-accident pace for any sort of long distance race. Now, though, I do my best not to imply that I will definitely reach it. I use phrases like, "if I become able to run four minute ks once more".

This post isn't meant to invite sympathy. First of all, I am incredibly lucky to have survived my accident and be recovering as well as I am. Secondly, you can be certain I will fight tooth and nail to reach those paces and achieve my pre-accident goals. But I accept that I've had my brain injury and I might never reach them and I might never do what I once did.

Cheers,
Mike

TBI Recovery - Not About Restoring the Old Me, But Improving the Current Me

In The Hardest Thing of Mike's TBI Recovery? Acceptance!, I talked of an idea about the process of TBI recovery. For me, at least, TBI recovery can be better thought of not as a process of restoring the old me, but as one of improving the current me!

Seeing recovery as a process of restoration is common. My Mum talks about how, if you do something like break an arm, recovery is more or less what can be done now, compared to what was previously done. For arms and such forth, I agree, such an approach might be appropriate and very useful for motivation, for instance.

Mum then goes on to a very important point. Brain injury is quite different to a broken arm because a brain is so much more fundamental to who we are and what we do. That makes a view of recovery as restoration much less appropriate. Sure, you can help the brain repair itself and try to teach it to do what it used to do; that's like a process of restoration. But, once you've retaught it something, it's most likely the brain has learnt to do it in a slightly different way. Nothing's restored, things are merely improved.

So a restoration idea for TBI recovery seems inappropriate. Yet people still try to beat the square peg through the round whole and continue with it. Most won't even realise they're doing so, but there are some who, through work with brain injury, should know better. It's a pity that they don't stop and think what their view fully implies.

Cheers,
Mike

Wanting to Leave Care

Related to acceptance of a TBI, many TBI recoverers want to leave care as soon as possible. Their desperation means that rehab centres have to keep the doors locked at all times. The desire to leave comes from the recoverer linking the effects of their TBI with their environment. They often believe that everything will be alright as soon as they get home. While that belief is understandable, it would be difficult to find anything less true for nearly all recoverers.

To help with the many and varied problems caused by a TBI, there is quite simply no substitute for thorough, professional care for a TBI recoverer. Leaving this care early will not make anything better; instead it will almost certainly make it more difficult to recover well. During my recovery, I remember the desperate desire to leave, but, in my case, it was somewhat limited by the fact that I couldn't walk! I needed the physiotherapists' help to relearn how to even get through the doors, first. I quickly saw that care was the best place for me to begin to come to grips with my various problems (only one of which was not being able to walk!).

Other recoverers have greater difficult dealing with the desire to leave. One recoverer at my rehab centre even went as far as to have conversations with his lawyer about his ability to leave. I only heard about this from him and so do not know how his conversations were received. I can only hope that the lawyer knew enough to attempt to discourage attempts to leave care.

I've written this post mainly to help family and friends decide what is best for their recoverer. Please keep in mind that, almost by definition, a TBI will mean a recoverer is initially confused and not thinking properly about what's best for them. In time, thinking will most likely improve, but, early on, friends and families may need to offer firm ideas about how best to help recoverers.

Cheers,
Mike

Mike's Path to the Third Level of Acceptance

I described here three different levels of acceptance. Like I said, reaching the final level took me over a year from my accident and I needed the help of a kind friend of my father to get me there. Funnily enough, he isn't even a TBI recoverer; instead he has Chronic Fatigue Syndrome (CFS).

First, a little of his background. My father's friend worked with him at an investment bank. The young guys there were tough, regularly working more than 80 hours a week! All of a sudden, my father's friend started suffering from unexplained fatigue. It gradually worsened and eventually he had no choice but leave his job. Years later, he has now recovered sufficiently to hold down a normal, 40 hour a week job while keeping a young family. I can only guess at how frustrating it must have been to lose so much ability in such a frustrating way without any obvious cause.

I was lucky enough to speak with him about a year after my accident. I continued to suffer a number of significant effects from my TBI. When it came to recovery, though, I felt very much like the young-buck learning from the old-hand.

Part way through our conversation, he said, you need to learn to let go of who you were. This was a real bomb shell for me; I quickly saw that I hadn't been doing that all. I'd been very focused on redoing the things I'd done before my accident. I was making common use of the phrases, "when I start doing this again" and "once I get back to that". I hadn't been thinking at all about letting go of who I was and what I used to do.

Learning that sort of acceptance certainly doesn't mean you can't try once more to achieve the goals you earlier had. But it does allow you to feel better about your progress in reaching any goal by better better enabling you to keep things in perspective. I can only regard what my father's friend told me as fundamental to my recovery.

Cheers,
Mike