QuarkPop

After coming home from rehab, I struggled to find ways to keep my mind focused,  to keep moving forward, and to help ensure my eventual return to work. My cognitive therapist provided me strategies that I implemented as best I could. Having never spent so much time alone or so much time having to just make the day-to-day of life work, I wondered how it could all come together so I could function like a fairly normal adult, and so I could return to my classroom and be successful. Classrooms aren’t exactly calm, quiet, stressless environments, so the quiet loneliness of home was going to be very different than work. I had to have a plan. Along came the Navy SEALs.

Somewhere in those first few months of coming home from rehab, there was a program on the History Channel about the Navy SEALs. I don’t remember what it was specifically about, but at least a significant part of the program was about the training the soldiers go through to mentally prepare them for the challenges they may encounter. One thing I learned from the show is that Navy Seals are truly men among men. These are the men we want on these ops. They can do what the average human cannot. And, their training is remarkable.

Their training is based not solely on other men’s experiences and on speculation, but on neuroscience. And, their training gave me something to hold on to in my preparations for my own mission.

There are 4 basic principles SEALsuse to keep their brains in the fight.

1. Goal Setting– Do not go blindly into anything. Know what you are going in for and how you are going to do it. Be specific. Know what you need to accomplish and how you’ll get yourself there.

2. Self-Talk  — What we say to ourselves matters. Tell yourself you will be successful. Be specific about what you will do, and how you will do it. Negative talk gets you nothing but the negative. Positive talk is all you can afford. Talk yourself through what you are doing. Call out the steps and be intentional and only positive.

3. Visualize – Using a combination of the first two, visualize how the mission will go. As you set your goal and talk your way through it, picture it happening the way it needs to go. See it happen before it happens.

4. Arousal Control –  This sounds more racey than what it means. Our amygdalas, our little reptile brains at the back of our skulls, are designed to protect us. Most of us, when threatened, will go into either fight or flight mode–we run away or we pick a fight. All the blood  goes rushing to the amygdala (the reptile brain), so the pre-frontal cortex (the human brain) is without nurishment, so we cannot rationalize, think critically, evaluate, make decisions– we run or fight–we are aroused. SO, we must control that arousal. How? Deep Breaths. Sounds cliche, but here’s the part no one ever tells us: it isn’t the breath in the counts; it’s the breath out. Take a deep breath, then BREATHE IT ALL OUT SLOWLY. Repeat as needed. The breathing out slows the blood flow to the amygdala, and allows our prefrontal cortex to stay in the game. We can still think. We don’t just react.

When you have have something you need to accomplish, set the specific goal of how you want it to turn out, visualize what the process will look like, talk yourself through the process and breathe deeply to keep your mind clear.

All 4 of these preceptsI had learned in rehab in various form. Then, after watching the program about our SEALs, I got it. These principals work for everyone for all situations because it is based on how our brains work. It works for the elite in combat–it will work for me in middle school.

Through so much of my recovery,  I’ve often heard “You have such a great attitude! It’s so great that you have such a positive attitude!” or “How do you have such a great attitude about all this?” Therapists and friends alike always seemed amazed.

Throughout the first year, my cognitive therapist constantly checked in on me, wondering if darkeness was setting in. She was justifiably worried as depression is a typical and expected struggle post-TBI. She was always shocked that I was doing so well. That I wasn’t experiencing grief. That I didn’t want, or seem to need, counseling to help me find my way through recovery.

At the time, it seemed silly to me. I’ve always had a pretty positive attitude about life. I’ve made my share of mistakes and had to pay some unfortunate consequences, but I’ve always just kept moving forward. I’d like to say I consciously chose to always be positive and not let things get to me. But really, I’m just private enough that I was afraid that if I let my consternations show publicly, that people would pry and want to dig into my life where I didn’t need people digging. So it was more of a survival strategy. And  I always found my way to the other side, so I never spent time reflecting on it.

At the beginning of recovery, things were pretty easy, really. I was extremely well cared for and always felt safe. I knew what my jobs were. I was given all the things necessary to be successful. I had Stew, my amazing friends, my amazing family. Stew made everything all about the future, so whatever was tough, was made better by knowing we were moving forward together. Without doubt I did have some really tough days. Stew made a deal with me early on that I was entitled to those bad days. I just couldn’t have two in a row. What I loved about that was when those bad days reared their ugly heads, I got to go with it. I yelled. I cried. I complained. I cried some more. I gave myself permission to feel the frustrations or pains that had come along. And without fail, the next day was better. Allowing myself to experience the pain, instead of trying to ignore it, let me process it and get it out. No counseling required.

Often when people ask how I am now, I respond with, “I can’t complain. Well, I could complain, but that wouldn’t get me anything, so I won’t”. And that’s the truth. There is always somethings I could complain about, and they are valid complaints. But whining about them won’t get me anything. I still do my best to honor the No Two Bad Days in a Row rule. But some days, my bad days have hangovers. Now I occasionally have to just decide to have a good attitude, or to at least fake it. The facade usually works, and in short time I’m doing OK again.

The cliches about attitude being everything exist for a reason. And as Herm Albright once said, “A positive attitude won’t solve everything, but it annoys enough people to be worth the effort.” So when necessary I go with the bad days, and scream and hollar and throw (soft) things, and then if the next day isn’t better, I put on my happy face and fake it–if for no other reason than to annoy others. And I know that hangovers do subside.

Most of us as we went through school endured some sort of testing that ranked us in percentiles. What a strange thing it is to have ones intellect, or academic abilities, ranked against one’s peers. With standardized testing being all the rage these days, I spend a lot of time telling my students not to get wrapped up in test scores. They only tell what you did on that day. I tell them to do their best and just consider the results information, not a label, or a prophecy.

As a kid, I ranked “well” on ITBS and such. I never really thought much about those results or what they supposedly meant. And while I had some people, including a few teachers, tell me I wasn’t smart enough to do advanced work,  I never bothered to listen. I just figured I knew more about me and what I could do than either tests or my teachers knew. In college, after my initial semester g.p.a. of  1.44 , I went o to graduate Cum Laude. After initially failing my comprehensive exams in grad school, I earned my M.A.. And after failing my first attempt at earning my National Board Certification for teaching, I am now an NBCT. All my struggles were frustrating to say the least, but I never bothered with thinking I couldn’t do what I wanted. Stubbornness is one of my best traits. 

And then, along came brain injury. So, in this journey I’ve never bothered to really consider that I couldn’t retun to teaching and be successful. I never spent time thinking I couldn’t figure out how to do differently what used to be second nature. There have certianly been screaming fits and moments of doubts, but those moments were fleeting and have just been part of the journey.

And then along came official neuropsych testing. Testing has obviously never been my strong suit. So after surviving a few weeks of panic, in January I had a neuropsych evaluation. Five hours of testing. They told me to plan on 7 to 8, so I was thrilled with only 5.  I knew the tests would test brain functionality, but I didn’t know which tests indicated what and what the the tests would indicate en masse. The psychometrist was great and tolerated my ridiculousness. I figured if I was going to be stuck in there for hours I’d have to have some fun, so I did. I think she may have even agreed when I said the testing was kind of like advanced kindergarten. Stew is very proud that I managed to keep my inappropriate thoughts in my head. I figured since the psychometrist was writing down just about everything I said, I didn’t really want those things in print that might eventually be seen by my bosses. So, I survived the testing and then awaited the results.

And then they arrived. Overall the evaluation indicated what I’d already known regarding what I can and cannot do, what I struggle with, and what skills are that I haven’t lost. Despite the results confirming my knowings, it still doesn’t feel good to have someone say, “You did really well! You scored average in most of the areas of testing!” (That average is average of gen pop, not of other TBIs.) Ok. Average isn’t all that bad, but many of those areas I used to consider myself to be above average. Now what about those other areas that weren’t average.

 I know better than most anyone how far I’ve come, how great things are for me now, how bad things could have been, and I am forever grateful. And, hearing and reading “below average” still isn’t fun. I knew I would hear it, but it still wasn’t welcomed. Like so many other elements of my recovery process, I have powerfully conflicting emotions and thoughts. For the first time in my life, I struggle with my intellectual self-image. I may teach that tests only tell us how we did on that day, but this test feels different. This test feels like prophecy. With all my previous struggles, I knew what the end game was. The goal was tangible. This time the goal is not so concrete. This time, how will I know when I’ve gotten where I want to be?

There were some high points to hold onto in the test results as well.  A few ”above average” ratings were a welcome result. And then the one test result that I tell people first when they ask about the results: Superior. That’s right. Superior, in the 99th percentile as a matter of fact. Be impressed. My one area of supremacy? How many different animals I can list in 60 seconds.  Noah can relax, I got the list covered for the next ark. 99th percentile.

Stand back.

What a strange thing it is. I  began receiving financial disability support at the beginning of this adventure. I had previously purchased a short-term disability policy, so that began immediately. Then Long Term Disability took over after that. And, the long term disability company felt it pertinent for me to apply for Social Security Disability Insurance. What conflicting emotions and intellectual challenges have come with all of the paperwork involved.

I’ve thought often that did I not have Stew’s help and an ability to read and think critically that I would have quit the paperwork and just not dealt with it, and therefore, not received the benefits to which I have been entitled. The paperwork is frequent, repetative, and lengthy.

One of the challenges in all of the paperwork is that all of the forms request details of what my disabilities are. Unfortunately, their detailed form askes only for data regarding disabilities that are–visible. Mine are as real and disabling as a wounded body; they are just not visible and readily identifiable. I can stand, and walk and hold a pen, and type, and pick up more than 10 pounds and crouch and bend. The form they want a physician to fill out has only to do with these activities, and absolutely nothing to do with the neurological or vision deficits I experience.

TBI is one of the primary injuries with which our soldiers are coming home from the Middle East.  Sadly, again because of war, a medical mystery is getting research attention and medical validity. Yet, those outside of medicine haven’t caught up with medicine, and frankly unless a doctor specifically deals with TBI, he or she isn’t necessarily caught up either. Traumatic Brain Injury is only just now gaining ground as a recognized disabling  injury. It is an injury that leaves permanent deficits, but insurance companies haven’t modified any of their paperwork to address TBI, so I am left making alterations to their forms.

I’ve spent a lot time this past year and half writing out in detail what I am unable to do that I could previously do.  And that is where the paperwork becomes emotionally difficult.

 I have always believed that once something is named, it is real. It exists. And thus, when something is written, it becomes real. Dealing with the day-to-day of my struggles is certainly a challenge and often irksome. But having to write it out in such a way that others, especially non-medical people, can understand my deficits makes them all real. Makes it all truth.

Most of us spend time hiding our inabilities. What a thing it is to have to publicly own my inabilities and to ask others to honor them as truth.

When Congresswoman Gabby Giffords was shot, I found a surprising, significant, tangential relationship with this remarkable woman. She and I are the same age. We married amazing men in 2007.  She used to ride a motorcycle, and, well, so did I. We are both very close with our families. And within 6 months of each other, we were recovering from Traumatic Brain Injury.

A couple weeks ago, I was walking through a bookstore and happened upon the book she and her husband Mark have published sharing the beginnings of her journey post-TBI. I wasn’t sure whether to buy the hardcopy, or just get it on my Kindle. So, I picked up the book, discovered the pictures inside, and flipped through. Adorable pictures of her fabulous 80′s hair. Sweet pictures of her and Mark. Then, one of her lying in her hospital bed, intubated.

I do not and will not ever remember being intubated, but when I saw that picture I saw me. It was real. It was truly like seeing a picture of me. I closed the book, held it close to my body and walked to the counter and bought it. I am hopful I can manage to read it, but as of now I’ve not yet started. I know I’ll cry all the way through. Not tears of sadness, mind you. But an overwhelming flood emotion. I’m not sure the emotion even has a name.

One of the experiences of this TBI life is a new understanding of what “knowing” something means. I remember being at NW Hospital’s rehab facility, ordering my blueberry pancakes, going for walks up and down stairs to get balance and coordination back, baking chocolate chip cookies from a mix and  cooking spaghetti. And when I remember all the things I can remember of that time, I know that I had no real understanding of my injury, my future struggles, what I really couldn’t do, what had really happened, how long a month really is. I didn’t know these things. I knew I had to do all different things to prove to the rehab team that I could come home safely, but at the time it never occurred to me that any of those things might actually be a problem. Of course I can remember to shut the stove off. Of course I can find my way through a grocery store on my own. Of course I can climb these stairs. Of course I can remember to take my meds. I didn’t know what I couldn’t do. I didn’t know what was really to come.

We all have these experiences of  “I just really didn’t understand back then”.   Yea, but this is– different. It isn’t the “if I’d only known then what I know now” experience. It isn’t “now that I’m older”. Instead it is me as my adult self being robbed of prior knowledge and understanding and recognition, without knowing anything is missing, without knowing I don’t understand.

Then, I watched the interview with Gabbyand Mark on 20/20.

To watch her learn to talk again. My Brocha’s area wasn’t much damaged, if at all. Wordfinding is only occasionally a problem for me, but, as I watched her learn, I know that look in her eyes. I know what’s happening. I know that feeling of processing information. It seems slow to everyone else, but in her head it’s all going so quickly. I know that feeling of trying to make everything all go together where you know it’s supposed to go but you just can’t quite get it there.  It’s similar to confusion, but she isn’t confused.

I see myself in her. Our lives are forever altered. Llife will never be all we had expected or planned it to be. That isn’t a bad thing, it’s just what it is. I will enjoy watching her rehabilitation and hearing more of her accomplishments, as I continue on my own path.