Brain Biofeedback

Proprioception Efficiency Improving after Eye Surgery

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I’m back on the weekly brain training track: enhance gamma (39-42 Hz) brainwaves for three neurofeedback screens; inhibit 16-20 Hz and enhance SMR (12-15 Hz) brainwaves for the next three neurofeedback screens. The latter three are supposed to help me adapt to and keep my improved and more efficient vision, perception, and proprioception.

Right after this week’s training, I got a taste of the latter.

I normally go down most TTC steps slowly and carefully. It’s easier and quicker to walk down their stairs when my eyes are on the steps in front of me instead of looking ahead. But with that method, I only see the steps. I don’t see people coming at me or signage or anything else. So I make myself look ahead. Gotta see what’s around you! The problem is the last few steps. For whatever reason, they give my feet the willies. I slow down and stop on them, look down, then continue to the landing. The step I stop on has been improving from two or three steps before the landing or the second step before to the last step before. This week (for the first time?) I felt distinctly the difference between the texture of the step and the texture and flatness of the landing. Yeah, I’m wearing shoes, but I could feel a difference in the hardness and how the landing had a bit of a dip from where many feet had worn down the terrazzo. Being able to feel the difference made it easier to know where I was and give my feet confidence to keep stepping down until I touched down on the landing. I didn’t have to look down to check (though I did from habit, except the last time — sweet). Since this is all at the conscious level and not yet automated, I do it slowly, slowly. As my brain learns and stops trying to return my vision back to what it was used to (so annoying), it’ll become automated gradually and I’ll be able to speed up and do it automatically like I used to before my eye surgery.

The TTC uses an enormous variety of tiles for its steps. Most of them have low contrast. My fave is when they replace a light tile with a dark grey one — makes it grab my eyes, scream look at me, look at me, as if walking down and up TTC steps wasn’t hard enough. Just another wonderful example of the TTC’s systemic discrimination against those with visual or cognitive impairments. I guess we’re not supposed to use public transit.

Anyway, getting a taste of my increasingly efficient proprioception was way cool.

Brain Biofeedback

Miracles of Biofeedback

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Something spectacular happened. And happened again. My heart rate dropped into the 70s and stayed in the 80s during brain biofeedback two weeks in a row. And my HRV (heart rate variability) hit 6. Six!!! Back in 2012, two was good news, and ten was the goal. So five years later, more than halfway there. (By the way, athletes have HRVs of 60 or something silly high like that. But even old people are higher than me.)

My EMG (muscle tension) was also below 2.0 uV for most of the training for the first time in months. I’ve been a bit stressed, and it’s shown up in my jaw muscles. But turns out getting Invisalign to straighten teeth banging painfully into each other has the rather nice side effect of relaxing jaw tension. (You’d think going into debt for my teeth in our universal health care system we enjoy here in delist-as-much-as-we-can-so-we-can-employ-more-hospital-admin-Ontario would counter the relaxation.) Was that also why my heart rate went down? Apparently, I have a narrow airway so maybe when these things are in my mouth, I get more oxygen. Or maybe not.

Maybe it’s doing more to ease my lower back or maybe it’s taking a new anti-inflammatory for joint and muscle pain after exercise. It contains devils claw (what a name), ginger, chokeberry, Angelica gingas, turmeric, and green tea. Apparently, Angelica gigas (dang gui) has been used in traditional Chinese medicine for circulatory health. Was there enough in my not-quite-daily intake to strengthen my heart and improve brain control of HRV??? There’s no doubt my brain is improving rapidly again; that means more resources to control autonomic functions like the heart. I still get short of breath though, so I gotta be careful not to push the limits just because I’m thinking clearer, am more alert, am improving control over my emotions — the latter only as long as I use SMR/Beta L13.5/R18 Hz audiovisual entrainment most days. And most of all, the chaos in my head really is GONE!!!

I really think that the three sessions of gamma enhancement and three sessions of SMR enhancement and two of 16-20 Hz inhibition, along with the concussion protocol of the low-intensity light therapy that kickstarted the heart improvement is most responsible and the effects are beginning to show.

Topping the amazing heart news is the miracle that happened last week during my first gamma enhancement neurofeedback screen of my brain biofeedback session. For one minute and thirty-six seconds, I was in the zone. In what psychologists call “flow” and what brain injury took from me. That sweet feeling of being so deep into a book or work that the outside world disappears and your mind and brain hum along in harmony. I was oblivious to my brain trainer’s noisy typing as I followed the virtual triplane in its swoops around its virtual mountain island. My delta-theta brainwaves that always show my brief (or lengthy) distraction as she’ll suddenly bang a key or mouse hard, stayed down and didn’t spike until at one minute and thirty-six seconds, I heard her typing like some sort of loud office cacophony. (Part of the training as you progress is to try and distract you so that your brain will work harder and you’ll learn to focus in a distracting environment.)

We both went WOW!!!

Flow IS possible for me. Disappearing into a book again IS possible for me. Sweet mother, I could weep. But am too stunned and unable to process this unreal progress. Will it happen this week?

Brain Power

A Whale of a Post

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Majestic Heart

I wanted to see the Blue Whale heart at the ROM (Royal Ontario Museum), but I hadn’t been there in years, never mind in the year since my eye surgery. Navigating large indoor spaces with my new vision still makes my head spin. Yet I asked my CNIB orientation mobility trainer if he could take me for our next training session. No problem. I like his laid-back, don’t-worry, what-you-need-I’ll-help-you-with style. Makes one feel safe. And when the world unexpectedly dizzies you and leadens your brain as if lead weights have attached to every neuron, it makes one feel things will be OK.

So I had no extra worries as I stepped into the Crystal. Sure, the outside with all its spectacular angles spun my head and slowed me down, but I expected that.

Blue Day

I paused in the small area between entrance doors. And then we entered. My trainer had explained that the tricky thing about the Crystal is that there are no 90-degree angles. OK, I thought, not sure why that’ll affect me, but nice to know. It’s one of the reasons I like the Crystal over the previous forbidding, boring ROM addition.

I stepped further into the large area where you drop off your cloak, pay your ticket, and pass through the gates at the top of the rather long slope. No slope, my trainer said. The floor is flat, he stated. Uh, no, I’m walking uphill, and it’s really throwing me off. I stuck close to the wall of angles and asked again about this uphill. The floor is flat, he repeated patiently then lead me into a room off the entrance.

Oh. My. God. I’m back in that freaky room at the Ontario Science Centre! The floor is really sloping, and I’m going to fall! Don’t fall, he instructed firmly but patiently, adding that the floor was flat. I absolutely didn’t want to walk further into this room of angles, of white walls and black floor. But my trainer was pointing out two chairs across the room from where I was standing frozen. Um, all I saw were two metal tetrahedrons or some geometric form with no seat, no back. Come closer, he persuaded. Some days, I’d rather stay home and not do training. Whose idea was it anyway to see the Blue Whale?! Oh yeah, mine.

I inched my foot forward, carefully feeling the sloping floor so I wouldn’t wobble and fall. He reminded me the floor was flat.

I struggled to believe him. My new, so-clear vision pretty persistently told me we were standing at the bottom of an angled uphill.

I was also perturbed that my new 3D depth perception couldn’t perceive the seat or back of these chairs he was warning me about. One careful step after another after a pause after reassurance the floor was flat after careful inching feeling-the-floor step, we made it to the chairs. Halfway there, my brain perceived the seat and then the sloping back, but I wasn’t about to sit down. He sat down. Yeah, OK, I get it. I sat. He warned me the back slopes more than I perceived and to lean back carefully. I never felt the back because I lost my nerve as I leaned and leaned and leaned and felt no metal touch my back. I stood up. I followed him out the room, walking uphill the entire time.

It really was the most disturbing and weird thing. He explained the lack of 90-degree angles was why I saw the flat floor as being on an angle. I thought about how I had no trouble perceiving this area when I’d come years ago and how I would need exposure to this a few times to be able to see the floor as flat again. Who would come with me to do that?

Mercifully the exhibit area had nice straight walls and a flat floor. The wall-size videos were discombobulating to the extreme, but I could turn my back on them. And the lighting was the usual, expected challenge.

Blue Head

We turned the corner, and there it was: the skeleton. Enormous. Imposing. Majestic.

Yikes! How Far Away is the Tail?

The remains of a mysterious mammal I’ve been a fan of since a kid. In the battle between perceptual difficulty and taking photos, my photography instinct won, as it always did. It’s gotten me into some precarious situations for decades. As I strained to capture the whale’s puny vestigial leg bones that look like jet planes, I almost fell backward. Sheesh, Shireen, don’t fall! Your trainer is near but he doesn’t need to be freaked out.

No not bone jets but Blue Whale legs

He had to leave and asked if I’d be OK. Uhhhh… I hadn’t seen the heart yet. But I wasn’t sure about that sloping floor. He repeated instructions several times. We scheduled our next session. He reminded me to stick near the wall and rest. It was kind of lonely, but then I saw the heart.

Big Blue Heart

Another thing I learnt in the ROM is my reading is improving. I read the labels and absorbed them! The words didn’t bounce off my brain. Yeah, I knew much of what I’d read from way back; still there was an awful lot of new information to absorb and process. The cognitive effort began to take a toll. I considered just not reading anymore and leaving. But I didn’t want to waste this opportunity. I wasn’t about to let my brain injury and eye surgery changes shortchange me AGAIN. So I obeyed my trainer and rested for a bit. Then I continued.

By the time I was walking along the other side of the whale, I’d had enough. Thankfully a couple of couples were taking selfies next to Blue’s ribs. Great excuse to stand and not move. Also to let my brain map the video wall and now see the skeleton in light of what I’d just learned.

I conked out early that night. But what a day! So glad I went!!

Brain Biofeedback

Week Three of New Brain Biofeedback Protocols

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I arrived at my brain biofeedback appointment cold anger fusing into brittle ice over something I’d learnt about my treatment from another health care professional. It had taken a few hours to percolate into comprehension and explode sharp-eyed moral anger through my being. Looking at brain injury through the lens of the DSM, through the distortion of behavioural and personality defects and simplistic anger management issues, inflames trauma. Withholding knowledge of treatment that will restore a healthy alpha rhythm and dramatically reduce the agitation and anxiety associated with brain injury, because it’s not the “usual way,” because it’s not within familiar therapy modalities and would require learning and working with me, prolongs suffering. It is egregious. It counters the essence of being a health care professional who also teaches. That I had to read a paper with my mother and then work out on my own how to incorporate the treatment within my regimen months after this health care professional knew of it, robs me of words, of trust in the healing professions. Does anyone in the medical system know anything about brain injury, want to learn about and actually heal the injury and the injured person? Or do they prefer to be like George Orwell’s comfortable professor, sitting in his comfortable armchair, opining comfortably in their ignorance?

After a few clipped words, f-bombs jumbled almost incoherently with spitting words as my anger and betrayal and wounds flew out at the start of my brain biofeedback session. My brain trainer listened. Then she ensured we did all six neurofeedback screens. And I felt better after.

She told me that for the first time, my tone and emotion matched when I vented to her. My anger at the profound betrayal was controlled in the sense I chose not to control it. My face was grave when I walked in, she said. But once I expressed my emotions over 15 minutes, it was gone. Normally, my tone and words were less intense than my emotion and didn’t match the emotions I was trying to express, she explained. She could sense what I was feeling and was able to figure it out, but not from my tone and words. Because I could not express my emotions at the same level they were at, the anger, the upset, the trauma stayed within me. Venting didn’t really make me feel better. I guess because she understood my broken physiology impaired my emotions, my ability to feel and recognize them, and my ability to express them and that only healing the injured neurons and neural networks would allow me to first feel them, then recognize them, then express them at a level matching their intensity, she didn’t assume the superficial was what was going on internally, unlike others. She worked to figure it out. Whereas old-school ones mired in the DSM nodded but didn’t fundamentally understand and accept that my broken physiology affected how I expressed my emotions and so slapped false labels on me. I’m not the only one. Those of us with brain injury get labels like depression, anger management issues, inappropriate behaviour, etc. I learnt just over a week ago that the standard way to handle some of those is apparently to withhold validation of one’s emotional experiences and knowledge of brain-based treatments. It is to validate and empathize only when one is behaving “appropriately” and not demanding treatment to heal broken neurons and to not be put in a perpetually traumatic situation to make others happy. I had no idea. I found this out because my emotion and communication networks had begun healing enough to markedly improve and suddenly the way I was treated changed. It will be awhile before I fully process this. But thank God for my brain training, for being able to express myself in a safe environment to someone who understands how brain injury affects emotions and communications.

The first gamma enhancement neurofeedback screen made me nauseated. No surprise, my brain trainer said. I was working hard, and it was hot. My heart rate was right up there too: 114. (Even more worrying, it was 102 when I woke up. By the end of the session, it finally stopped pounding too. The feeling of pounding doesn’t correlate with rate. It’s been at 130, and I haven’t felt it pound.)

She gave me mint tea to sip between screens and after to settle my stomach. The nausea eased off though rose up again on and off after my session. I got tea instead of coffee to ensure it didn’t get worse at my after-session treat time.

Anyway, for a few days before week three training, things had been out of focus. Gamma training didn’t do much to improve my vision though it did open my awareness. The amazing thing was though EMG began at 4-5 uV, which I rarely see in me, and dropped to 2+ by end of 30 seconds of the assessment, I brought it down to 1.3-1.4 uV. It was the venting I did, my brain trainer said. Even better, several screens in a row my gamma/EMG was above 1.0. Yes! At last!!

PZ training of inhibiting 16-20 Hz almost immediately began to clear up my vision and bring middle distance into sharp focus. By the third neurofeedback screen, colours had gradually intensified, and I could see clearly. Also my head turned to the right easily. Even at the beginning of the session, she noticed I was turning my head to look at her, not my entire body as usual.

Five and a half hours after training, my head straightened. My bad eye had been trying to close then suddenly began to work with my other eye. Fucking brain. Stop trying to shut down the new vision! Distance still out of focus. Sigh.

The next morning, my heart rate was back down (69! phew) and head straightening was present and stronger than week two but not as strong as week one. For the third week in a row, my mood was markedly different right after training as if trauma had been healed somewhat or a lot. This was different than happy gamma. It wasn’t as strong in week two, but quite marked in weeks one and three. Also, although I woke up too early in week three, after I fell asleep for another hour, I woke up with happy gamma having taken effect. Nice.

I recall research showing treating the back of the brain with brain biofeedback having a healing effect on PTSD. It helped with me somewhat a few years ago, but I’m now wondering if combining gamma with PZ inhibition of 16-20 Hz would heal or at least alleviate PTSD more effectively than enhancing gamma or SMR alone? In me, anyway. Way cool if it did. Better than enduring therapy with someone who’s welded to the DSM and blinded to the physiological effects of injury or trauma.

Forty-eight hours after training, head straightening effect mostly gone, but my neck could still turn all the way to the right (to the left didn’t change much, maybe because the seatbelt injured my right shoulder so scarring??). And if anything, happy gamma grew stronger. I was more talkative and sharper and more flexible in thinking. I had to rebut some man trying to derail my focus and rationalize BS. For once, I was able to dance like a butterfly and sting like a bee.

All but the head turning effects were gone by three days after. Can’t wait for my next session!

Brain Biofeedback

New PZ Brain Biofeedback to Work on Injured Precuneus

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OMG. The brightness, the clarity, the colours popping and sharp are almost as overwhelming as right after my eye surgery. We trained a new area this past week in brain biofeedback.

I haven't yet blogged on my evoke and 19-point qEEG assessment. But the big finding was that once again my precuneus was off the chart in some frequencies. This year it was over four standard deviations above the norm in 16 Hz. This was the first full cap assessment since the eye surgery, and the difference was that the abnormality was bilateral instead of predominantly one sided.

Location, location, location, is what is important, Dr. Lynda Thompson told me, like in real estate. Location is more important than frequency in determining where to treat.

LORETA is the most efficient way to treat the precuneus, a large region of the parietal lobe. And, turns out, the ADD Centre now mostly uses LORETA to treat people with brain injury as it's a network approach, a more suitable way to treat many injured locations all at once instead of one location at a time (changing position every 40 to 60 sessions). Gets quicker results.

But I can't get to Mississauga to do the LORETA nor can I afford it. And the ADD Centre doesn't have the facilities nor enough trained personnel to do it in their Toronto office. This mightily sucks. Trying to cope with all my stressors, managing my health on my own, struggling to keep reading rehab going, plus unable to access what I need (I've known this since 2013 when I had to give up LORETA), is just too overwhelming.

Lynda said single-channel brain biofeedback can work with the precuneus too. She was trying to mollify and give me hope. All is not lost. But I had to give up my reading screen to do that because this time, I'm absolutely adamant I'm not giving up gamma training and they don't have extra space in their schedule to accommodate the additional training.

In the last week of July, for the first time in such a long time, I experienced the happy gamma effect an hour after training. Since November 2016, the gamma training has been swamped by overwork (insane CCAC deadlines to help me write the revised edition of Concussion Is Brain Injury and training my working memory to the edge with Cogmed) and the stress of my neurodoc fucking up my PTSD and grief therapy (because like all the other docs out there, he stuck like glue to old-fashioned views of the brain and brain injury and doesn't collaborate well). I'm having a harder time keeping my EMG down last few months. So in July, I began actively relaxing my jaw. It's succeeding. That plus the work dropping to saner levels, gamma training has a chance to not only keep me going but also pep me up.

I suppose I mayn't be able to access what others can, the LORETA, but I can access something most can't, the gamma, because I can keep my EMG below 2uV.

I'm tired of searching for the bright side though. I'd like the bright side to blind the dark side with light for once.

Anywho, we began to do both enhance-gamma at CZ and inhibit 16-20 Hz at PZ in one one-hour session. PZ accesses the precuneus. Training two locations in one hour is a bit of a sprint-marathon.

It's sort of like 2005 when I used to do two locations sequentially, but back then they were able to give me 1.5 hours.

Anyway, the results made me realize, we can inadvertently test my theory: training gamma first could potentiate other brainwaves and make their training easier and quicker.

Since it’s just my theory, not what the ADD Centre thinks, there's no trainer effect on the results. And I've long since realized my expectations have no effect. Things never happen the way I expect, like this past week.

Gamma training went as usual. Keep deep breathing rhythmic, relax jaw, focus on the visual feedback, look for the letting go feel and when get it, try to stay in that zone for as many seconds as possible.

My brain trainer put both CZ and PZ electrodes on at the start. She had to re-paste the PZ one though because my hot head melted the electropaste. That done, she explained we were inhibiting 16-20 Hz. There is such a thing as bad beta! Still, I worried this unusual training of reducing thinking brainwaves would make my vision worse. When I'd spoken to Lynda, we’d theorized that perhaps there was four standard deviations overactivity of beta because the visual cortex was still rewiring itself after eye surgery. But there apparently could be other reasons: stress (badly treated PTSD and untreated grief plus 2016 social isolation) and/or overwork. Probably both.

Since we don't really know what's going on, we're doing the PZ training as an experiment for a few weeks. And I'm to closely monitor myself and report back. So best way for me to do that is blogging like with the gamma back in 2012/2013.

First neurofeedback screen, we inhibited 16-20 Hz and EMG and enhanced SMR 12-15 Hz. I had no idea what to do to achieve that, so I focused on relaxing my jaw, breathing, and flying the triplane. Oh. My. God. Woozy! Nausea! This was like after the eye surgery but not quite so extreme. Should I stop? No, things like this settle down. My head was heavy, nausea kept on, and then my operated-on eye began feeling worked like after surgery. But no eye pain! About a couple of minutes in or so, the nausea began to lift. I also noticed both displays of equal "weight" in my vision. Much more sense of bilateral like I'd glimpsed shortly after my surgery but which hadn't stayed. Strong 180-degree vision!

But my brain so confused as to how to manage these different parameters. Head felt heavy.

I told my brain trainer. She left it up to me whether to continue to a third screen. Then as I glanced at the display, I couldn't stop exclaiming that the colours were popping.

"Did you hear me? The colours are popping!"

"Yes, I heard you," she laughed, with me.

We moved on to the second neurofeedback screen. Enhance SMR 12-15 Hz and inhibit busy brain 24-28 Hz and EMG. WOW. What a difference! My head felt so light. No nausea. But, uh, kind of too easy.

That was so weird. We change one of the neurofeedback screens during gamma training to inhibit busy brain instead of EMG, but I feel no difference in the amount of work or how my head feels. In fact, the only time my feeling of work and how my head feels change is when we move the electrode position. I've never had such a dramatic change when the electrode stays in place and we change one inhibition parameter.

Was this for real?

Gotta do a third screen to see. The third-screen parameters are the same as for the first screen but instead of a two-display triplane visual feedback, it's one-display bowling ball.

No onset of nausea this time. But that bilateral vision strong again. Colours so bloody vibrant at the end, almost blinding.

When I looked in the bathroom mirror after, I was startled because I saw the entirety of the room behind me in the mirror. I wasn't narrow focused on my face. Whoa.

My brain trainer was excited about the numbers. Unlike gamma training where we focus on what the ratio of gamma to EMG is doing, here we want to see what the absolute numbers are doing. Is 16-20 dropping while SMR going up? Is busy brain going down? And as always what's EMG doing?

Amazingly, even during the second screen when we didn't train it, 16-20 dropped with each screen. My EMG went up only when actively inhibiting 16-20. As I said: work! SMR went down during the first screen. Not good, but I brought it back up. Busy brain was pretty good. But then I've been working to inhibit that at CZ for the last many months.

My brain trainer was astounded at my brain’s quick learning curve. I said that it may prove my theory. Of course, it could just be my plastic brain. Only multi-person robust studies could prove it for sure. But research often begins with a single-subject study.

As I write this as a first draft about 1.5 hours after training, happy gamma is blossoming in me. Phew.

After some food and coffee, I began a short practice walk. Six minutes in, head began to feel challenged, dizzy. Stopped to regroup then feeling OK, set off again. Below are all the effects.

Vanishing point seeing it automatically not having to become aware consciously.

Lighter head.

More energy. Thought I can do walk! Before so damn tired decided just going home right after.

Distracted yet not because I saw things on blind side and read signs and looked long enough to take them in.

Crossed side street sans slowing though truck turning right on opposite corner, car waiting to turn right at my corner, and car waiting to turn left into street. Normally I'd just wait for them all. No hesitation, no fear!!!!!

Next street just crossed it like a normal person.

Head kept turning to blind side. Not sure why. Kept looking at stores and signs on that side. I kept walking with NO balance problems with head fully turned. Got a bit much but couldn't stop it. Weird.

Looked to good side with eyes tracking that way but bad side whole head turned.

Noises behind me not like bombs going off. In fact, barely noticed the quieter ones. The rest I turned my head and tracked with my eyes into the middle distance as if only curious not to also assess for danger (PTSD-like vigilance). Head became challenged and brain tried to keep closing bad eye. Fuck off brain. Use the visual info! It's good for you not just me!! Consuming energy quickly being so aware and looking about and navigating world differently than three hours previously but able to get Walk in anyway.

Taking in visual info is faster. I don't have to stop to take it in, process, recognize, understand, and appreciate. Even flowers. Can eye track a bird while walking with no unbalance or feeling need to stop. Huh.

No difference with stairs. No difference on TTC, still as effing disabled unfriendly as ever, except I was able to read small numbers on sign from a meter away up till I passed it while walking sans feeling umbalanced!

After a couple of hours, realized I could see as clearly looking straight ahead as looking out of the corners of my eyes towards the good side. My surgeon had said as my eyes synced, focus would become sharp looking ahead and towards the bad side. Not really. It did slowly and deliberately when looking ahead but not to bad side. But now as easily ahead as to good side; and to bad side, slightly unfocused but not to usual point of ugh-too-blurry as had been since surgery. Three hours after training, brain wants me to see iPhone straight ahead not from corners of my eyes on good side. Oh. Uh. Weird. Nice.

I'd been listening to my music while walking for many months now. But for 3.5 hours after training, no thoughts to do so, and, when realized I wasn't, brain refused to let me. This was like early months after surgery.

Maybe because of the heat outside and in my head, my visual acuity diminished to blurry after 3 hours post-training. Rest of the effects remained. I discovered normal-sighted people can read that fucking tiny-lettered TTC sign OK. Sigh. At least I could ask someone to read it for me.

About seven hours after training, I didn't get angry, impatient, or frustrated with someone who seems to persist in not hearing me. I actually repeated things I'd said several times over the months sans feeling any anger. Yet I'd been raging to myself over it that morning. After new training protocol, I felt like I could handle it. It wasn't just an absence of anger but also an uptick in competence and patience. During those six hours, I was bizarrely flipping back and forth like anger switch being turned on and off rapidly then happy gamma switch plus something stayed on longer and longer.

Next Day

I couldn't sleep the night of the new biofeedback. About 4:00am, I used my CES Sleep which I normally do when I wake up. When sleep eludes, I'll use it at 4 or 5am. Earlier I'd normally use my AVE device and its SMR For Sleep session. But I didn't want to "pollute" the brain training as I was supposed to monitor the results nor did I want to push my brain that much…although my brain trainer had said SMR OK for me to use whenever. Woke up about 5 hours later tired but feeling rather up and ready to tackle the day. Nice. Unusual. And in the is-this-for-real category…although my feet hurt as much as usual, when I got out of bed, the rest of me was much less stiff and in pain. I walked upright, not like some crouched old man, stiffly moving one leg at a time as I slowly slowly straightened up and smoothed out my movements.

In my reading practice with Mum, I was able to recall the entire previous chapter easily. It felt like it was flooding in to memory and out of my mouth. Mum noticed the change. Reading was about the same. So maybe my reading practice is encoding OK. It's retrieval that's the sticking point…

Vision acuity, colours, and head straightening remained the next day but almost all the effects were gone the second day after. Why the improvement when it should have remained after surgery? Perhaps since the same area is involved in emotions and memory, trauma had overridden the ability of the brain to process and integrate visual, auditory, and kinesthetic input.

After I returned to my current normal, I noticed I can see into the distance but not while walking. I need to focus on something stationary in the middle distance. And turning my head while walking is a careful, deliberate slow, slight turn while monitoring my balance. I hope the effect of being able to look into the distance or turn my head while walking effortlessly returns with my next biofeedback!

I suppose this is why Jesus told men to stop mistreating women. It wasn't just about being nice; it was about not harming women's cognitions such that it kept men in power. God is not patriarchal. He created humans to be equal as humans, not to be gendered humans with gender-determined power and roles.

Brain Biofeedback

Brain Injury Reassessment, Part One

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I got my brain assessment results back. There are a lot of them! I'll talk about them in the order I did them until I peter out then finish another time.

The first ones were the usual questionnaires. Can't stand them as I did a bazillion the same or like them for too many insurance experts. Nothing new. It's really me self-reporting.

The IVA and TOVA are tests of attention conducted on the computer by a computer after someone has set you up and watched you do the practice to ensure you know how to do the test. Then it's just you and the computer in a quiet room. The IVA tests both visual and auditory attention. The TOVA I had tests visual attention only. Both test results blew the ADD Centre staff away. I began my odyssey with them with poor attention and extreme hyperactivity (I'll be showing before and after results in my book Concussion Is Brain Injury since visuals really show how much and quickly I began to improve back in 2005. Makes me realize how severe and through my whole brain my injury was that I still need treatment. It being delayed years made it harder to treat too. People who start treatment quickly are way better off than me.)

Now I have excellent attention.

The tests measure various aspects of attention, too many to cover here. Attention isn't only about focus, it's also about speed, accuracy, vigilance, consistency, stamina, etc. The Response Control Quotient measures how consistent and how much stamina I have as I attend to the most boring task in the world — except for the TOVA. That's deadlier boring. When I began in 2005, my score was 93. It's gone up at each reassessment. By 2013, after gamma training, it was 122. This month, it was 134. I could feel the difference when I did the test this year. I felt more solid, and I wasn't screaming in my mind, when will this be ooooovvvvveeeerrrr. Instead, I just attended to the numbers, knowing it really would come to an end. My Total Attention Quotient, measuring speed and accuracy, was not as high, with my visual attention significantly lower than auditory as my brain is still rewiring my visual system after eye surgery. But both scores were still freaking amazing. The TOVA was at 5.86, dramatically up from last time. I'm not sure why. Since it's a test of visual attention, perhaps the eye surgery along with the gruelling Cogmed, which requires intense visual attention, upped it. I'm sure all the other things I do, like the gamma brainwave training, also influenced it.

In any case, these scores are proof that treatment works, that one can heal an injured brain. You don't need drugs to prop up attention or convince people with brain injury a diminished life of day programs, movies, and feel-good outings is all there is. You can actually fix it.

The next test was CNS — an online test the computer conducts on you that's a combination of self-reporting and testing your verbal, motor, visual, attention, discriminant skills. The part that surprised me and pleased the ADD staff was the increase in my reaction time. Brain injury slows you down so much, a snail is speedier. Things drop from your hands and hit the floor, and a few seconds later, you think, I should catch that and try to react. So for me to be speedier in IVA, TOVA, and this test is quite remarkable. It means my neurons and neural networks are speaking to each other again and in real time. I can feel the difference because I can hear, comprehend, think, and respond in real time even to unexpected questions. Fatigue still impedes me, and group attention is still not great and so I'm slow to react in those conditions. But to be able to hold a normal conversation with one or two people is huge.

The single electrode EEG shows the brainwave frequencies in relation to each other. Dr. Lynda Thompson explained it this way. Think of a car with its windows rolled up and music blasting. You can hear the thump of the bass easily through the glass but not so much the trebles of the singers. Similarly when listening to brainwaves with EEG, the lower brainwave frequencies can push through the dura and skull easier than the higher frequencies. So as you go up from the lower to the higher, the amplitudes of each frequency shrink like an angled line. Any frequency that dips off that line or rises above tells her something. It could be a good abnormality that reflects a talent or skill or it could be a bad one. She determines that by asking you about symptoms.

The first dip in me was at 6 Hz. That's hippocampal theta or central midline theta. It reflects long-term memory. The surgery did a number on my memory, which had been gradually recovering. But even before that, my long-term memories developed black holes then the holes shrank then appeared elsewhere. It could be reflecting an encoding issue. That wouldn't be true for events before my injury though. I encoded memories both naturally and deliberately. I had one hell of a memory. But since the injury, that could be true. I also think retrieval is a bit short circuited. So I told my brain trainer we have to add 2 minutes long-term recall, testing how well I remember what I read the previous weeks, before reading for 5 minutes and doing immediate recall. I'm trying to do that with my reading practice the rest of the week, but so far a bit tough as I have to have enough initiation to make it happen. Not always a given.

Anyway, the next blip was a rise at 8-9 Hz. This could be daydreaming, but in me, Lynda said it reflected creativity and brilliance. I do feel my daydreaming is returning. But for me, it was never a bad thing. It's the source of stories and ideas. And now it helps me see what I'm really feeling.

The next blip was at 23-25 Hz. Busy brain. Not good. But given my busy brain used to go from something like 20-30+ Hz, this is a huge improvement. Since it's not gone, we still have to inhibit it during brain biofeedback.

The last rise is a subtle but significant one. Gamma. It begins at 39 Hz and increases more and more up to 42 Hz, exactly the frequencies we’re training. Also, some of the gamma frequencies above that also show a rise rather than the expected amplitude drop off. Awesome!

The big 19-point qEEG test showed a ton of stuff. The big one for me is that even though my HRV SDNN remains stubbornly half of the minimum for good heart health, my heart rate has decreased steadily at each reassessment. It began at 100. It’s down to 85! I also noticed my heart rhythm is stronger (higher amplitude). My heart’s getting stronger! All those cardiologists couldn't understand how brain injury injures heart health and so couldn't help improve my cardiac health, only give me fatiguing drugs that didn't control my heart rate all that well. This biofeedback way takes forever, but I don't need drugs, and I don't need to worry if my prescription runs out or there’s a shortage or side effects or losing the battle to additional life-sucking fatigue. Also, drugs don't make you feel stronger inside, and they didn't take away my shortness of breath nor did they increase my exercise tolerance. They couldn't because they were only sticking a band-aid on my symptoms, not healing the brain injury causing the problem.

It is worrying my SDNN is still so low. But cardiac care after brain injury is such a nascent area and so few are treating it appropriately that it doesn't surprise me we haven't been able to budge that marker. There’s still so much to learn. At least people like the ADD Centre are trying to learn and tackle it. More than most cardiologists or brain injury specialists are whose bailiwick this should be. More later!

Brain Biofeedback

A Stunning Heart Improvement

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"Did you see that?" I exclaimed to my brain trainer after I'd finished my HRV screen.


"It went up to 5.5!"

"I know, and it was smoother."

"Yeah, and I couldn't tell, but was it bigger?"

"Yes, it was definitely bigger."

"We should have video'd it."

"I know. I was thinking where's the camera but didn't want to interfere. And did you see where it started?"

"Yes! In the 70s! And it didn't go up to 100!"

We both stared at the screen, boggled.

The ADD Centre had set the HRV goal to be 10 for the LF part of the heart rate variability screen. Over the years, it had crept up to 2.5. I'd seen it go up to 3, maybe 4 then drop right away. But this one went up and up, hit 4, hit 5 and KEPT GOING. At 5.5, it stalled then slowly fell back to just over 3.

If it was only that, remarkable enough, but for me to see my heart rate start at 79 or so then go SMOOTHLY up and SMOOTHLY down, not erratically, in sync with my breathing climbing into the 90s but staying in the 80s way longer than a few seconds and never hitting the triple digits (that I saw) is just…

Words fail.

My heart is healing!!!

I'm convinced people with brain injury die from heart issues because they're not treated appropriately or even acknowledged as being really serious. My neurodoc and ADD Centre are only ones to acknowledge cardiac sequelae from brain injury is serious shit. And the ADD Centre to do something about it in a way that TREATS it, not masks a couple of the symptoms while throwing me on the couch from drug-inducing fatigue like physicians do. (What is wrong with the state of medicine that even top notch docs don't want to think outside the box, learn, and find answers for their patients when it means reading the literature and working with others?)

And may I say being able to exclaim in delight and celebrate a health uptick with my treating person is wonderful, something physicians don't seem to have the time or inclination to do. Too bad, eh?

Brain Biofeedback

Brain Assessment at the ADD Centre. My Sixth…or Seventh…?

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It’s hard to believe it’s been 12 years since I had my first proper brain assessment. Since then, new ways of looking at the brain have emerged and software updated. As well as my vision. That’s what I first noticed when I walked into the ADD Centre, Mississauga office — how blue it was. No, they assured me, they hadn’t repainted since last time I was there in 2015. Same blue. A specially chosen shade too. Whoa. What used to look pale, barely blue to me was so very very blue. My improved colour perception from 2016 eye surgery has stayed!

Dr. Lynda Thompson has also changed the order of the tests because they found that people were too tired to do the computerized neuropsychological testing at the end. And she also took the elastic out of the EEG full caps. No more headaches. Bonus!

Everything else was the same though. The endless questionnaires at the start that remind me too much of the shit IMEs I was subjected to year in and year out for almost 8 years. I noticed that the questions didn’t actually get to the heart of my PTSD. Depression and anxiety scales don’t accurately measure the effects of flashbacks, triggers, startle responses, vigilance, breaking of human trust and bonds, or memory fragments that intrude and relentlessly distract when you’re innocently reading a funny story with your neurodoc for reading rehab that then needs to be processed and soothed over before you can continue. People like me who suffered a brain injury from a car crash will, I think, come with PTSD from the crash, the way insurers treat you, and the wonderful abandonment of family and friends fleeing you while hurling insults on their way out. Yeah, those legal files I recently had to fact check my book against still slamming my emotions around.

Anywho, after the questionnaires came the IVA. No more headphones but a speaker. Easier since headphones usually tried to slip off my head. But I could hear all the voices through the solid walls and door — I have acute hearing and a distractible brain. Kind of weird since my ability to focus is pretty good now. But it seems group attention and distractibility remain impaired.

My CNIB orientation and mobility trainer guided me on the long public transit trip from Toronto to Mississauga and from the bus stop to the office. I could see signage so much clearer. Wow. I kept stopping to take that in and let my brain regroup as it worked to integrate the increased information in with the old.

As part of guiding me there and at Thompson’s suggestion, he observed a lot of the testing so that he could report back to his boss at the CNIB. So many are blinded by brain injury; maybe, this sort of assessment and treatment could help them. Some of the tests though would have to allow for voice over or magnified text or adjusted for auditory only. The IVA he thought had enough contrast and size that many could see and do it.

I was a bit peeved that the Start Bar popped up as the IVA test began, distracting me and making me miss seeing the first “1” until too late to click the mouse. But I settled in after that, reminding myself regularly not to let the Start Bar or voices through the walls distract me. And not to let myself fall asleep from the utter boredom of the 15-minute IVA and even worse the 20-minute TOVA, the kill-me-now 5-minute Continuous Performance Test in the neuropsychological test that followed (which almost sent my CNIB trainer asleep — where’s that “B”?!! for her to click already, he kept thinking), and the final 10-minute timed Reaction Test at the end of the full-cap 19-point EEG evoke testing. Oh. My. God. That last one I thought I was going to fall over comatose and miss the large circle. I clicked on a small circle just to wake myself up and express my pissed-offness at the endless staring at the screen, waiting to see the large circle so I could finally click the mouse. I guess I shouldn’t have done that. Mess up my score, eh? But I figured the Start Bar had messed up my IVA, then I moved in the TOVA to wake myself up and accidentally clicked, so might as well go for a hat trick.

The big BIG difference between me at this week’s assessment and before was that I felt solid. My brain felt coherent, solid, knew what I was doing, and what I was looking at. I didn’t feel unsure if I’d missed a “1” in the IVA or if that was a bottom square in the TOVA that just flashed off or if that was a “B” or not in the CPT or if I was confusing small blue circle with large. Well, OK, the length of time between large circles was so long, I worried I wasn’t recognizing the large ones anymore. But when I saw one, I knew for sure it was large and as the test went on, that the small ones were small. (When you first practice this evoke reaction test, you can’t distinguish between large and small blue circles. But by the end, somehow, they come to look different in size.)

Another brain change: I always knew there was a pattern in the IVA. But this assessment, I actually saw it at a conscious level. It helped to make the endless 15 minutes go by quicker for the first time! I counted off each pattern change so I knew how much was left. I also anticipated when the “1” would show up in a sequence of “2”s and vice versa. The TOVA pattern is a little more random, but visible enough for me to use it to help me. The CPT and evoke tests were almost too randomized; but I picked up the pattern of endlessly flashing non-click letters or shapes before the target one appeared then back to endless non-click ones since not very likely to be more than two target ones in a row.

Pattern recognition has always been something that allowed me to still navigate the world after my brain injury. It kind of made me look like cognitive functions were working better than they were. But it’s not been at this fully aware level before during testing. Neat. Weird.

The Drs. Thompson weren’t there during my assessment. First time ever! I felt like I was experiencing the next generation. I’ve long known the ones who assessed me, and it was nice to see them more knowledgeable and having grown in experience and competence. But I missed talking to Michael about the latest research he was investigating and Lynda about my IVA and TOVA results and some of the new things they were doing. I’ll be getting my results over the phone from her when they’re all in as my CNIB guy can’t help guide me back to the Mississauga office a second time (it was a one-time only mutually beneficial trip), and I’m not yet solid and confident enough on public transit and wide intersections to do it on my own after only one practice. I’ll have to practice more in Toronto in these areas before I can.

My EMG was pretty good. Even during training now, it’s better than it has been for months. I’m wondering if that’s because I’m no longer working on the edge of my ability and in a chronic state of deep exhaustion, which I have been since I began Cogmed and then wrote and edited Concussion Is Brain Injury at the insane pace CCAC set for me with my rest period gobbled up by intense emotional stress.

Ever since the big-nausea week and big improvement that followed, my brain has continued to change. (My brain trainer noticed too: Humour is improved. Resilience is better. More positive in mood. Reading quicker. Recall improving. I didn’t notice myself that about my humour.) During the tests, I could see the screen and office in a 180-degree-view unlike all the times before because of the eye surgery. And that feeling of solidity when doing the tests, I’m also feeling now in phone calls with banks or interactions with offices I have to go to. I think it’s my treatments healing my brain of that confusion about what I’m perceiving/hearing that had wreathed my brain since the injury. I still have it, but in fewer situations and at a very very reduced level. My ability to remember what I was talking about despite continuous and sustained interruptions is also back. Nice.

For the first time since 2000, I’m not stressing about test results, counting down the days, or worrying if they’ll show the damage I’m experiencing. Maybe it’s because I’m working on my book — hoping for a September release! — or maybe it’s because my cognitions are markedly better to the point that I’m no longer in a state of desperation. The emotional shit is another issue, but as long as I can write and work on my books, I manage. For now anyway.

Brain Power

Fording Union Station for TTC Presto Card

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I haven’t updated on the recovery-from-eye-surgery front in awhile. Here’s one.

The first week of May, I had to go to the GO area in Union Station to buy a Presto card for the TTC. Why? Because the TTC in its disability-and-poverty-and-non-online-people hating wisdom, haven’t installed machines that take cash. At their in-station Gateways, you can buy with cash a $20 preloaded card – $14 for fares, $6 for card fee. But you can’t reload them at Gateways or their in-station machines with cash. You MUST have a debit or credit card. People use cash for a myriad of reasons, and those who are on the strictest budgets will probably use the TTC over cars and use cash only. But better not to fill all that vast space in their subway station entrances with a large, white Presto machine that takes cash. Much better to hide the tiny card-only green ones in far corners and force us to travel far and into the under-perpetual-construction Union Station GO area. (GO is government of Ontario regional public transit.)

Aside from the problem of getting lost when you have a brain injury, it’s an unnecessarily imperilling and exhausting journey.

Luckily my CNIB orientation mobility trainer knew the way and the station renovators had thoughtfully placed elegant benches here and there. My head felt like it was under pressure. The further we walked, the greater the forces of information overload pushed till I felt like my cranium was being crushed.

I wasn’t ready to enter the busy hub of local, regional, and long-distance rail travel. But the TTC in its quest to be a beacon of accessibility changed one of the subway entrances I use to Presto only, and I only have cash these days. So . . .

The machine was easy to use — because my trainer guided me. I think under normal circumstances, I could’ve figured it out on my own. But then I realized with horror: every time I have to reload this card, I have to come back here!

I can’t on my own!!

The TTC really doesn’t like creating a system that facilitates independence does it? Where is our Mayor? Where is the Ontario Human Rights Commission? Where is the Ontario government to rap their knuckles and inform them that like the London Underground, they must put the Presto machines that take both cash and cards in to every station?