Brain Health

Brain Injury Grief: The Experts Begin to Recognize and Define this Profound Loss

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The last time I tried to find some info on grief and brain injury, I found nothing helpful. This past week, I half heartedly looked again. I was surprised and heartened to find that brain injury grief was being recognized at long last. Skimming articles from the US and UK validated my belief that brain injury grief is a different and much more difficult beast than other kinds of grief.

Janelle Breese Biagioni wrote on Brainline: “Then we have what I identify as extraordinary grief resulting from a disease such as Alzheimer’s or a catastrophic injury such as a brain injury. This kind of grief is profound. People must grieve who they were, and the family also grieves the person who is no longer there, albeit physically present. Sadly, I think society as a whole is only beginning to understand how profound this type of grief is….”

I’m not sure society is recognizing it. After all when most health care professionals don’t and I see person after person having to subsume their grief or being labelled depressed, you know social work and psychiatric care hasn’t evolved in this area yet.

Biagioni continues: “Dr. Alan Wolfelt’s Companioning Model identifies potential grief responses as shock, numbness, disbelief, disorganization, confusion, searching, anxiety, panic, fear, physiological changes, explosive emotions, guilt and regret, loss, emptiness, sadness, relief and release, and finally, reconciliation and healing.”

I so relate to this list up to sadness. And brain injury does complicate it because it causes confusion, disorganization all on its own. PTSD also overlaps many of those listed states. How does one tease out the cause for each? How does one address multiple causes for one state and know which order to treat the causes or if best done simultaneously?

She continued: “If one is allowed to truly feel — to grieve, this will lead to mourning. Mourning is the process of taking those feelings from the inside to the outside. It is giving expression to how we feel. This may be done in a variety of ways, such as funerals, talking, writing, art, and music. Wolfelt describes it like this: “Mourning is grief gone public.”

I have to wonder if we need to develop new rituals of mourning for internal deaths, deaths like reading, identity, musical accomplishment, hobby skills, memory, specific identity memories, sense of humour, emotions, etc. And then also develop rituals when some of them return in part, distorted, not the same or maybe fully suddenly years and years later. The pre-injury person suddenly returning isn’t always welcome — it’s another change after having adapted to fundamental change and perhaps you’ve come to like some radical new parts of you, like I liked not being so self-controlled to the nth degree. It was so freeing.

Dr Rudi Coetzer on Headway U.K. wrote with great insight: “brain injury survivors and their family members often find traditional approaches and support networks are unable to adequately address the problem. Reaching the acceptance stage is difficult and by no means a certainty, but after brain injury things can be further complicated by the unfamiliar, complex and often unpredictable effects of the condition…

“From a more academic perspective, factors such as time since injury, awareness, family support, pre-injury personality traits, social networks, and severity of the injury can all influence the person’s experience of grief.

“Furthermore, there is often a focus in the literature on the loss of ‘how things were’, but again, as a clinician, working psychotherapeutically I also often hear about the grief regarding the loss of ‘what might have been’, were it not for the injury.”


Figuring out Brain Injury Grief

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I had to figure out how to bring my temperature down and stabilize my thermoregulation; I had to, have to continue, to figure out how to rehab my reading; I had to figure out how to persist in relearning skills, doing life in a new way long after bean counters in hospitals and insurance decided I no longer needed outpatient and community care. Do I have to figure out how to grieve brain injury, too?

In all things, I began with standard medical care, with learning the medical system’s usual way of approaching relearning, living with brain injury. When that showed itself to be completely inadequate, I sought better care that actually treated. They taught me things, but they too went only so far. After that, and also when I failed to find any help whatsoever for some problems, I had to seek the answer within myself from painfully pulling out old neurophysiology and psychology knowledge, willing my brain to absorb new knowledge from reading, and putting it all together through writing.

But I never thought I’d have to do that for grief!

I thought eventually I’d find someone who got it, who knew how to guide me through grieving the death of myself because they’d learnt it from experts and they’d worked with other people with brain injury. I was wrong.

Brain injury has been around for eons. Loss of self has been a known effect for eons.

So why is there no help‽

This is like hell ten times over.

There’s no help because the psychiatric model labels it depression. The neurophysiological model focuses on healing the physical brain. The therapist model extols the virtues of discovering who you are now. Friends and family model get sick of hearing the confusion, the pain, the repeating what-the-fuck-is-going-on-help-me! cry.

Eighteen years, two months, and seventeen days, and I’ve not had one consistent stretch of grief work. And I’m not alone. No wonder after a couple of decades of seemingly doing “well,” people keel over. Grief doesn’t disappear into happy positivity that the experts and family want us to leap into on the day of our diagnosis. It lurks until the work of relearning, of learning a new life, of becoming used to the routines of daily living, is done and brain space opens up. Or a bad event will throw the entire system into shock and grief flows back up like a magma flood.

What do you want, my neurodoc asked. I wanted my grief to be respected as real and different from depression and from grieving another human being; to be honoured with consistent healing work. I guess I’ll have to do that alone too. The only way I can think how is through my writing.


Running to Grief

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Watching 1 Mile To You. High school boy, runner. Loses his entire team in a bus accident. Girlfriend and friend, too. Runs to remember them. The faster he runs, the more he sees them. Remembers them. He doesn’t want to forget them.

His new coach asks:

What do you want? Your heart. The most important muscle in your body. Never rests. It remembers everything. I need your mind to know it. Your heart to know it.

He can look at pictures of his dead friend. Dead girlfriend. Text them. Watch video messages, see their smiles. And he remembers them.

He grieves.

But how do you grieve yourself? How do you grieve the reading slaughtered in the injury? How do you talk about lost reading like you talk about a dead girlfriend? Girlfriends who are gone don’t return distorted, damaged, done in. How do you grieve something you can’t look at, touch, watch, talk to, is a distorted, damaged, unfamiliar version of itself inside yourself? Not outside yourself. How do you grieve when you don’t want to remember yourself reading when it hurts so much? Yet the memory comes, and you remember you always saw yourself so long into the future holding a book, absorbed, silently slipping the pages over, one by one, living, breathing inside the story. You bang and bang on the doors of people to help you. To go back to that time when reading was just there and the future was certain. But no one can help though they try inside their own way.

It’s not coming back. You’re not coming back.

And then the expert calls it depression. Not grief.

Brain Health

Happy Christmas to All the Hurting

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Happy Christmas AmaryllisIt’s Christmas Day, the snow lays on the ground glistening and white. Sparkly icy flakes blow in crowds off roofs as the wind gusts into the face of walkers hurrying to get their Starbucks or Timmies. Cars hiss on the snow-wet roads, waiting alongside each other at red lights, impatient to get to Christmas breakfast or lunch or dinner, some enjoying the quicker commute others the waiting at the lights, delaying the family roar for a few more seconds.

Church walls block out the city noise. Candle flames vie with stained-glass sunlight as imperfect voices sing carols and greet each other joyfully before parting to their separate feasts. Or barren homes.

Life chatters, joy laughs, pots clang, children screech, grandparents help little hands rip paper, parents gulp down drinks, and the injured brain hides in the bathroom, driven there by conversations swirling around in an unintelligible cacophony of piercing pains. It’s either that, pleasing the family with the presence of the body without joy, the brain’s needs ignored, or sipping eggnog alone in the blessed quiet of one’s own home with no one reaching in.

If it’s one thing I’ve learned — again — from social isolation, part II, it’s that when you can’t get out, people in real life won’t reach in. A token email, a couple of messages, an offer to answer your call if you need anything without an offer to come over and bring coffee or health care, and then silence . . . until you can once more get out to where they are.

Christmas is no different.

Except that God, that Jesus, is always with you.

You can rage, cry, sniffle, marvel over a blue blue sky, take quiet pleasure in watching cardinals glare-hop outside your window, sink into a Netflix movie, and Jesus is always there with you to share in every emotion or lack. People say God keeps his promises. I don’t know. But one thing Jesus does not do that every human does: abandon the sufferer.

Pain drives people away. Pain and a broken brain invites human judgement and criticism. Pain and injury imprison you. But excluding, exquisitely painful suffering draws Jesus right in there behind the bars with you. Happy Christmas.

Brain Biofeedback

Cogmed 50

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I like nice numbers, ones like 50. So I’m rather chuffed with myself that I achieved 50 Improvement Index in Cogmed. During the maintenance sessions to be sure. But still . . . Even better I did it right after I achieved 49. Improvement two sessions in a row, whoa! Rest of my life might be shit, but this one area where I have full control and no one can affect how I do and I don’t have to depend on anyone to do it, is working. Awesome.

Got to 50 in Improvement Index in Cogmed!
Brain Health

Cogmed Rehab of Brain Injury Working Memory Over!

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Cogmed is over. I’m both really glad and kind of sad, for it’s been five weeks of something different that also makes me feel like I’m regenerating my brain in real time, not the usual let’s wait a couple or more months or years (or decades with traditional rest and strategies) and see if this will work. The usual takes patience and faith!

Leaping into Cogmed took faith too. But not as much patience. And interestingly, it gave me the ability to be patient with my fatigue.

Cogmed is like taking the toughest school test you’ve ever had when you’re at your most tired and trying to stay fully focused while being wise in timing your breaks the entire hour to one and a half hours it takes. First two or three weeks, fatigue got to me. The deep, deep desire to nap would overwhelm any sense and sensibility, and I’d rush through the rest of the exercise then lay my head down till my eyes would open and go on to the next exercise, repeat, until with a heaving sigh of relief, I’d be done. And could go watch an animation movie on Netflix.

But in the last ten or so sessions, I began to notice a change. I no longer absolutely had to sit and watch blankly an animation movie while inhaling chocolate right after my Cogmed session was over. I could maybe put laundry on then go watch any kind of movie. Even better, I began to be able to stick with my method of deep breathing, adjusting my vision to peripheral or eye tracking, focusing right to the very last try in the very last exercise. No more rushing just to get it over with and go watch a movie so I wouldn’t have to think any more. After about session 18, I became more methodical in my rest breaks, having noticed that too-short breaks resulted in not great performance but too long also didn’t work well. My coach mentioned in a couple of our early calls about staying in the rhythm of the exercise and not taking long breaks between tries. That’s difficult when fatigue is pulling down on your eyelids, making your hand jerk the mouse spastically leading to errant clicks, and your brain on an unconscious level is trying to reassert my old vision and narrow my new wider peripheral vision back to my old narrow focus.

So I focused hard on the task, put all my effort in to keeping my eyes open, and tried a quicker method of just taking a sip of water in between tries during the Rotating Wheel of Joy exercise. That worked. Then from Day 17 or 18 to Day 22, I expanded that method gradually to the grid exercises and then the number exercises. I had felt that methodical with breaks worked better for the latter; also the patterns of numbers bled from one try into the next if the break was too short.

But on Day 22, I went for it: I stayed in the rhythm of every exercise, at most sipped some ice water, only stretched my neck and shoulders to wake me up and stick my face in the feeble sunlight in between exercises and only rested for 10 minutes between the first set of four exercises and second set.

Unbelievably it worked! My daily index and Max Index both shot up.

It definitely wouldn’t have worked in weeks one and two, even in weeks three and four because I didn’t have the mental stamina.

Fatigue makes one hit the proverbial runner’s wall: you can’t see or think never mind remember anymore or remember so slowly it’s like watching molasses ooze down a glacier’s side as your memory finally comes into view so that you know what to click. You need confidence the memory will come into consciousness eventually and the patience to wait.

Somehow this intensive memory training has improved my stamina so that by the middle of the last eight sessions, I could stick to my method to the end, work quicker, and improve my performance — and all without my head hitting the desk in a dreadfully needed mini-nap time.

The number exercises are my absolute best ones. Grid ones and most movement ones are in between. My absolute worst are Twist and 3D Grid of Doom. My vision and eye tracking are the reason I do poorly. And too late I realized my depth perception being so new and my brain trying to shut it back down again is why I haven’t improved at all in the 3D Grid, the only one I haven’t improved even a little bit. Even Twist has improved a tiny bit — that’s with most of the time the patterns I’m holding in visual memory disappearing the moment the 4×4 grid twists back 90 degrees before I have to click the sequence I saw lit up.

Having tried Cogmed on both the iPad and the computer, I’d say that the computer with its bigger and thus more challenging display is better to work my peripheral field and eye tracking. I think working on the iPad helped me understand the exercise and train the eyes to know what to do. But after that, though much harder, the computer display is better at training peripheral vision and eye tracking and thus improving and retaining the improvements, like my head staying straight and my weak eye continuing to work with my stronger eye.

One of the best parts of Cogmed is that I had absolute control. The problem with brain injury rehab is that you depend on others to make it work. The person you depend on has all the control, even when they claim you’re trying to hold onto control (ie, when you demand, beg, ask for, fight for more help) and they claim being controlling is your issue. You’re screwed if they don’t feel like it, it’s not within their regular practice, it’s not how they operate, they only have time for some of what you need, they prefer to refer you to someone else — which entails waiting months or years never mind more hours in the waiting room because hey you don’t work anyway so your time ain’t worth much — they cut you off as you’re improving but before you’re stable. There’s nothing you can do but accept the inadequate help and hope you can live within brain injury hell under the cover of gratitude and a positive vibe without going insane.

But with Cogmed you have all the control. You do as well or as poorly as you want within the limits of your own neuroplasticity.

No one can let you down.

So rare, so empowering, so uplifting when you begin each session reminding yourself that this rehab is yours, all yours, and no one can let you down or undermine your efforts.

Improvements I’ve seen so far:

Reading speed quicker.

Reading length longer.

Short-term ie immediate recall of what I just read or someone read to me increased, richer depth of detail, quicker and for longer to speak it out.

Perhaps better long-term recall — this has been tested only once in a clinical setting. It was good.

Intonation of reading is up: I don’t read in a monotone anymore. I even put in a character’s tone in dialogue after Day 22 of Cogmed.

Walking is quicker; after 20 sessions, it’s normal in all areas I’m familiar with unless people suddenly rush past me or a group is wandering (how my brain perceives others walking) towards me. My eye surgeon advised me that the last part of my visual system to adapt will be motion:
Me moving while others and objects are also moving. Sometimes it feels like I’m on some psychotic tilting sidewalk trying to navigate people. Anywho . . .

Better stamina for cognitive work.

Starting to be confident of my cognitive skills because my memory of what I read is much more reliable.

My coach was sick so I have yet to have a final call with her. But the program told me that:

My working memory is up 57%.

My ability to follow instructions is up 24%.

And my math performance is up 1%.

Why is math barely improved when my affinity for numbers means those exercises just keep on going from one level to the next? Processing speed, peripheral vision, and fatigue. I can feel my neurons slowing down, the answers being held behind a viscous wall through which I’m pulling and pulling until they finally pop out while my peripheral vision narrows and narrows so I have to eye track every number in the equation and in the answers next to the arrow keys so that I know which key to press. And fatigue drags down my ability to keep at it. It’s the same issue I have when trying to calculate the tip on a restaurant bill for my mother. What I once could do in my head and rapidly too, now is arduous. After a year or so being completely unable to do it after my brain injury, I lost all confidence so that I wanted to avoid it. My mother’s math ability is worse than my injured one, so she won’t let me avoid it. Still, I usually throw out a guess instead of methodically doing it even in the last week of Cogmed. I guess patience through fatigue and slow processing hasn’t translated to math in the real world yet.

Cogmed and the ADD Centre say that improvements continue for the next six months. That’s why there’ll be a final assessment around June. Also, I will be taking the option of 100 maintenance mini sessions. I also have three regular sessions as make up ones for where I encountered technical snafus because of my hand jerking or finger double tapping on the iPad (the software should recognize and ignore tic-like double taps). They do warn tics can increase. And they did, but then in the last week, they decreased!

Whatever happens in my life, this accomplishment can’t be taken from me.

Brain Health

Cogmed to Train Working Memory — An Experiment to Help Post-Brain Injury Reading Rehab

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I’ve begun Cogmed to train my working memory, that brief moment you hold something in memory in order to accomplish a task or store a piece of knowledge before you forget then scratch your head as you futilely try to remember what you were doing or reading.

The folks at the ADD Centre had told me about Cogmed a few years ago, but between lack of funds, lack of social support at home, and lack of energy, I declined at the time.

But I’ve spent most of 2016 stuck at home, and despite floods and pests trying to suck up dollars, I’ve saved a lot in medical costs. (Unfortunately, Virginia, there is no such thing as universal health care in Canada. What we call universal covers only the basics and no treatment outside of hospitals, especially for brain injury. There is no Santa Claus of health care despite the Canadian myth.) Also, I hate this time of year, too many long-term traumatic memories, and needed something to consume my brain space.

Cogmed is an online course you do about 1 hour per day, 5 days per week for 5 weeks. It’s intensive, and part of the pre-admission interview is to ensure you have the time and are not planning on doing anything else beyond your usual routine. (You really don’t understand how intensive it is until after the first 5 days when you reach your optimal memory level.) Also, they tease out whether your issue is attention or memory. Since my attention has been well treated at the ADD Centre, and as long as I’m in a quiet environment, I’m not likely to be distracted, memory not attention is my issue now. They want you to do Cogmed in a quiet place anyway. They also ask you about your sleep — they have my sleep study results — and current level of working memory — they assessed me most recently just over a year ago. It helps being their client: I don’t have to gather up any test results to send to them!

They take you through a demo then send you all the login details. While they set you up, you work out your Cogmed schedule; weekly and maybe daily rewards and a final one to help motivate you to keep going; and a time for your weekly 15-minute coaching call. My coach sent me the best times for her, and I picked when good for me too.

I had trouble coming up with rewards. My coach was patient, gave me some suggestions, but was thrilled when I came up with pretty inks for my fountain pen and a new groovy fountain pen for my final reward. During our coaching call, which happened on Day 6 of my Cogmed training, she also suggested a small daily treat as I had reached my optimal level and would no longer see the big daily improvements I’d experienced during week one. The program is designed to make you feel good in week one; then it gets tough. Lots of tries and fails at the same level, no going down a level quickly so that you have a success.

Anyway, I’d intended to start on a Monday, going Monday to Friday, taking the weekend off. But then realized the first two days of the week are actually my toughest. I need energy for this! So I began on Saturday. I tweeted:

17 Dec: I’m going to start online CogMed training,see if we can get my working memory to, uh, work. Step 1: schedule it. W #braininjury not done yet.

Cogmed. Round 1. Oh. My. God. My forehead crushed then: got my highest score on the very last exercise. 8 on Reverse Numbers! 😯 #braininjury

Cogmed cool down: Zootopia (English voices; French text Netflix). Still hv concentration headache tho pumped completing day 1. #braininjury

Dec 19: Cogmed Day 3: improve on prev 5 working memory training exercise but the 1 I forgot the instructions for. Ha! 3 new exercises. #braininjury

Dec 21: So an astounding thing happened at brain biofeedback: my HRV went up to 4!!! My heart rate dipped into 70s briefly! Holy f—! #braininjury

Cogmed Day 4: I suck at Sort. Numbers are my friend. Um, number of Assembly levels barely fit on screen already. Yikes! #braininjury

Dec 22: Cogmed Day 5: 3D Doom doomed. That rewarding sound à la The Game silent too much. But then picked up w rest of exercises.Phew. #braininjury

Dec 23: Cogmed Day 6: crash breathe! Coffee! Eggnog! fight breaks out twixt eyes & brain Somehow I improve. 😳👏 #braininjury #eyesurgery

On Day 7, I hit a wall, a mental wall like the famed runners wall. I’d only taken Tuesday off my first week and launched right into week two. My coach said to take either Saturday or Sunday off since I’d done my 5 days in the week and could afford the time off. Plus I needed it.

I felt good after Christmas Eve family service. Loads more energy than some days! I didn’t want to do Cogmed on Christmas Day after all, now the idea of a day off had been presented to me, soooo…

I was good in the first 12 minutes or so. I positively zipped through the early exercises compared to Friday. I even did slightly better on 3D cube of Death, um, Doom. But in the third-last exercise, my best one — Hidden — with only 2 or 3 tries left in it, I hit the wall. Brain stopped working. Totally. Oh-oh.

It would take hours to recover, I knew. But I had two more exercises to do. OK, I’ll run on instinct, I decided. That worked for Rotating Wheel of Joy — unbelievable! But for Numbers: complete miss. I got a few “Close” ones, meaning I missed only one number on each try — apparently Close is good because it means I’m pushing — yeah, no kidding. But no hits at all, wow. So glad I have 3 days off! It’s going to be optimal training from now on: always training me at the upper level of my memory. If I get one or two hits for every miss, I’ll be lucky. But a pushed brain is a brain that improves!

Brain Power

Reading Rehab Experiment: Reading a Wordless Graphic Novel

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The psychology prof I meet with occasionally to discuss reading suggested an experiment: read a wordless graphic novel. He loaned me Cinema Panopticum by Thomas Ott. We had been discussing how the brain takes in information one word at a time and then processes the same bits of information but combined in another area. The prof noted I don’t have trouble creating or understanding concepts; instead I have a lot of trouble ensuring my brain absorbs each bit of information — each word — and putting them together, depending on the complexity and length of the material.

What if we gave me something where the words were already put together, so to speak? What if we bypassed the basic problem of getting my brain to absorb each word and to combine the words? They say one picture equals a thousand words. Well, maybe in a wordless graphic novel, one picture isn’t equal to a thousand, but it sure is equal to many, maybe even one paragraph. Would that make it easier for me to read?

Today, I am sitting down with Cinema Panopticum to find out.

It’s a large-sized book I can lean on a cushion while I read it. Each page has a black background, and each panel is drawn in grey scale, like a pencil sketch. Fairly easy on my eyes, and fairly easy for me to perceive. Some panels are on the outer limits of how much detail I can comfortably perceive.

I used the same routine as for my regular reading homework: begin with three minutes of deep breathing to relax me and prepare my brain. Wear my reading glasses. Set the timer for 10 minutes. Begin.

I wasn’t sure how one “reads” a wordless novel. I have a tendency to look at images or photos quickly, and that’s what I did with the first panels. The first part of the story is also fairly familiar to readers: a girl wants to go to the fair, she only has five coins, all the rides cost more than five. But I suddenly realized a headache was coming on. I checked my timer.

Two minutes.

I remembered I’m supposed to take three deep breaths between each paragraph to ease any burgeoning headache or prevent one. But what is a paragraph in a wordless graphic novel? A page of panels? Two pages? Or is it better to go by time?

I took the three deep breaths but didn’t recall out loud. I read for another minute and a half. This time I looked at each panel longer, and a few of the panels I studied carefully, like I was the girl trying to figure out what she was looking at as she explored the fair. The headache began to encroach again, and I was at the end of the first section. I remembered this time I’m supposed to recall out loud. I spent another minute and a half recalling out loud section one — or is it chapter one? (no, the description of the novel says it’s the intro to four novelettes) — while I took three deep breaths.

I considered continuing on because I had been reading for only five minutes, but I had a small headache, and I was tired. Better to quit while ahead than try to push it. I’m looking forward to reading novelette one tomorrow.

Brain Biofeedback

Everyone on the Same Reading Rehab Page: Finally!

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 This floating piece of metal is huge. It dwarfs the Redpath sugar plant, which is no tiny building but itself an edifice on the waterfront where people gather to work and play, enjoy life.

As it is with that ship, so it is with reading.

Reading is a huge cognitive process, a monolithic problem that’s a part of, yet is bigger, than the injury of the brain that sits between you and the world.

It looms over the enjoyment of life.

Yet most people can’t see reading as a problem; they talk about that monolith as if it’s not a lake freighter but a tiny sunfish dancing on the waves.

It’s taken me years to first acknowledge that I could not read then to acknowledge the enormity of the problem then to accept it wasn’t going to go away and finally to nag and nag nag my health care providers to truly help me.

My neurodoc began back in January; CCAC said recently, OK, let’s connect you with an agency that helps people learn to read, preferably with one of their ex-high school teachers since it’s the long-form, cognitive aspect of reading you struggle with; and now after the ADD Centre reassessed me this past week, they are going to use my neurodoc’s reading methods with their materials in concert with brain and heart and breathing biofeedback protocols to heal what my EEG reveals as the reading blockage.

I am jumping up and down, screaming in delight!

For the first time, all my health care providers are working on the same issue to complement what the others are doing, with my neurodoc the “non-expert” in reading leading the way. Thank God.

For once I do not feel like a human being being pulled in three different directions as each provider works on totally different issues and don’t talk to each other so that they think I’m only working on what they are doing, which kind of leads to awkward situations where I get questioned on an area one of the others is working on as if I’m not, which then leads to my mind going blank as I grapple with this broadside so that it really does look like I’m doing nada when I’m not. And yes, I’m having trouble blogging and writing too. But I digress.

So my neurodoc is continuing to improve my stamina so that I don’t fatigue to the point of needing a nap and so my will headaches go away. CCAC will hopefully find an ex-high school teacher at a reading-rehab agency who will help me ensure I keep up with my homework, especially in light of my recent out-of-the-blue-forget-to-read issue, and perhaps offer other remedies to restore my reading, maybe even read rhyming poetry to me. And the ADD Centre will treat the damaged areas that are probably responsible for my reading problems while also working on strengthening my recall and being able to spot and understand subtle meanings under timed conditions.