It’s been over three and a half years since I’ve entered the world of ABI (Acquire Brain Injury). I haven’t written in a while due to trying to adjust to the shift in my reality. I’m coming to terms with the realization that there are aspects of my injury that are not likely improve.
In the months immediately following my injury, there was a level of hope and anticipation that came from learning about the injury and seeing improvements albeit very gradual. It was mainly in looking back that I could recognize certain improvements.
The hard part is the transition from seeing hindsight improvements to coming to terms with various areas in which further improvements are not likely to happen.
I’ve gradually developed routines that helps me mitigate symptoms that would otherwise push me into the area of neural fatigue and sensory overload. Key is having things carefully planned out. The planning is more specifically focused on anticipating unexpected changes in plans or expectations.
I have a recent example of having carefully planned out a project. I had wanted to build a handrail for my daughter so that their front entrance would be accessible to seniors and others with mobility challenges.
I had taken measurements and created a list of materials and tools I would need for the job. Since it was a simple project I could reasonably expect to complete it in a half day. For good measure I gave myself a full day to do it. I could make that fit into a weekend visit involving a 4 or 5 hour one way trip.
A last minute change in design meant that I had to run to the hardware store and buy three ground spikes or as one retailer calls them, “Big Mike” spikes. It required a visit to two different stores in two different towns to find a store that had enough of them in stock. Fortunately the staff at both stores were very helpful. Had I been left to fend for myself the project would have gone off the rails before I even started.
I arrived from the store with the necessary supplies. All went well till I tried pounding the middle spike into the ground. Turns out there were the remnants of an old sidewalk that made it impossible. That required some rethinking. I needed to find a different way to secure the middle 4X4 cedar post.
You might think. That’s not too difficult. Pre-ABI I would have thought nothing of making the change. The logical solution was to attach the 4X4 into the side of the steps. So simple. Nothing complicated. Go back to the store and buy a Tapcon, get the drill and in a couple minutes the post is in place.
For me it just about meant being unable to complete the job. Mental flexibility continues to be a challenge. The process of thinking of an alternate way of securing the 4X4 post meant the original plan which I had carefully thought through had to be changed.
Making the change meant I needed to go through a cognitive process that zapped much of the energy out of me. Rethinking the project and trying to make adjustments on the fly created noticeable neural fatigue.
Time and again when I go through a rethinking process I’m reminded how many cognitive steps are involved. When one’s brain works efficiently, one if able to make the changes on the fly and not even realize all the mental changes that had to be made. With injury in one part of my brain, another area of the brain takes over. It can do the job but seriously lacks working efficiency.
Had I had a couple days to complete the project, the best plan of action would have been to stop construction for the day, take some time to understand the change in design and finish the project a couple days later. No neural fatigue. Minimal chance of making errors.
However, since I had only given myself one day at the most, I continued the project. I slowed done since neural fatigue drains energy from the whole body. I found myself humming, tuneless humming, which is a further reminder that I am not in a good space.
I was pleased to have the job completed by supper time. Even though I was totally worn out, I was feeling pretty good. The ‘Cost / Benefit’ factor was such that I was in a very good space. I had achieved my goal. I knew that completing the project with the side effect of neural fatigue would come at personal expense.
I hoped that a quiet evening and a night of sleep would put me back on a good track. Even though I had my doubts the next morning I pushed ahead. I realized after the first couple of hours that I needed more recuperation time. Engaging in simple conversation was just not working. Focusing on what was happening around me just wasn’t working.
My best option was to take some personal time. I went for a walk. The minimal physical exertion helped my body to gradually shed the neural fatigue. The repetitive motion of walking and the minimal cognitive demands made it an effective choice. Walking by myself meant there were no social demands, no expectations to engage in conversation or respond to someone else expectations. By mid afternoon I was ready to visit, drive or participate in activities with other people.
Time and again I’m reminded to have a contingency plan in case things don’t work out as expected. If I have time on my side, I can make it work without putting myself into a lengthy recuperation phase. It’s either make more time to complete a project or else take more time to recuperate.
Sounds simple in hindsight. As they say, “Hindsight is 20/20 vision.”