Living with a Minor Brain Injury

I was very fortunate. The accident that caused my brain injury wreaked damage that even I consider to be relatively minor. That’s saying a lot. It is very hard for anyone with brain injury related cognitive impairment to view their situation as anything less than devastating, but I am working on an objective view of my situation, and through that objective view one thing is begrudgingly clear: I skated.

Having experienced a simultaneously catastrophic and insignificant electrical injury when I was six years old, my medical chart is a hodge podge of questions and quirks. When a person suffers an electrical injury, there is are a nearly unlimited number of combinations of potential ramifications possible as an outcome. The human body is made up of approximately 70% water, and the brain itself is even higher than that , comprised of approximately 75% water. Water is an excellent conductor for electricity, and the damage caused by the introduction of electric current to the system can be as minor as a small burn to the outer layers skin to major events like cardiac arrest, coma, and death.

My experience was believed to have inflicted a very fortunately minor amount of damage to my 35 lb body, but as years progressed, we discovered that the long term consequences of the accident were far more involved. Peripheral neuropathy was diagnosed to explain the numbness, lack of sensitivity and “dead” feelings that I experienced in my arms, legs, hands and feet. My migraines, although not an unusual problem, set in in adolescence and are debilitating in their severity. Persistent arm and wrist pain lead to the discovery of bilateral, non-repetitive-stress-related Carpal Tunnel Syndrome, which was caused by the passage of the current through my arms. A persistent state of dizziness was after many years of investigation and frustration discovered to be the result of a missed problem with the electrical conduction system of my heart, called Short PR Syndrome, which causes arrhythmias.

Of most concern and frustration, however, was the problem with my brain. My family, my doctors, and I had no idea that I had sustained an brain injury. Overall I appeared relatively normal as a child. I possessed a high IQ, but was forgetful, and scatterbrained, and I displayed some trouble with impulse control. I also had a lot of trouble with simple processing, and would prefer instead to work from the first solution to a problem that presented itself rather than go through the grueling task of working the steps to come to the most logical and productive answer.

For many people living with Traumatic Brain Injury (TBI) the problems that I am living with would be considered laughably minor, and I feel extremely lucky that I can agree with them. The damage done to my brain was fortunately limited to the White Matter Tracts, which comprise an electrical conduction system to the brain. As with the electrical conduction system to my heart (the problem manifesting itself in the Short PR Syndrome), the injury to my brain was effectively caused by a “short in the system” that was precipated by the accident. The injury to my brain causes me to experience difficulty with what is called “working memory.” Also of note were disruptions to my abilities in task switching, memory encoding and retrieval, and left-sided fine motor control.

One of the devastations of Traumatic Brain Injury is that it can have an effect on the brain similar to that of a tornado touching down in a Mid Western town. One structure can be completely decimated while the structure next door remains completely untouched. Because of this phenomenon, many people living with Traumatic Brain Injuries can be impaired so significantly by their injuries that they can not speak in complete sentences, can not perform simple tasks like tying their shoes or toasting a piece of bread, but they can speak in double entendres and often have an excruciatingly acute knowledge of what the current status of their brain functioning is, and of what it was and should be.

My case is more simple. I am fully independent and I can work full time at a challenging job that entails task juggling and involves responsibility for the well being of others. I am able to engage and participate fully in a “normal” social scene. I can cook dinner for my husband and myself while running only a slightly greater risk than most people of setting fire to the house.

None the less, living with a minor brain injury is something that hard to truly describe because the problems caused by the brain injury present themselves in a million different ways, every moment of the day. I have had to learn some compensation techniques. I am rigidly organized and need everything in its proper place, all the time, or I can not make my surroundings make sense to me visually. What has been long believed to be a form of Obsessive Compulsive Disorder that I exhibit is now thought to more likely be long ingrained habitual technique of having everything where I can locate it. Alarms and Outlook Calendar alerts ring in my ears and flash before my eyes all day long as my only mechanism for ensuring that I make it to the meeting, the appointment, the party I am expected at. I constantly call my own voicemail extensions and email myself reminders of things I have to do, as if I don’t find a way to remind myself the second that the memory presents itself to me, it is unlikely that it will return again until after the reminder will be able to do me any good.

Carrying a note pad and pen is next to useless. The notepad does not jump up and down and remind me to look at it.

I am often laden down with awkwardly filled pockets and by carrying envelopes in my hands that will easily fit in my bag. If I don’t make myself uncomfortable with the item that I need to deal with, I will find it happily nestled in my bag one week after I was supposed to mail it, deliver it, or return it, despite the fact that I have gone into my bag countless times during that week and never acknowledged the item’s presence.

There are some safety concerns. I generally remember to turn off the oven (just a couple of slip ups thus far), but whether or not I’ll turn off the curling iron is anyone’s guess. Anything that I begin that that does not make itself a habitual compulsion, but rather relies on my short term memory to see to completion, invariably ends up with unpredictable results. Moreover, while husband and my cat have never miss a meal, no plant has ever made it out of my house alive.

One of the hardest things about living with a minor brain injury, however, is the trouble that the injury causes on the inside. Those parts of my brain that are not effected by my damaged White Matter Tracts have little patience for the parts that are. I feel the grumblings start to rumble inside my busy brain after I’ve made a careless mistake or have just spent thirty minutes in the grocery store going over and over the shopping list because I’ve forgotten to bring a pen to cross items off it. It is a special kind of frustration to be smart enough to know how stupid you’re being.

The eventual diagnosis of minor Traumatic Brain Injury due to Electrical Injury was not without a fair amount of irony. By the time I was diagnosed, I had been working in the field of human services for many years, assisting people with mental retardation and Traumatic Brain Injuries in residential settings. I possessed a wealth of information about brain injuries and the randomness of their aftermaths from my experience in the field, but I never thought to investigate the possibility that my cognitive problems might have been caused by such an injury. The accident I sustained as a child had, at the time, appeared to have left me unscathed.

Traumatic Brain Injuries are unique in their challenges, both for the injured person and for the doctors attempting to help the patient to navigate their way through the elaborate maze of their brain. I am fortunate that my brain injury is relatively mild, that I have a phenomenal support system and incredibly smart and creative doctors. None the less, it is a challenge every day. The randomness of brain injuries, no matter how small, make for some very uncommon difficulties. If a person presents as intelligent and capable, than when they are unable to remember things that you have told them, or if they regularly forget or run late to plans that you have arranged, it is easy to become insulted and frustrated.

As I mentioned earlier, the electrical injury I sustained as a child was simultaneously catastrophic and insignificant. In the greater scheme of things, the catastrophe was insignificant. In the day to day, the insignificance of the accident was catastrophic.

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