Rest is an Action Word (VIDEO – TBI Rockstars)

TBI Rockstars strike again! This time we’re talking about rest being an action word. I touched on this in my Five Things I’ve Learned from PCS post, but it bears expanding upon.

Rest is an action word. Really. I make choices every day to support my healing. I need to make choices every day in order to continue to heal. That’s how it works. I am the master of my fate. I must choose what I do and – sometimes more importantly – what I do not do.

I didn’t learn to rest gracefully. Nope. Not at all. In fact, I fought my body and brain limitations every step of the way, insisting that nothing had changed and that I could still meet all of my commitments and responsibilities in the same way I did before my first concussion. But that wasn’t true. And, eventually, I had to admit it. Unfortunately, because of that denial, I am much worse off cognitively and energy-wise now versus if I’d acknowledged my limitations from the beginning and worked within what I could actually do. Plus, it has increased my healing timeline exponentially.

Don’t make the mistakes I did. Save yourself a lot of time and aggravation, and adapt to your new circumstances. They aren’t fair, they aren’t fun, but they are what is true right now. Denying it, fighting it isn’t going to make things different. My friends, I give you permission to rest and to create a life that matches what you need and what you can do now.

Check out the newest TBI Rockstar video below. Blessed be.

 

For those who don’t see the video, the direct link is here:

https://www.youtube.com/watch?v=xai_kRwFoe0&pbjreload=10

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Learning Comics

“Nope. That doesn’t look right.” I say out loud to myself. I grab the eraser and begin again. How does a table look from the side? What parts are actually visible? I concentrate and imagine a folding table. Okay. A line here, two lines parallel. And the top of the table looks much narrower than it actually is, when seen from the side.

I sketch, erase, and sketch again. Eventually, I get it. It looks right, or right-ish, certainly as right as I can get it now.

I put down my pencil, mentally tired. A new part of my brain is getting a workout, and I can feel it. I’m not a particularly visual-oriented person, so it’s a stretch to try to recreate reality on a piece of paper.

Or, not reality. A facsimile of reality, a caricature of reality. I’m not drawing reality. I’m drawing comics. It is definitely fun! And it is my relaxation, my calming activity before bed right now.

It was back in 2015 when I first thought about comics and me.  I realized how concise, how clear a visual might be in conveying my experience. Can a 1000- or 1200-word blog post be summed up in a few frames of comics? Sometimes. Sometimes not. But I know computer use is hard for many people after mTBI, so maybe I could reach a broader audience with something quicker and easier to digest. Wouldn’t it be great to make my words, my message more accessible to people?

Like many great ideas, I have been slow to implement. There just isn’t a lot of extra energy lying around these past handful of years. And, I have had this one problem. A big one. I can’t draw. Whoops!

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Of course, everyone can put pencil to paper. The finesse, though, isn’t anywhere near where I want it. A house, an airplane, and a bagel, for those curious.

 

The task of learning to draw felt overwhelming, impossible. And, in some ways it is. Years and years of practice are needed to draw well. But since my initial idea, I have seen the wide variety of drawing skills displayed in comics and realized – there is room for me. I don’t have to draw well, I just have to draw well enough to be understood.

In my slow crawl towards comic making, I did buy a book – a very helpful book – How to Draw in 30 Days back in 2016. This was a great choice for me. The writer provides step by step instructions on specific images so even if you don’t have any particular talent, if you follow his instructions you end up with stuff that looks pretty good.

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Case in point.

I didn’t finish the book – I’m not even close, still, in 2019. And 30 days? Hah. I knew I wasn’t going to do anything in 30 days. Speed is not an option in my life, particularly when learning is involved. But the parts I have completed taught me important stuff that has slowly, slowly sunk into my skull.

During a fit of winter inspiration, I decided taking a class about comics is my next logical step. So. I signed up for a graphic novel class with a local art organization and started it two Mondays ago.

There are some roadblocks to me being successful. It is at night (sad face). It is in a building that does not have walls that go all the way to the ceiling, so you can hear just about every word of the class next door (even bigger sad face). The HVAC system rattles and moans like a monster all evening (sad face). The class runs 2 ½ hours (worried face). I want this, though, and the class isn’t offered during the day. So I took a big hit of caffeine, rested during the day, and made it there.

I learned things. First, that I am likely the worst drawer in the class. I expected that, though. More importantly, I learned how fun it is to explore comics in a group setting, with a great teacher, and to be exposed to all sorts of new ideas and interests. That, for me, is 100% worth it.

It was during class that I felt – yes, felt – a new part of my brain engage. This whole other part of my mental capacity that I didn’t even know existed crawled out of a closet in the dark recesses of my mind, brushed off the cobwebs, and became completely engaged in learning. A strange sensation.

And now I’ve been drawing. Last week I drew three comics. This week, I hope to draw three more. I’m making progress. Any skill requires practice. The more I draw, the better I will become at drawing.

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I’m rather proud of last week’s drawing of my hyperbaric chamber.

One big downside. I expected to be tired after class. Of course, right? It was at night and is a new environment. What I didn’t expect was to be deeply core exhausted the next day. And only semi-functional the day after. And for about three more days after that I could tell my sparkle had been seriously dampened. That new part of me I used during my class was completely worn out. No stamina yet.

But I recovered. Luck is with me, and my class was canceled this past Monday, so I’ll have a full two week break before attempting it again. This time, I’m clearing my calendar the day after. But the reality is – most likely – it won’t be as bad. The first time doing something new is almost always difficult. The next time can be the worst, or a little easier. By the third time, almost always, it becomes more manageable. Over time and repetition, any situation becomes less draining.

That is the beauty of an adaptive brain. This class is a little outside my capacity, even with caffeine and rest and everything else. So, I will plan accordingly, put in place the accommodations I can, and keep at it. With time, it won’t be so hard for me to attend. It will become, if not easy, then doable. My ability to cope will improve. It is inevitable. It is inevitable.

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Five Things I’ve Learned From Post Concussion Syndrome (PCS)

Friday marked my five year mTBI anniversary. It’s been five years since I hit my head playing roller derby and got a concussion (details here). Symptoms from that concussion and another mTBI haven’t disappeared. Yet. Every day from January 25, 2014 until today I’ve had to deal with physical and mental fatigue, impaired memory, and a whole lot more.

I don’t want to talk about my symptoms or injuries today. I want to talk about what I’ve learned. Perhaps it will help you. Perhaps you have things you’d like to add. Feel free to post in the comments section below. For those newly injured, check out 10 Things I Wish My Doctor Had Told Me About Mild Traumatic Brain Injury (mTBI).

Now ~ drum roll please ~ my list!

Five Things I’ve Learned From Post Concussion Syndrome (PCS)

1. The Brain Rules

I’m not talking about my mind, about my thoughts, ideas or feelings. No, I’m talking about my physical brain, that organ that makes almost all other functions possible. It wasn’t until after my first concussion that I began to appreciate how important the brain is in every aspect of my life.

That great head for numbers I use to have? Well, I still have that affinity, but I no longer have the memory to hold 132 and 259 in my head long enough to add them together. Or how about my physical strength and fitness I was so proud of during roller derby? Pretty worthless when lifting a gallon of milk gives me a headache that lasts for days and plunges my thinking into a deep fog. Or how about my innate efficiency that allowed me to work faster than anyone else I knew? Turns out that skill was based on having lots of brain power available to use. Now there isn’t extra available, so speed and efficiency aren’t even a possibility.

The brain is important. My brain and how it is functioning each day is important to what I can or cannot accomplish. Hell, it determines what I can or can’t think. So. I must make healing, protecting and supporting my brain my #1 priority.

2. Rest Is An Action Word

You think it’s easy to rest? It isn’t. Slowing down when all you want to do is live a normal life? Extremely unpleasant. I promise you.

Resting is about making active choices to support my healing. It’s not just about laying on the couch and watching the birds, although that is an important part of it. Resting requires redefining the limits of my life to reflect my current reality.

I tell you, I fought changing my expectations of myself for years. I didn’t (and don’t) want to be impaired! Maybe if I denied it long enough, it would go away. Well – spoiler alert – it didn’t. And so finally, I had to deal with it. I shrunk my life until what was expected of me, what I expected of myself, fit with the energy I had available. That allowed me to finally stabilize my symptoms. And slowly – oh so slowly – it has allowed me to regain function and increase my energy.

Every day, I actively make choices of what I will or won’t do with my extremely limited energy. Most of the time, by focusing my energy on what is most important to me, I feel satisfied by my day. I may not have control how much energy I wake up with, but I can choose what I do with it.

3. Most Things Can Wait

Turns out, most things in the world can wait. There is actually very little that can’t wait a few hours, a few days, or maybe even a few months or years. Really. Since my energy is so limited, in order to have enough energy to make the most important things happen, other things have to wait. Or, perhaps, don’t need to be done at all.

It’s an enlightening shift of perspective. I put things I want to remember to do on my calendar. If I don’t do it one week, it moves to the next week’s calendar. After something has been on my “to do” list for weeks or months I realize – I’m just not going to do this. Either it’s not important enough, or it will take away energy from what is vital to me, or it is just too hard. So I drop it off the list, forget about it, and move on. So many things clamor for my attention, my energy. If something isn’t yelling loud enough or my heart and mind don’t want it enough, I let it go. Turns out, the world doesn’t end.

4. Adequate is Enough

Pre-injury, I had high standards. High standards for my behaviors, my work, for how I showed up in the world. Post-injury, that just isn’t possible. Life is a lot more haphazard, my functional level varies widely, and I don’t have enough energy to do… well… much of anything.

So, I stopped trying for the A+. Instead, I go for adequate, for the participation award. I don’t want to waste energy trying for something that is unreachable now, or that is only reachable at the sacrifice of all my energy for the day. It’s a better investment to set the bar low enough that I can always jump over.

Post mTBI, going out at night, driving somewhere, and showing up at a mixer, a housewarming party, a dinner is challenging in and of itself. I can’t know how well I’ll function once I get there. Will I be able to follow a conversation in a room full of voices? Can I think of a question to ask a friend to start a conversation? Will I be able to access my past fast enough to carry on a conversation about this place or that place I’ve lived? Maybe, maybe not. So I decide beforehand that being there, standing there with interesting people, listening, with a glass in my hand – that is success. Someday, I will probably be able to do better. Now, adequate is good enough.

5. Life Can Be Satisfying

Not to get too hallmark greeting card on you, but this is true. For a long time, I wondered – how can my life have meaning when it is so small, so limited? My big accomplishments today were making dinner and filling the bird feeders – how does that matter to anyone? Why do I keep going? I’ve talked to other people living with brain injury, who struggle with the same sense of limitation, and learned a few things.

Human beings are adaptable. We can adapt to any circumstance, any situation, any level of impairment. When all the purposes of our old lives are taken away, we have to find a new purpose, a new way to contribute. I had to figure out one thing I could do that mattered. For some, that might be volunteering a few hours a month with hospice or teaching kids a sport. For me, it is writing. Writing is one thing I can do that matters. I don’t know what my future holds, how much I will heal or not heal. What I do know is that as long as I can contribute to the world in some small way, I feel satisfied.

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A walk in the woods at the local park helps the winter go by faster. Thankfully, spring always follows winter.

Five years, and that’s what I’ve learned… the highlights at least. I still need to remind myself of these lessons, once in a while. Take this blog post, for example. Hitting my own deadlines is a point of pride for me. I planned to finish this post three days ago – a day early – but Mary is recovering from a concussion and needed my care. Two days ago – my proper deadline – I wrote some but had a root canal in the afternoon. Yesterday – my actual anniversary – I was exhausted and worked diligently, but my brain wasn’t able to bring things into focus. Several angry exchanges and my storming out of the house led Mary to remind me, gently, it really could wait another day. Now, with more time, caffeine, and a bit more energy, I’ve been able to finish. It hurts my pride to miss my deadline, but it turns out… hey, most things really can wait.

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Documentation

“Hey Charlie, hold up!”

I pause on my way back to the waiting room and look over. There is my neurologist down the hallway, waving me down. I loiter and watch as she juggles several files in her hands, putting down this, picking up that.

“I’m ready for you” she says as she walks towards me. It isn’t until hours later that I appreciate the deliberate care necessary to call me Charlie, when the last time we met I was still Kim. That thoughtfulness is indicative of the care I receive at this hospital.

As she passes me at a brisk pace, I follow and quickly catch up with her. As we walk along there is time to chat, to say hello, for small talk, but I’m tired from my drive. I prod my brain, but nothing comes to me. I say nothing. She says nothing. Soon enough, we arrive at the appropriate exam room and sit in our respective places.

After we’re both settled, she asks me “So, how have you been doing?”

I knew she’d ask that. How else would she start our meeting? I planned ahead and made notes about what I would say, loosely. With a briefly-lived sense of triumph, I whip out my mini notebook and look at what I have written down.

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Meeting prep and notes

Damn. I didn’t organize my notes; I didn’t put them in the order of a normal conversation. I just listed thoughts as they came to me. Not very helpful now. What goes first? What will answer her question? I look down my list and try to get my tired brain to jump on command, to find the right response. My mind only manages a heavily sedated shuffle, so I decide to start with politeness.

“Good, I’ve been good.” That’s a safe, polite response. “Some things have gotten better since that last time I saw you.” True, without being overly effusive.

Now what? Ah, here we go. “My PCP increased my thyroid dose last year, and since then I’ve had more energy. It’s really made a difference in the quality of my life, things are much more pleasant. I mean, it hasn’t fixed everything or made me ready to work or anything, but the little things. It’s helpful.”

I quickly balance that with the greater truth. The truth I try not to notice very often because it would drive me crazy, but the truth every doctor and decision-maker in my life needs to know. “I am still very limited. I have fatigue every day, every single day, that interferes with my ability to function. All my other symptoms are still around, too.”

I fear saying anything too positive from habit. Overly positive things, words denying or ignoring my limitations, are dangerous. This medical professional only sees me for 30 minutes or an hour once or twice a year. I present well – I know I do. The caffeine helps. Since I don’t looked screwed up, I have to use my words to paint a picture of my life and my daily challenges. My default, my tendency is to gloss over problems and focus on the positives. I know that. So I make a deliberate effort to tell the whole truth, both good and bad.

Our conversation flows naturally and easily. I’ve been seeing her for several years now. We chat back and forth, and I refer to my notes often to make sure I say what I have to say, and ask what I have decided to ask.

“I’m investing my extra energy into making friends, to developing friendships.” This is something that is very important to me. Making and growing my friendships now will create the stable and secure foundation I need to be healthy.

“Since upping my thyroid, I have started being able to read more complex writing. I joined a writer’s group, and most of the time I’m able to read through writer’s work and participate during the meeting… most of the time. Sometimes it’s too much, but usually I can do it.” I still struggle with reviewing 40 pages of other peoples’ writing twice a month. It’s gotten easier with repetition, but it is still hard and takes hours of my time and energy.

Overall, my neurologist seems pleased that I’ve had marked improvement. I definitely am pleased. She offers some advice on supplements. I request her analysis of several alternative therapies I haven’t tried yet. I ask her to make sure to put detailed notes in her office visit report, specifying my limitations. She kindly adds several diagnoses to my chart. Another good meeting.

As I climb into my car for my return trip, I assess my energy. Low. I’m exhausted. I woke at 3:30 am this morning and couldn’t get back to sleep. I already drove 2 hours to get here and I have 2 more hours of driving to get home. Out comes the caffeine I expected to need for the return journey. After some rest, some food, some time for the caffeine to hit, I’m on my way.

In another ten months or so, I’ll make the trip again. Not because anything particularly earth-shattering is happening at these meetings. No, I’m not going to be cured here. Rather, it’s all about documentation. Documentation, documentation, documentation. In order to continue to have the space and time and money I need to heal, I have to document and prove my disability on command. So I do.

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Dental Accommodations

I recline in the dental chair, full of anxiety. I have done my best to prepare for this event – an early appointment, 30 mg of caffeine in my system, and plenty of rest beforehand. Regardless of the preparations, though, I am still nervous. I never know how it will go, post mTBI, never know how my body and mind will handle the stress of dental work.

Today, I’m not having anything particularly big done. I’m having a small cavity filled, and a cracked tooth prepared for a crown. Both could have waited weeks, months, if I wanted them to. But – insurance. It’s the end of the December, I have plenty of insurance left, and next year I have some expensive work that is necessary. So, the more I can get done now, the better.

That all seemed well and good last week, when I decided to keep my appointment. Now, though, I actually have to do it. My experience so far, this appointment, has been impressive. A warm stone to hold in my hands, and a warm neck wrap to help me relax. A dental assistant that actually sees me and cares about my comfort. As I squint at the bright overhead lights, she offers to turn off the lights until the dentist shows up – offers, without me having to ask. So helpful.

The dentist walks in, greets me by name, and gets to work – focused, not rude. First, of course, is the numbing shot. I clench my fists as I always do, and try to keep my jaw relaxed. He says, “Do you want a hand massage while I give you the shot?”

What? I know this is a holistic, touchy-feely sort of place, but I have never heard of such a thing. But, what the hell! “Sure!”

The assistant moves down and gently takes one of my hands. She nicely rubs it for a moment, then squeezes on the headache pressure point in the webbing between my thumb and forefinger once the dentist actually pokes me. I notice the sensations in my hand, but more than half of my attention is taken up by the poke poke poking happening in my jaw. Having the dual sensations is distracting, though. “Huh, that does really help”.

“That’s why we do it.” He says with a smile. I smile back.

He leaves and I wait to get numb. And wait.

“Is your lip tingling yet?”

I hate questions like this, ones where I have to be aware of a physical sensation, judge what is going on, and then communicate it in words. For some reason, since my injury, that is particularly hard for me. I don’t know why, but it is. The sensation changes? My focus changes? I don’t know.

Now, I focus with all my might on my lip. Some tingling. I touch my lip, it tingles just a bit, but I feel the sensation of my finger. “Nope. Not yet.”

“I’ll come back in five minutes.”

More waiting. Another round of questioning. Actually, now, my lip isn’t even tingling. Another round of numbing agent is injected. Another round of waiting. Still, nothing.

“Let me get my association, Dr. M, to do it. She’s right handed, and sometimes that makes it easier to get this corner of the mouth numb.”

Shortly, she arrives. A different numbing agent. Another searching injection. Ugh. And then it is done.

“How’s your lip?” I’m asked a few minutes later.

It’s tingling. I touch it, and I have a hint of a sensation on the surface of my lip. But mostly it’s numb. What do I say? So hard to make a decision. Is it numb enough? I guess so. “It’s numb.”

The procedure begins, but first I settle my sanity-saving accommodation in place. I hate the sound of dental drills. That high pitch squealing is horrible. Everything else, I have found some way to cope with, but dental drills – no. In the handful of years since my initial injury, I have had several occasions to block out the sound of dental drills. At first, I used double protection – earplugs in my ears, then muffs over that. It works pretty good.

Last night, though, I remember what I use to do about dental drilling. Music. Loud, fun music to drown out the screech of the drill. I don’t much listen to music, since my injury, so I didn’t have any tunes on my phone. After a bit of searching, I found a solution – my old ipod! I’m glad I kept it. The workout tunes I put on there a decade ago will be just right for this experience. Even better, I can change songs and control the start/stop without actually looking at the display.

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My trusty old ipod, still kicking after all these years.

I put in earbuds connected with my ipod, then put my earmuffs on over them. As soon as the dentist starts the drill, I turn on my music. Loud. Louder than I would ever listen to anything. But almost, almost, I can’t hear the drill. Perfect.

The rest of the procedure goes well. I start and stop the ipod with ease to answer small questions or hear directions without having to change my setup. As soon as he picks up the drill, the music is blasting again. Normally such sound would be unacceptable, but in this situation, and with the caffeine flooding my system, it’s okay.

Eventually, it’s all over. My mouth is numb, then sore. When I get home, I cry in Mary’s arms because – although I made it through just fine – it is simply way too much for me. I’m exhausted.

And now, my final accommodation. Rest. Lots of rest. I have nothing scheduled for the next two days, and I can just rest and heal. Another scary difficult task made possible with rest and accommodations. At this rate, nothing can stand in my way. Blessed be.

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Rest Days

The sun glares strongly this afternoon, filling the entire house with brightness. Each of my three cats have positioned themselves around the living room so their faces are in full sun, yet they aren’t close to each other. I sit down on the couch and make a phone call, my weekly call to my mom to catch up. I, like the cats, position myself in the bright sun’s rays while I talk – or mostly listen – for the next half hour.

After the phone call, I sit for a while longer, staring at nothing. The weight of fatigue I woke up with this morning hasn’t abated; perhaps it is even heavier now. Without any internal debate, I let myself fall sideways and stretch out fully on the couch to enjoy the sun. A new decorative pillow comfortably supports my head, and my granny square blanket easily pulls off the back of the couch to cover me. I sigh and make myself comfortable.

Today is a rest day. An unplanned rest day, but a rest day none-the-less. In this iteration of my life, they sometimes just appear, are sometimes just required without warning. Five years post mTBI, I know the signs and no longer fight what my mind and body needs.

In the past, it would have been different. I would have become angry with myself, for needing the rest. I would have tried to push through. I would have felt agony about having to change or cancel my plans. I would have felt like a failure and worthless, self-loathing permeating my being at my own perceived inadequacy.

I’m glad that part of my life is over, the struggling part, the denial part. Much better, for me and everyone else, to allow and rejoice in my ability to take care of myself and to craft the life I need.

It isn’t 10 seconds after I lay down on the couch that a cat visits me. It is my old deaf cat, Eleanor. She comes and sits directly in front of my face, requesting attention and blocking my sun. She seems content to be there, both close to me and in my sunlight, but I chivy her away. I want the sun. She comes right back and sits again. As I patiently wait for her to lay down, the sun highlights every detail of her. I see each individual piece of fur shining with its own beauty, her 18 years a lie next to her determination to get her own way. Eventually, she settles, an old familiar companion, and I get my sun back.

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My girl cat and me.

I doze with no worries. And I wake to the sun no longer in my face. In fact, it’s getting ready to set – 3:45 pm. The quality of light has changed, the blues deepening and some pinks starting to be hinted at in the sky. Winter Solstice is approaching fast.

Although the nap took care of some of my foggy fatigued feelings, it didn’t help my head. I have a headache. I have had a headache since I woke. No, maybe it was since yesterday. I’m not sure. I feel like I’ve been guzzling water for days, trying to get the headache to ease. It’s irritating, but not bad enough to deal with the digestive slowdown or additional dehydration caused by using ibuprofen. Can’t fix it, so I ignore it.

I still feel no need to push, no need to move on to the next thing, no need to think. So, I don’t. For me, the key to knowing a rest day is needed isn’t only the fatigue, it is the lack of motivation. I lack the desire to do anything, to do one single thing. I don’t care about my tasks. I don’t care about my plans. All I want, need, desire, is to rest. And so I do.

Why is today a rest day? I really don’t know. I just know the need arises, regularly. Yesterday was a great day. I went to my writing group, fueled by green tea. During the lunch afterwards, I keep myself caffeinated with a soda and have a really productive talk with three other writers over a BLT. Home to rest and HBOT, then out in the evening to check out a new game night at the local library. A busy day, but not one that necessary – any more – requires recovery time. But, when I woke in this morning and felt how deeply tired I was, I knew my plans needed to change.

Luckily, I’m much less attached to any particular path of action these days, whether something happens now, later, or not at all. If not today, maybe this week. If not this week, then maybe this month. If not this month… well, maybe it doesn’t need my attention at all, or maybe it can wait until next year when I might have more energy.

My tasks, lined up like soldiers, will just have to wait.

Two mTBIs and post concussion syndrome has taught me to listen to my body. Or, rather, that I ignore the needs of my body and my mind at my own peril. Much better to rest now when I have time than to push through and crash harder and very inconveniently later. It’s better to let my body and mind lead me where they need me to go. Or, as in this case, lead me to not go or do anything. Lead me to a day on the couch, sitting here napping with my cats, waiting for the energy to pick my life up again. Yes, I choose self-care and rest. It saves me quite a bit of time and aggravation in the end.

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Lunch Time

“Okay, let’s talk about your lunches.” Mary says as she leans against the counter with pen and notebook in hand.

Immediately, I tense. I don’t like this idea. Deep in my gut, an irrational, reactive urge starts to swell. With those few words, I feel overwhelmed, questioned, challenged. I want to yell, get crazy, push back hard. My fear tightens the muscles of my back – fear of failure, fear of proving yet again how incompetent I am.

I take a breath. Not this time. I am aware of my feelings, but they don’t control me right now. I don’t have to be reactive. This is a reasonable topic for discussion, and Mary has chosen a good time to talk. It’s not evening. I’m not exhausted. I am me, instead of my post concussion syndrome.

“Sure” I say guardedly. It helps that she has been prompting me about this change for weeks. Weeks. Maybe months? I’m not sure.

“So instead of me choosing your lunch for you every day, you’re going to make a list of lunch options for each week.”

I make grumbly sounds, but I stop what I am doing and think about what I want for lunch. I can’t think and do something at the same time, not since my first mTBI.

After some silence and some staring, she prompts me. She is handling me so well. “What do you normally eat for lunch?”

“A tuna melt” I say. After some thought, “That ramen and a hard boiled egg”. She jots these choices down for me as I speak. More thinking. “I have turkey left over from Thanksgiving, enough for two servings. I could have a turkey sandwich, and I could have turkey dinner, once each.”

This isn’t as scary as I thought it would be. I’ve been having leftovers and certain lunches for months, years. It’s nothing new. What’s new is me choosing, me taking responsibility for figuring it out.

“Okay, you need one more” she says.

One more. Hmmm… “Rice! Something with rice!” I say with relish. Ever since a three-week intestinal bug in October, white rice has become my favorite favorite food. It was one of only a few things I could eat without problems for quite a while, along with bananas and applesauce. Now all three are in my top five favorite foods in existence.

I frown. “But I need a protein.” I think for a bit. Then I turn around and open the fridge, perusing its contents. Darn, we don’t have any easy already-prepared-meats available.

“You could add some beans. They’re a good protein.” Mary suggests.

“Ugh. No. I’m not having beans and rice.” I think back to an orange juice flavored beans and rice combo I made for dinner last year. It was tasty, so I made it many, many more times. Too many times. No beans and rice for me this week. Anyway, adding beans would kill that deliciously pure jasmine rice taste I am looking forward to. “I could have a hot dog. I have some in the freezer.”

I already know what Mary’s going to say, and she doesn’t surprise me. “No. Those aren’t good for you.” If she wasn’t watching me, I’d probably just have a hotdog regardless of her judgement. But, since she’s involved right now, I need an official proper protein for my last lunch.

Silence descends on the kitchen as I strive to figure out an easy protein. I’m already having hard boiled eggs, so those are out. I stare off into space as I think, try to solve this problem. Mary gives me time to think, space to struggle to solve this problem. Finally, something comes to me. “I always have more tuna than I need when I make my tuna melt. How about instead of cramming it all on the bread, I set some aside and have it with the rice. That’s a good protein.”

We agree, and the list is complete. Mary kindly puts little check boxes next to each meal. I’m to check each one off as I eat it, so I only eat each option once this week. A good idea, as I might forget what I’ve eaten, otherwise. Plus, somehow, interacting with the paper grounds me, makes the choices more real and decided, more concrete.

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This week’s meals – our dinners, my lunches, Mary’s lunches.

Another small step towards my independence. It hasn’t come easily, for either of us. Mary has been prompting me and preparing me for this moment for months, maybe years? Each time she has suggested it, I have resisted. Vigorously. Not because I feel like Mary should do that work for me. Rather, I have resisted because it feels so overwhelming, so upsetting, so heavy and unmanageable to do this task of thinking and deciding, of problem solving. There has been yelling, hurt feeling, wounded looks, woe-my-world-is-ending thoughts and plenty of crying. But this time, success. She has eased me into it. And this time, she caught me when I wasn’t already exhausted – an important key to success with brain injured people.

As this week has progressed, she’s been checking in with me regularly. “What did you have for lunch today?” she asks as she walks over and looks at my list, making sure I’ve checked off the item I ate. It’s helpful, and it reminds me to use my list regularly.

I know how this thing will play out. I have some experience with Mary’s management style… and this is one area where Mary, truly, does manage me. She’ll help me with my lunch list a few more times. She’ll keep checking on me, that I’m eating and that I’m using the list. Once she’s decided I can do it myself, it will become my responsibility. Permanently. Probably, she’ll put it on my weekly to-do calendar.

She’ll check on me periodically, but I’ll be left to my own devices. There will be frustration, and flailing, and difficulty, but eventually I will succeed. If I’m overwhelmed and foggy from a particularly rough week, she might help me a time or two. But then I’ll be expected to take it over for myself, again. Eventually, it will become routine and normal and easy for me. And, because of the mTBIs, soon enough I won’t really remember anything different. For all that it is a painful process, I like the outcome. Me, re-becoming a competent, independent adult.

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