Traumatic brain injuries are like snowflakes, they’re all different but still the same. The way I understand TBI, and explain it, is as follows: TBI patients don’t regain their lost abilities, as much as relearn them. The section of my brain that told my right hemisphere what to do doesn't work anymore, because of the blow it took. So the undamaged parts had to learn how to direct the body's right side limbs. It's a new job for that part of my brain, and although I can now use my right leg, arm, hand, fingers etc. they don't work like they once did.
I didn't look into, or research my disabilities, until several years after my TBI, when I began writing about my experience. The frontal lobe is important for voluntary and planned motor behaviors. I was drawn to a list that describes problems associated with injury to the frontal lobe because I had whacked mine pretty hard. The list told me damage there may result in any, or all, of the following
1. Paralysis
2. Inability to sequence
3. Loss of spontaneity in interacting with others
4. Perseverance on a single thought
5. Inability to focus and express language (Broca's Aphasia.
When I woke from my coma I was certainly paralyzed, on the right side. But, I came away from the hospital able to walk with a loft strand cane; the tall cane with a strap around the upper arm, midway between the shoulder and elbow, and a horizontal handle to grasp, below the strap. My right side motor skills function now, but not like they once did. There is a delay somewhere in my circuits so I limp. And the hitch in my get along is such that I can no longer run.
They also worked to get my right arm, hand and fingers moving again. That was occupational therapy's (OT''s) primary goal. I started by manipulating large blocks, and moved to puzzles with large pieces, like my own kids had among their toys. OT deals with being productive, and I was a housewife, so they must have assumed I baked. One session of occupational therapy dealt with following a recipe, as well as cutting an apple with a sharp knife. My family thought the whole activity was crazy because therapists had me holding an apple with one hand, and wielding a sharp knife in my compromised hand! Today, I am apt to warn everyone in close proximity that I have a knife in my bad hand, and to stay clear!
I didn't look into, or research my disabilities, until several years after my TBI, when I began writing about my experience. The frontal lobe is important for voluntary and planned motor behaviors. I was drawn to a list that describes problems associated with injury to the frontal lobe because I had whacked mine pretty hard. The list told me damage there may result in any, or all, of the following
1. Paralysis
2. Inability to sequence
3. Loss of spontaneity in interacting with others
4. Perseverance on a single thought
5. Inability to focus and express language (Broca's Aphasia.
When I woke from my coma I was certainly paralyzed, on the right side. But, I came away from the hospital able to walk with a loft strand cane; the tall cane with a strap around the upper arm, midway between the shoulder and elbow, and a horizontal handle to grasp, below the strap. My right side motor skills function now, but not like they once did. There is a delay somewhere in my circuits so I limp. And the hitch in my get along is such that I can no longer run.
They also worked to get my right arm, hand and fingers moving again. That was occupational therapy's (OT''s) primary goal. I started by manipulating large blocks, and moved to puzzles with large pieces, like my own kids had among their toys. OT deals with being productive, and I was a housewife, so they must have assumed I baked. One session of occupational therapy dealt with following a recipe, as well as cutting an apple with a sharp knife. My family thought the whole activity was crazy because therapists had me holding an apple with one hand, and wielding a sharp knife in my compromised hand! Today, I am apt to warn everyone in close proximity that I have a knife in my bad hand, and to stay clear!
If they thought I could cut an apple with my affected hand, why didn't they think I would be able to write with it? I know they didn't, because they tried to teach me to write left handed, just before my release. I never came close to proficient, and no one could read my chicken scratches, but I continued my left handed scrawl after leaving the hospital because that is what I was told to do. I am, at heart, a rule follower.
My legibility never did improve, and during my 1st year home, the young son of friends visiting, watched me struggle to write notes to myself. Robert said to me, Why don’t you just try to write with your right hand?
Why didn’t I think of that? I wondered. And then I attempted to finish with my right hand. Bingo! My left hand knew how to assist the other by holding/turning the paper, and my right hand knew how to form the letters. It took much concentration, at first, but the letters were more legible, and the task was much easier than with my left hand. Over the years, I have gotten pretty good.
I can type now, too. But, to use both hands and all ten fingers is very slow and laborious. So, throughout the years, I have perfected unorthodox typing skills. Mostly, I utilize my fully functional left hand. My right pointer finger is relegated to hunt and peck, and usually hovers above the right shift key, for capitalization.
Because my right hemisphere does not work like it did previously, I have come up with tricks to use the disability to my advantage. It is most comfortable for my right fist to be closed and that arm pulled up to my shoulder. My hand remains closed, without thought, so it’s easy to hold things that are easy to lose; like the pencil you need for quick notes, correct change for the snack machine, or the keys to… anything. Nothing, and I mean nothing, will cause me to inadvertently release whatever I hold in the claw, and once there it will stay indefinitely.
Also, because my elbow is naturally bent, I can slip the handles of many grocery bags onto the hook, and as long as I even out the weight by carrying something comparable on the left side, I am fairly balanced. I guess I could say, One really does have to look for opportunities to best utilize what they have, rather than focus on what is missing, but I really was just trying to make my life easier.
Number 2 on the list is inability to sequence, and it continues to be difficult. I had cognitive therapy to deal with this. Those sessions included playing Where in the World is Carmon San Diego on the computer. I don’t forget the steps involved, as much as I misjudge how long each step will take me. It can take me an inordinately long time to do something I think should be done in a jiffy. So planning a meal where the food is ready to eat all at once, is not one of my stronger skills. I’m sure that my head injury plays into that, but I also realize that the desire is not really there. Hunger is something I rarely feel, but I do eat, and cleaning up, after the meal, is what I am best at. It’s routine.
The 3rd thing listed is loss of spontaneity when reacting with others. This was never a problem, that's how strange TBI's are. My difficulty is that I am impulsive; I vocalize what is going through my mind, at any given time. During a physical therapy session with Kyle, I looked across the room at Jim, a therapist who often assisted when more than two hands were needed. I simply stated, Jim needs a haircut, as his hair was floppy long. You could say my comment was inappropriate, as well as arbitrary, but it brought a smile to Kyle’s face, nonetheless. He even laughed aloud! Kyle told me later that my comment showed him I was finally coming around.
Next on the list is perseverance on a single thought. Although I was always driven to complete what I started, I don't find that to be true anymore. But, I think the perseverance indicated here has more to do with focusing on only one unimportant issue, and has a slightly negative connotation. All I can say about this is that I probably do it, more often than I think, and I know I still struggle with letting things things go.
The list concludes with the inability to focus and express language. Aphasia is defined by Webster’s Dictionary as …a loss or impairment of the power to use or comprehend words usually resulting from brain damage. Broca's area is in the lower part of the left frontal lobe (exactly where my head was hit) therefore it is called Broca’s Aphasia. It feels good to know their is a name for what has plagued me since 1991.
The frontal lobe controls the motor aspects of speech so that’s why, especially early on, my speech was halting, and mono tone. Speech therapy, then, was also part of my daily regimen. Once home, the daily conversations with my family provided the practice I would need to sound more normal. I spoke easily to my two young children, and later, I was comfortable talking to my fifth grade students. Even though my speech definitely improved over the years, I still hate to hear my recorded voice.
My inflection may be right, and I'm not as mono tone as I once was but I’m still a step behind verbally, struggling sometimes to find the words I want. I know the word is very familiar but I can’t locate it. I pause, as if thinking deeply on the subject when all I’m really doing is rifling through the files in my head for the simple, much-used word I need. It can feel like I’m wading through sludge trying to reach it.
Close friends, who know my history and feel comfortable with me, often fill-in-the-blank with the word I am searching for. They are not surprised when I say Can you flip that thing on the wall so that… poof? They know that I am referring to the light switch, and that I’d like the lights turned on. Or I give the a brief definition of the word just out of reach and they provide the word.
Not only was my brain's left frontal lobe damaged, the brain stem also took a shot. That's why I see double. But since my TBI, I've had two eye surgeries. When I started to drive again, I wore an eye patch. I didn't want to be caught trying to determine whether the car coming straight towards me, was the real image or not. I don't wear the patch, anymore, because now I only see double if I'm very tired or just want to.
Sometimes I like to show people my weird eyes. I cover one eye, focus with the other, then uncover the covered eye because then my pupils jump around. Both of my eyes work, but they don't work together, is how I explain it. My right eyeball does most of the work, and focuses on what I'm looking at. My left eyeball looks off to left, but it still can visualize things that are to the right. It doesn't appear to be looking at what it should be focused on until the right eye is closed. It's as if my eyes have a brain of their own, that I'm not in control of.
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