Compensatory strategies

Compensatory strategies is a term I first heard at the beginning of my rehab at Shepherd Pathways which is where Shepherd Center conducts the outpatient acquired brain injury program.  I had no idea what the term meant.  Of course, at the time, I had no idea what a lot of things meant.  I eventually learned they were ways to help us survivors work around or “compensate” for our deficits.  I learned some strategies in speech therapy that were meant to help me deal with my memory loss issues or as we call it, things falling out or not sticking in the first place.  Those strategies would have been far more effective if I had not had the bullheaded idea that I had never needed strategies before so why should I need them now.  That was just one of the obstacles that made these fantastic tools my insurance company paid a lot of money for me to learn not as effective as they should have or could have been.

The effectiveness of compensatory strategies depends on how the survivor and their support system look at them.  My memory was one of my greatest assets all through life prior to my injury.  My head was and when it comes to long term memory, still is full of what Bonnie calls useless information.  I like to think of it as a collection of Jeopardy answers.  I knew all our family birthdays and anniversaries.  I knew all the vital statistics about our children’s births; date, time, weight and length.  Lots of things stuck and not all of them were useless.

On a serious note, one of the above mentioned memories was the one that made me first actually realize I had a problem.  Bonnie and everyone else had been aware for weeks but this one hit me like a brick.  We were at Grady Memorial for a follow up exam on the braces that held my jaw together.  After the exam, I was at a desk where they were scheduling my next appointment and the date selected was August 14th.  I knew there was something special about that date but could not remember.  I looked at Bonnie with what must have been a lost puppy expression and asked what happened on that day.  She said “It’s Bryan’s birthday”.  I had a sick feeling and when we got to the elevator to leave, I completely lost it and cried like a baby for several minutes.  How could I forget my own child’s birthday?

Enough rambling about me, I’m supposed to be rambling about compensatory strategies.  Using compensatory strategies requires a level of discipline and consistency.  Discipline is not always a strong suit of tbi survivors; at least I know it isn’t for me.  Sometimes that discipline comes from other people.  My wife, Bonnie, helps a lot but she sometimes gets tired of telling me the same thing over and over.  The doctors and therapists emphasize it but they are not with us 24/7.  At some point, if we survivors want to live functional and useful lives, we have to make the effort to take charge of our future.  This has to be done daily since, like Bonnie says, I and most other tbi survivors wake up in a new world every day.

We live in a time when technology can be used to implement compensatory strategies.  Smart phones, computers and gadgets like timers can be used to keep us in touch, up to date and on time if we implement them properly.

Here is a list of Compensatory strategies my Speech pathologist at Shepherd Pathways gave me when I finished Rehab.  Like I said earlier, these are only effective if you use them consistently so read them and use them.  By the way, the strategies are not just good for brain injury survivors but anyone who wants to be more organized and efficient.Compensatory1


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Memorial Day


I am retired from the US Army so I know Memorial Day was established to honor veterans of the US Armed Forces.  With that said, though, this year I have done what most of the rest of the country had done and applied my own twist to celebrating Memorial Day.  Mine is not as commercialized as most and actually involves memorializing people I have known, some Veterans and some not.

Bonnie and I visited many of the cemeteries where members of each of our families are buried.  We traveled with her parents to some and went by ourselves to others.  We listened as her Dad told us stories about his memories of times spent with those whose graves we visited.  Some of the stories were of good times and positive experiences while others were of tough times and hard work.


Ma and Pa Grave

The grave site of my maternal Grandparents who raised me from the time I was three years old.  I owe them everything.

We spent some time with a close childhood friend who has many family members in a cemetery where I also have two brothers.  We reminisced over the fun we had growing up and some of the not so smart things we did.  We mourned the loss of people who were with us through all of those good times.

I stopped by the home of my older brother, Mike whom I probably hadn’t seen for close to forty years.  We talked about the loss of our brothers, mother and father and about losses caused by time, bad decisions and misunderstandings.  The decisions and misunderstandings, sadly, contributed to our not staying in contact.

Another loss reflected on is my own due to my accident but I look at that from a few different perspectives.  Yes, I lost some functionality and handle things differently now but I’m happy with where I am.  The changes caused by my tbi have more impact on those close to me and you can read about them in my post “The Other Victims”.  My injury caused me to look at things in a different light.  I try to be more concerned with things that really matter now.  When you almost lose it all, you realize there are a lot of thing in your life that are not all that important.  I have to be honest, it sounds a lot easier than it really is.

I now wonder how to best use this second chance that I have been given.  Since I am not lying beneath one of those stones we visited, how can I share the life that has been given back to me?  There is a scripture that keeps coming to mind:

3 Blessed be the God and Father of our Lord Jesus Christ, the Father of mercies and God of all comfort, 4 who comforts us in all our tribulation, that we may be able to comfort those who are in any trouble, with the comfort with which we ourselves are comforted by God.  2 Corinthians 1:3-4 (NKJV)

I used to think the only way I could live this scripture was to help those who had an injury or condition just like mine.  I guess I selectively ignored the part that says “those who are in any trouble”.  As I talked with family and friends this weekend, it dawned on me that maybe I could help and encourage people with troubles that are not related to mine at all.  Tbi does tend to make you a little slow on the uptake sometimes.  I wonder how many opportunities I have missed to encourage people with problems because they weren’t in a wheelchair or brain injury rehab.  I must be more conscious of people’s tribulations and less concerned about why they have them.  Their issues don’t have to fit neatly into my tbi box for me to care about them.  I just need to be available and willing to help whoever God puts in front of me in any way possible.

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The other victims



My family minus my grandson Sean who was riding a 4 wheeler and son in law Scott who took the picture


May 14th is the 8 year anniversary of the accident that caused my traumatic brain injury.  We survivors are considered the victims of tbi but we are not the only ones who suffer.  The other victims are almost always the people closest to us.  My wife or as I now consider her “My Angel”, Bonnie was naturally the most affected by my injury.  She had to reinvent her life long before I was even aware that mine needed to be reinvented.

We had been married for almost 33 years.  We both had jobs that were challenging and fulfilling.  The children were all doing well and living independently.  We lived in a home we both loved.  According to all of the American Dream criteria, we had made it.  I was there for her.  I worked every day like a man is supposed to and I was home every night and did whatever projects needed done.  I reached things she couldn’t, opened things that wouldn’t and did the things women shouldn’t have to do.

Well, May 14th 2008 all that changed in the blink of an eye.  When the truck pulled out in front of me, I became “Husband number two.” Gone was the strong independent thinker, the self starter, the multi-tasker and the master problem solver.  What was left was a babbling idiot who gave his boss the finger when he came to the hospital to see me.

Bonnie has always been the perfect example of the devoted wife and mother who takes care of everyone else before thinking of herself.  Just as it looked like we had time and opportunity to focus on us, the accident happened.  I went from being one of the few things she didn’t have to worry about to the thing that now required her constant attention.  The fact that I survived is nothing short of a miracle but that miracle became her nightmare.

Our oldest son, Mike, had his own adventure because of my injury.  It started while I was still in the hospital when his boss refused to give him time off to visit.  Mike, being Mike, told the boss he was heartless and walked out never to go back.         The first few days when it was still touch and go, Mike told Bonnie he didn’t care if he had to sit and feed his dad mashed potatoes, he just wanted him to survive.   Mike says he was immediately ready to step up and be the “man of the family”.  He was very glad though when I was making progress early in rehab because he already knew he wasn’t ready to be walking around in those shoes.  After I came home from the hospital, he moved into our guest house and started doing everything he could to help Bonnie around the place.  Another issue for Mike was that his coping mechanism at that time was drinking which intensified after the injury.

Bryan our youngest, was in the Navy and stationed in Okinawa, Japan so his experience was different.  Since the injury was not considered “life threatening”, the navy would not reassign him stateside.  He was away for most of my recovery and came home to the new me.  He had been gone nearly two years before the injury and didn’t get discharged until almost two after the injury; he didn’t experience the sudden change or the slow recovery process.  He just knows the accident took a piece of me away from everyone in the family.  He had been under some stress already in the Navy and had begun to apply the sailor solution which comes from a bottle.  This of course got worse after my injury.

Our daughter Amy is the most emotional one of the family and when I asked her to tell me about the impact of my injury on her; I got a lot more information than I got from the boys.  Even eight years later, it is all still very raw and real to her.  Here is what she had to say:

“I dialed the number that I found on the accident report. I was nervous and angry and I needed to be heard. He wasn’t home when I called. His mother answered the phone. He was out getting his tux for prom. His tux??? For prom??? How can he even think about prom???

That was one of the times I completely lost it. It was months after dads accident…but that was the night I officially let everything out. A complete stranger, that’s who I shared my most private thoughts with.  I remember crying uncontrollably saying that her son took my dad from me. I told her that her son had taken my children’s Papaw from them. That because of her son my kids would never know the man I knew. I don’t remember what she said but I remember thinking that she handled me and my meltdown fairly well. (I’ve let that anger go and forgiven since that night).

That wasn’t my only meltdown… There have been plenty. The first was the first night in the hospital. They had gotten daddy to a point in the trauma unit that he was ready to be moved to ICU. He was still unconscious and if you didn’t know him like me you wouldn’t have been able to recognize his face. Mom had stepped out to make a call and I sat there holding daddy’s hand. I had taken on the role of “the strong/together one” since the call came that he had been in an accident. But we were alone and as daddy’s girl I was hell bent on getting my way. I leaned over and put my head on his chest. The tears came and I couldn’t stop them. I remember clinching that awful hospital gown and screaming at him to wake up. I was pushing his chest and I remember how my tears just faded into the thin, faded fabric of his hospital gown just as quickly as they fell. This man who had been my hero my whole life wouldn’t even open his eyes or squeeze my hand. I screamed at him…I screamed that he wasn’t done yet, that he was being selfish, that I needed him and that it was time to wake up. I screamed that he had to be ok. I screamed that I wasn’t going to let him give up. And then I just fell over onto his chest and held him. I was drained.

This whole journey has been like nothing you could ever be prepared for. Your whole life is spent a certain way. You know people as they always were, you have expectations, you have memories and you have plans. And then…you just don’t. It’s the most terrifying and frustrating feeling in the world. For the first year after daddy’s accident it was so hard. Have you ever had that “homesick” feeling? Where your stomach just seems to drop and you get scared and everything feels so unsure and strange. I lived with that feeling everyday for over a year. I was trying to be a lot of things to a lot of people and it’s one of those situations where you just don’t get that sense of accomplishment. I needed to be strong for my mom, I needed to help her any way I could. I was trying to be there for my dad but that man wasn’t my dad. It took time, therapy, treatments, doctors, hospitals, and never ending love. Some days I wanted to slap him, some days I wanted to cry with him and some days I think we all just felt defeated. But through every bad day I always felt grateful beyond words that my dad was still here. He survived. And I did too. It took a long time for me to accept that he isn’t the same as before the accident…a really long time. But different isn’t always bad…just different. Guess that’s just life when your dad ends up “eating a truck” for breakfast.

If there is a down side to being dependable, it is that you are, well, dependable and an injury like tbi shows this by how quickly things change.  One minute you are there for everyone and the next, you aren’t there for anyone including yourself.  Tbi creates a situation overnight that would take most people years to plan for.  My family met this monster head on and didn’t give up or run and hide.  I am very proud of each of them for giving their all.  I tried my best to get better as I became aware of my injury and the deficits it created.

This many years out, we are all in the moving on process.  Bonnie and I have moved back to West Virginia to be close to her family and help as her parents get older.  We are remodeling a house there.  In a way, the injury made that possible since I am not working anymore.  Mike has moved on to a new job building cars and is now an avid mountain biker.  He has finally given up drinking and smoking.  Amy and her family have moved to another city where she manages an auto repair and tire shop.  Imagine my “little girl” slinging tires and turning wrenches.  Bryan is out of the Navy, married and they are doing their own home renovation.  He is also a worship leader and musician/singer at his church.

I am so blessed to have a wonderful family to support and be there for my recovery.  I love them all and am extremely proud of them all.  I thank God every day for placing me in the company of these wonderful people.  They say you can’t pick your family but this is the one I would pick if I were given the choice.

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The Other Side of Recovery

Rehab is a very challenging process and doubly so for someone with a brain injury.  Not only do you have to do cognitive therapy to stimulate the brain but physical therapy PT is almost always a necessary part of rehab.  It was in my case due to other injuries and post-traumatic vertigo, PT was a large part of my rehab.  Some of the things they have you do in PT don’t seem to make sense especially to a person with a brain injury.

During the family day visit at Shepherd Pathways, we walked into the PT room and the therapist, Beth Ditrich, simply said “Let’s get started.”   I sat down on the side of the therapy table and immediately fell full force onto my right side.  My daughter, Amy looked at me with eyes wide open and said “What the hell are you doing?”  The move was part of the vestibular therapy designed to help my inner ear issues that resulted from my head hitting a truck windshield at approximately 50 miles per hour.  This therapy was very effective and along with other things like keeping a balloon in the air while walking around the room helped me get back to walking a straight line and eventually playing basketball again.  It was strange but extremely beneficial therapy.

Speech therapy was by far the most grueling part of my rehab.  It felt like I was back in high school English class.  I didn’t like it the first time and at times, I liked this even less.  I was determined to get better so I tried my best to apply myself.  That was not like high school.  As I mentioned in my earlier post about the role of music in my recovery, my speech pathologist, Karen Patterson, introduced me to the listening program.  This used classical music as therapy.  That’s not exactly what a guy who grew up on 70’s rock wants to listen to.  I saw immediately that my thinking was clearer and I was calmer.  Once again, therapy was very effective though unconventional.  Doing papers and other exercises in speech therapy gave me confidence that I could communicate using the written word which eventually led to a few published articles and starting this blog.

By far, my favorite part of rehab was occupational therapy OT.  When you hear the word occupational, you tend to think job related but that’s not really what it is.  OT actually is focused on the things that occupy your time all day from waking up to going to bed.  Paula Miller, my occupational therapist, started by going step by step through my daily routine in minute detail from showering and brushing my teeth to driving to work to cooking dinner and getting ready for bed.

This is the therapy where we worked very hard on driving skills.  During my first few sessions, I failed miserably on the simulator.  My reaction time was at least a half a second slow which needed work.  I also had judgment issues resulting in running over cars, curbs and people which are not particularly acceptable in the real world.

What I enjoyed the most in OT was working with power tools.  Before the injury, I did woodworking as a hobby and wanted to be able to do that again.  They had to make sure it would be safe for me to operate machinery capable of severing limbs.  My wife Bonnie was all for that idea too.

My hope was to resume the hobby of woodworking in my spare time but when it became apparent I would not be able to continue my career as a computer engineer, it became a far more important to become proficient at building things.  Since completing rehab, I worked very hard to develop my carpentry and woodworking skills and have completed many projects for our home and several other people.  Some projects were a little over ambitious and I needed my son Bryan to help but most have been within my capabilities.  I now help him figure out how to do his projects.  Building and woodworking are actually very good exercise for a damaged brain.

Folding Table

Laundry room folding table

           The rehab process may seem daunting and feels like it takes forever but in the end, it will prove extremely valuable.  As you move forward, you will feel like you belong and are genuinely providing a contribution.  Hang in there and give it all you have.

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Random Thoughts on Awareness


brain_injury_awareness_month_round_stickerThe date of this post is March 16th, National Brian Injury Awareness day 2016.  That brings to mind different types of awareness that apply to brain injury.

The survivor’s perspective is unique to the individual.  There is the awareness or rather lack of awareness that most of us have early in the recovery process.  Our focus if you can call it that is simply getting thru the next minute.  My new reality is an extremely shrunken version of my old world and it contained a population of one.  It has eventually broadened but still shrinks back sometimes as fatigue increases.  How quickly improvements take place is influenced by any number of factors, some under our control and some not.  They range from the type and severity of the tbi to family members and friends reaction the injury.  Insurance coverage has far more to do with outcome than it should.  Another factor is the availability of quality medical facilities.

In my case which is the only case I can talk about from first hand experience, I became aware of things that had changed, which are referred to in our world as deficits, as I tried to do things.   In a way, this gave Bonnie an awareness of a serious deficit in that I didn’t try to do much of anything.  They call that self motivation initiation.  This lack of initiation made recovery a slower process than it could have been.  Some tbi survivors have to be told to slow down but in my case, I need a few kicks in the pants to get started.

Another random thought was brought to mind when I heard about Todd Palin’s snow machine accident, similar in a way to my accident.  What I heard most in the reports was about all the broken bones and physical things that need fixed.  The focus on me at the trauma center was how to fix what was obviously broken.  Titanium here, stitches there screws and pins where needed.  They did point out that there was some bleeding on the brain but it was not the primary area of focus.  I live in a very small rural town in West Virginia where I see people young and old riding 4-wheelers and dirt bike everywhere even in town and most of the time, they don’t wear helmets.  That’s not ok for anyone but when 2 children are on the back of an ATV with no helmets, someone needs to get dad’s attention.  My trauma center was Grady Memorial in Atlanta.  It is one of the best in the world but there is nothing around here even close so it scares me to think how much attention a closed head injury like mine would get around here if any.

Enough of my rambling focus on the negative.  What survivors and caregivers do with their awareness of deficits makes all the difference in recovery.  I chose to focus on things important to me and try to make myself the best “Husband #2” I could be.  I have been around many tbi survivors who have a negative “victim” outlook and never try to make their situation better.   Some of that has to do with the support system or even the absence of any support system.  I would like to find some ways to help survivors who weren’t blessed with an angel and good insurance get the help they need and deserve.  Any suggestions would be greatly appreciated.

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Laughter: The best medicine

Experience has taught us something that could help most tbi survivors and caregivers.  It is often more comforting to laugh at a situation rather than cry.  While it is easy to feel sadness when a survivor does things completely out of character and you know something is very wrong, finding humor in the moment can make it more bearable.  Don’t laugh to the point of ignoring it but don’t cry so much that you let hopelessness set in either.

We or I should say Bonnie and the kids, started seeing this during my week stay at the trauma center.  When the nurses would come to the room and have me walk anywhere for a procedure, I would go over and put my hands against a wall with my feet back and stretch like I was getting ready to run a marathon.  Quite strange since I hadn’t ran seriously in years.  They would ask Bonnie “What’s he doing?” and she would just laugh and shrug her shoulders, just as baffled as they were.

As a self-taught caregiver, Bonnie never knew when these things might happen; she was often caught off guard.  About a week after     I got home from the hospital, I was at the sink getting a glass of water.  I had my fingers under the faucet and said “hot” much the same as a three year old might.  I stood there a little while longer with my fingers still under the faucet and said “hot” again.  Bonnie came over and moved the lever to the cold position.  I then filled my glass with the new found cold water and said “I’m a dumb-ass”.  She still laughs a lot about that.

The long term effects can be very disheartening as you look for continuing improvement.  They can also be an interesting source of humor.  My working memory was affected by my injury so I can’t keep many things going at the same time.  To this day, this very day, it can take me a full day to drink a cup of coffee.  I will put it down, get busy and not notice it till it gets cold.  I’ll heat it back up in the microwave, get busy and Bonnie will find it in there two hours later when she gets home.  We just laugh about it then I heat it back up and finish it.  Nothing hurt but a little wear and tear on the microwave.Coffee Cup

Any of these situations could have been devastating had we let it. Brain injury can try to drag you down and keep you in the dumps but if you find the humor and share the laughter, what seems at times overwhelming can be a lot more a little more tolerable.

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My unfair advantage

I haven’t posted anything holiday specific so this Valentine’s Day will be my first.  I want to talk about my unfair advantage in my TBI recovery, my wife and angel Bonnie.  My Valentine. I must admit I feel guilty because I know not everyone is blessed with someone with her love, patience and determination helping them along.

My injury was a closed head injury; I had no long term coma and was able to talk in what appeared to be coherent sentences, at least to everyone but my family.  Because of that, the hospital did not refer me to rehab and would not have even referred a neurologist had Bonnie not insisted they give me some type of mental check.  Kind of like a football team not doing a concussion check.  She knew something was very wrong and wanted to know what to do for me.  She kept looking for help and guidance after she took me home from the hospital.  She asked our family doctor and got the “he looks fine to me” response.  The first neurologist office was no help but the second tried some things and said she could not test me properly but knew who could. She then referred us to the Shepherd Center in Atlanta and that was the real beginning of my recovery.  That was two and a half months after the injury.

Before we got to Shepherd Center, Bonnie had to figure out on her own how to be a caregiver.  I had absolutely no motivation to do anything.  I would set at the table and stare at the plate of food in front of me.  She fed me for a few days but finally got tired of it and decided to see how long I would sit there before trying to feed myself.  After a few minutes I finally picked up the fork.  It was always a guessing game as to when to do things for me and when to push me to do for myself.  These are things therapists go to school for years to learn.

Bonnie’s journey has been far more challenging than mine.  We survivors are very self-focused but a wife, mother of three and grandmother of four doesn’t have that option.  Being a caregiver is just another task on a list I could never handle without a brain injury.  Without her tireless efforts and unbelievable patience, there is no telling how my recovery might have gone.  This is one of the ultimate examples of the parts of the wedding vows “For better or worse” and “In sickness and in health.”   I thank God every day for blessing me with this angel who is the biggest reason I have made it this far back.  I love her with all my heart.

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