[QUOTE=_Ash_;1109707]

"On the headway site they take this approach saying that the level of trauma does effect the extent/duration of symptoms that follow."

Of course, this is generally true. For example, the longer one is unconscious, the worse the prognosis. However, the story is a bit more complex and, frankly, baffling.

In some instances, people with very profound injuries make much more complete recoveries than those with seemingly mild concussions. Why? No one has a definitive answer.

Part of it has to do with "hold skills." Patients tend to retain more capacity than expected in areas where they had a lot of practice premorbidly.

In my case, testing indicated very significant damage to the parts of my brain controlling language. In fact, it was so bad, the neuro-psychologist couldn't believe I was conversing with her.

Now, that's not to say that I don't have issues with language (aphasia, apraxia, etc...), but I am functioning well above what would be expected. Why? Because I was a professional writer before I was injured. Those areas of my brain are overdeveloped. I can mask, pretty well, the fact that I am struggling for words because I know a hundred synonyms for everything.

On the other hand, my French, which I used sparingly, is gone.

I also have a frontal lobe that was described as "mashed potatoes." Yet, while I do now have anger issues, I am not, as might be expected, an amoral serial killer. Why? Because I was a very calm, gentle person before. Someone with a far less damage, but with a pre-existing tendency to impulsivity, might behave far worse than me after TBI.

Who we were before, seems to matter in TBI recovery.

On the whole, educated TBI folks, with high IQs, do best. Why? It's probably a combination of excess capacity and a receptivity to learning that makes them more diligent about therapy and better at devising workarounds that mask their deficits.

Ironically, while high achievers tend to have the best practical functioning after TBI, they are more inclined to suffer mightily psychologically after injury. Even though some of them are still testing intellectually above most of the general population, they feel the huge gap between the capabilities of the old and new them.

This is a long way of saying that what is really important is how the injury is actually playing out in our daily lives.

For example, if your injury is significantly undermining your ability to comprehend numbers that might not matter much if you have little real need to use math. On the other hand, if you're a cashier, accountant or physicist, even a little damage in this area could have far reaching consequences. See what I mean?

The important thing is to have neuro-psych testing, identify your particular deficits and then concentrate on addressing the ones that most undermine the quality of your daily life.

What matters, above all else, is FUNCTION. How can I improve what I need to improve? How can I adapt to do the best I can do with what I've got left?

In the early stages of TBI, it is natural to think a lot about the incident that caused the injury. As one progresses through the healing process, the less important that becomes. We learn to forget could have/should have/would have and focus on moving forward with our lives. What matters is not where/what we have been, but where we are going and who we are becoming.

Yes, it's hard. TBI can be such a profound, life altering injury. When I was diagnosed with TBI, my doctor told me I would have been better off losing both my legs. She was right.