Hockey,

I would suggest playing Sudoku if you can. The mental math required is a very good exercise. It works on multi-step problems. Simple computer games like those included with Windows, Minesweeper, FreeCell, and some others work on visual perception skills, sequencing, visualization, etc.

The Nintendo DS games may track your progress, but I would not get hung up on tracking progress. Keep in mind that some of the progress noted is due to the repetitions. Other improvements are due to 'learning.' You get better at understanding the tasks and may even memorize some tasks. It is hard to differentiate between recovery of functions and learning new functions.

And, I would suggest being very open to recognize any mental fatigue. Muscles get strengthened by repeated fatigue. This is the opposite for the brain. As soon as you notice fatigue, take a break and maybe a short nap.

If you want a real challenge, check out Posit Science Corporation. They make brain exercises for the very serious. www.positscience.com. Also www.braintrain.com and www.sharpbrains.com.

The tasks that are good to work on are memory, especially mixed and interrupted memory. Memory where you have to recall in a different order and memory that is recalled after interference stimuli. Sequencing, sorting, and any efforts where you have to process the memorized items to come up with an answer. The more abstract the items memorized, the better.

David,
Regarding altitude, commercial flights other than air taxi, are required by law to maintain a cabin altitude of 8,000 feet. The airlines would not pressurize to 8,000 feet if they did not have to. Pressurization uses up jet fuel. If a commercial aircraft flew with a cabin altitude of 15,000 feet, half the passengers would pass out, especially any with heart or lung problems.

Sports at altitude, like skiing, are not even close to the same as neurological conditions at altitude. The blood can acclimate to altitude so that the lungs can better transport oxygen to the muscles. I am confused by what you mean when you said <The pressurization of the plane is far lower than sea level and the air is thinner.>

Any prospective pilot is taught the neurological effects of altitude. It is required for the FAA exams. I used the wrong term, 'vapor' pressure should have been 'partial' pressure. My damaged brain at work. SCUBA divers also need to understand partial pressure theory.

If you think that recovery is a philosophical issue, then the injury would be a philosophical injury. There are psychological components to PCS that, once recovered, make the PCS subject feel much better. The physiological components will recover better if the psychological issues are treated. Stress is a very negative factor to recovery.

The physiological components may heal to a point that, under normal circumstances, feels 100%. Put that same brain under stress, due to oxygen levels, stress chemicals, poor nutrition, illness, fever, etc. and the residual damage will become evident.

Also, there is a vast difference in the healing mechanisms of different tissues in the body. Muscle and bone tissue heal great. This is in part due to the 'remodeling' feature muscles and bones have. They lose cells constantly, as they get old. These cells are replaced with new cells. Some call this a remodeling function. It performs at all ages as long as nutrition is maintained, except for bones.

Osteoporosis is a result of this regrowth of new bone cells being hampered by hormonal irregularities and Vitamin D and calcium deficiencies. Biphosphonate drugs slow or stop the loss of the older bones cells. The women using them end up with dense bones with many old cells.

Although neuroscientists see evidence that there is some regrowth of brain cells, it is slow and not necessarily predictable. Young brains may rewire around damaged areas as the brain cells are continuing to grow and organize, sometimes until 25 years old. There is hope in stem cell therapy but it is still years if not decades away.

So, mind your brains. You were only given one. Use it to protect it for a lifetime of use. As one who has a number of brain damaged friends, erring on the side of caution is a good idea. One study suggests that as many as 60% of our prison population has suffered brain damage, mostly previously undiagnosed, such a PCS.