Ski and Nitro,

One way to help others understand what your needs are and what you are going through is to explain how your brain is malfunctioning.

The simplest issue is the over-stimulation or over-attending as the medical term goes. The brain receives a vast amount of information but needs to process very little of it. It has to filter out the excess information/stimuli and direct the needed information to the proper part of the brain. This is where PCS causes a problem.

The brain's filtering mechanism is the most commonly injured part of the brain, especially in a concussion. It is like a traffic cop at a busy intersection with impatient drivers honking their horns. As it tries to filter or direct (gate) the information traffic, it fails and lets too much information through without giving it a direction to go. The result is the individual part of the brain that wants just a bit of information gets too much information and some of it is information that should have been directed to a different part of the brain.

Crash, the information collides as it tries to get processed. This is the overwhelmed feeling. It causes a cascade of other malfunctions, especially in the epinephrine/nor-epinephrine system causing a flight or fight response. Now the brain is told to speed up by the flight or fight response. Problem is, it only has first gear. It can't handle any faster speed.

The goal is to let the brain work with only first gear until it can handle second gear. The epinephrine/nor-epinephrine system also regulates blood pressure and pulse. Raising blood pressure and pulse increases head aches, etc.

This is far too much to try to tell co-workers but it can be simplified. I just tell people that my brain's filter that filters out excessive stimulation is injured and it lets too much information through, causing an overload. They usually understand this simple explanation.

I also have a visual and auditory memory problem. I explain that my immediate and short term memory is severely injured, making it difficult to follow quickly changing visual images or verbal instructions. btw, This is likely due to the gating system not processing the information correctly.

The additional problem is called diffuse axonal injury. Each brain cell (neuron) has up to 10,000 wires (axons) connecting it to other brain cells (somewhere between 10 to 100 billion brain cells). The wires become stretched, broken and tangled. This causes information to not flow consistently. Neurons heal slowly but only during REM sleep.

There is some research that indicates that the neurons can replicate over time. The problem is axons heal very slowly and you need thousands of them for each brain cell to connect to the other brain cells. It took 20 years for the brain to accomplish most of its maturing and connecting the neurons with axons. Repairing this broken mass of axons will not happen over-night.

Stress is the worst thing for this brain environment when it needs to heal. Stress increases cortisol and epinephrine and nor-epinephrine. This is like trying to put a fire hose's volume of water through a garden hose. The excessive pressure and volume will just fatigue and break the garden hose. There go a trillion axons, stretched and fatigued. Back to square one and more need for rest.

I am surprised your doctor sees you weekly. A bi-weekly visit would be more frequent than the brain can heal. I have had brain overload crashes that took longer than a week to recover from. Often, up to two weeks.

The value of a journal IMO is to observe and report trends, not daily events. It also allows extreme events to be remembered and related to the doctor, like going out and overloading when a siren or alarm went off.

I have gauged change over months time, not days or even weeks. Often, I will realize after accomplishing a task that I had not done that task successfully in months or even a year or so.

I notice the doctors prescribed "no thinking." For me, that was not possible. Instead, I moderated my thinking. Music works well to fill my mind but not stimulate thoughts or reactions. Amusement TV also works. By amusement, I mean TV that allows passive watching, not active and reactive watching.

I believe there is a rhythm that the brain relaxes to. Music with a consistent tempo and a melody that is fluid rather than chaotic is very easy to relax to. It may require trying some music genres that you consider boring. Boring is what the mind needs right now. Lyrics with gentle meanings allow you to cognitively understand and agree with can be beneficial.

My wife can tell when my mind is at rest. I will have a sense of peace on my face. If my mind is not at rest, I will have a grimace on my face. When I wake up, I will not feel refreshed.

Instrumental music may be all that the mind can handle at first. Lyrics later as the brain can handle the extra information. Foreign language lyrics work for me. I imaging the thoughts of the lyrics rather than the actual literal meaning, like "Time to Say Good Bye" (Con te partiro) sung in Italian by Andrea Bocelli and Sarah Brightman. The English translations are available online to get the gist of the lyrics.

I hope this helps you understand what is happening in your brains. Once you understand the flow of information in the brain, it is much easier to explain to others and to not feel like you are going crazy.

My best to you.