I have been somewhat out of sorts as of late and not sure what to do. I think maybe I'm in the situation where I think too much of my abilities(as well as some people around me), and then there are those that think too little of my abilities. I get caught in this "I'll show you" game. I don't think I'm winning.
To give you a little background: I'm going back to school to be a sign language interpreter. I have my voc. rehab worker and disability rights and resources workers who says that there is no reason that I can't do well in school. On the other hand, I have the counselor at school in the disabilities office who told me that she had read my evaluations and could not see how I could process the information fast enough and translate it into sign simultaneously. She took some of the classes herself and said that she couldn't do it and felt that I couldn't either. She is very insistent that I look for another path. 1) I don't want another path. 2) when you're in a wheelchair and can't do math hardly at all (good-bye computer sciences), then the options are hugely limited.

The reason this is so stressful right now is because after ASL 4(American Sign Language) you take a 30 minute interview test, if you pass it then you go on to the actual interpreting classes. That's where people tend to start flunking out. I'm in ASL 4 now and will be finished in May.

To top all of this off, I found out today that my surgery date to have the baclofen pump placed has been set for Feb. 18th. I had asked the surgeon to wait till after March 1st because the short sessions would be over and there would be a 1 week break and I wouldn't have to miss any school or go to school just 3 days after having surgery. Apparently, he couldn't swing it.

I'm sorry for the rant. I just don't know what to do. I think I may have bitten off more than I can chew but don't have it in me to give up. School is the only thing that gets me out of bed in the morning. How do I know who is correct? I just feel this is killing me.

Thanks for reading.

Phyxius,

I tried to look at your past posts. I don't see any mention of a neuro-psychological assessment. Have you had one done?

What were your visual scores? Weschler Auditory and Visual Immediate and Auditory and Visual Delayed (Short term) would be the categories.

Also, WAIS digit span would be helpful to know.

How about processing speed?

Your struggle studying suggests to me that you possibly have some processing speed limitations along with visual memory limitations. If this is true, I would think you need to work on these areas and see if you can improve them.

ASL interpreting is an intense occupation. Unless you can find work in a non-legal environment, you background and the limitations from it may prevent you from maintaining adequate work. A few problems in the legal interpreting field will be tough to overcome, especially if they are tied to your TBI history.

The need to be able to translate (major need for fast mental processing ) while listening to the words and then manually present the signs will mean three tasks at the same time, plus with a delay from hearing to signing. This last will require a strong and flexible immediate memory function.

I would suggest that you seriously listen to an occupational neuro-psychologist. They have a good understanding of how you weaknesses will manifest in a fast paced interpreting environment.

Maybe you can do some interpreting tests to see what you aptitude for different speeds and verbal accents , etc. is? I know that I have a difficult with accents. If the person does not speak real slow, I can either try to understand the meaning of their words (spoken with an accent, this is a form of mental translation) or try to understand the sentence.

The need to get your skill set to an almost subconscious level may be a challenge. By subconscious level, I mean that when you hear a word or phrase, you do not consciously interpret it but instead, it flows to the mental image that become the ASL sign. The same would hold true for the other direction... sign to verbal.

If you have ever learned a foreign language, you likely understand how you need to learn to think in the other language to become fluent. I would think that there is a similar need with ASL.

So, I hope you have a occupational psychologist that you can trust.

You have some hard decisions to think through.

btw, I have know many who have tried to work and serve the deaf community. It is difficult for a hearing person to be accepted by the deaf community. I would suspect they would not be very tolerant of a hearing person who has any struggles with ASL.

My best to you.

Mark, I never had a neuro-psych evaluation. I did however have a visual evoked potential done after the mishap. The results of that test did show some slowing but it was never discussed with me as to the significance of that and how great the slowing was in the grand scheme of things. The only reason I knew was that I had to get my records and I read that it showed abnormal latencies "indicative of chiasmatic dysfunction and bilateral certical dysfunction". What ever that means. The recommendation was clinical correlation, which meant follow up-- never happened.

When you receive an injury during an operation, things can go one of two ways after you survive: 1) They bend over back wards to give you the best medical care possible in hopes to keep you and your family happy and limit the financial damage. 2) They do as little as possible in order to make it look like nothing ever happened, or at least like there was no evidence that it happened on their watch and could've happened at any time. I had been left to deal with the aftermath by myself and couldn't remember my name some days. So, I really was a good candidate for number 2 with no one down there who had my back.

I had a WAIS-R, not sure if that's what you're talking about. Don't know what the results of that were. They threw out the results because it was done at a time of stress because it was the day after a good friend had been killed. Because they were trying to get me approved for school they were able to use results from a wais-r that I took to get into mensa before the accident.

As far as the ASL-- I have already decided that if I do graduate and go to work, I will only work in a social work setting one on one with clients. I can't do the legal or medical setting which requires going from English to ASL to signed English which is really 3 different languages. In the legal setting you have to sign exactly everything said which is signed English but make a deaf person understand in ASL-- too much. I also can't do the big convention or presentation settings either. If there are multiple things going on around me then I go haywire. Right now I don't know if I will make it past the 1st interpreting class or the interview process.
I'm just going to *try* to concentrate on the ASL class that I'm in now and the upcoming surgery. Those have me about ready to jump from a bridge. They are enough for the time being.

The WAIS-R, or Wechsler Adult Intelligence Scale- Revised should have the scores to show some of your processing capabilities. The 'stressed' result is very worthwhile because it shows your brain in a stressed situation. You need to be careful to not take on too many tasks that require your brain to perform in a non-stress environment. This is setting you up for failure.

One of the biggest shortcomings of neuro-psych assessments is the subjects preparation by lowering stress levels. The neuro-psych who administered my first neuro-psych assessment was completely oblivious to the meaning and value of environmental and other stresses. He commented about how a noisy leaf blower working outside during some of the assessment had bothered me. He thought this was me being overly dramatic. He also discounted my struggle with the visual clutter in his office.

A later mini-neuro-psych done by a Social Security hired psychologist understood my struggles with visual stimulation and made a few changes in his office to lower the visual clutter.

I can't imagine ever being able to do sign language interpreting. My first reaction to visual over-stimulation is to close my eyes. Not a good idea for ASL.

I thought SEE Sign never took hold. I had friends learning it back in the 1970's. I guess they don't call it SEE Sign (Sign Exact English) anymore.

Legal and medical interpretation would be a nightmare with the addition of SEE.

Hopefully, you can find some opportunities to work with very young people. Persons with a damaged brain can be far more tolerant of the struggles of young children, especially when it comes to comprehension issues. In my experience, the young ones seem to connect with the struggles of the brain injured adult. Maybe it has something to do with the lesser intensity of the eyes. The forceful eyes of some adults who try to work with little ones is counter-productive. You may have a predisposition to success with the little ones.

Have you ever talked with an attorney about your situation? Even at this late date, you may have something worth pursuing. Your cognitive struggles and the dismissing attitude of the doctors should give you a chance at extending the statute of limitations. You have a long life ahead of you. You need to protect any rights you may have.

btw, Do you know what percentile MENSA uses as a qualifier? Many of my WAIS-III scores were above 99th percentile. The WAIS is not designed to measure IQ's above 140. My neuro-psych examiner used my very high IQ against me saying I could not have low memory and processing scores with high IQ scores unless I was faking it. He totally dismissed the malingering scores that showed no malingering. I guess he thought I was so intelligent that I could even fake out the malingering test.

My most recent neuro-psych also came to the same conclusion. I scored 49 out 0f 50 on each of the two malingering tests. 50 is a perfect 'no malingering' score. I think neuro-psychs are intimidated by subjects who test higher than the examiner on IQ tests.

I agree with Mark that you should have a neuro-psych by a competent neuro-psychologist. I also agree that folks with a very high premorbid IQ get shafted.

Mark is also right that a lot of doctors are put out when they have to deal with brain damaged patients who are still smarter than they are. My GP dismissed the findings in my neuro-psych about my difficulties organizing myself and spotting errors by telling me I should "stop whining" because I'm still plenty smart enough. I then offered to do his taxes for free. Funnily enough, he didn't take me up on the offer.

I was lucky to have one of the best neuro-psychologists in the country. He was able to put my test results in context. I still test above average on most things - but that's a staggering drop considering my pre-morbid IQ. Frankly, "average" is a pretty sad level of function and to rate as "disabled" you pretty much have to be in a vegitative state.

I am also blessed to have a cognitive therapist who isn't intimidated by the fact that I still process a lot of stuff faster than she does. She knows what's important is how I'm doing the tasks, the unevenness of my performance from task to task and the fact that when I do make mistakes, I can't see them. What job can you do where you're oblivious to glaring errors? (I mean, other than politics.)

The thing about brain injuries, is that they can be pretty idiocyncratic. I have a spiral injury (all areas of the brain damaged), but my function varies widely from lobe to lobe. I process visual information pretty well, but auditory is difficult. The high level cognitive functions in my frontal lobe are a disaster. The neuro-psych will give you a clearer picture of what your brain in actually doing so you can make appropriate career choices.

The neuro-psych is also important because, sadly, we are often not the best judges of our abilities. Many of us have lost the insight to appreciate the depth and impact of our cognitive deficits. As I said, I can't see my mistakes. For example, I could be numbering a page and jump from 102 to 210 and never see it unless someone pointed it out. Before my neuro-psych, I entertained thoughts of starting my own bookkeeping service. Oops!

Contrary to being whiners, over time we get used to our disabilities and tend to under-estimate them. In my case, I knew, because I had trouble with buttons and stuff, that I had some motor skill issues in my hands. I was shocked when the neuro-psych rated my function in the lowest 2%.

Over-estimating myself was a running theme in my neuro-psych assessment. I just had no idea how badly I was doing. During the follow up interview, I kept looking over to my husband asking, "Do I really do that?" And he'd just nod his head with tears running down his face.

The neuro-psychologist explained that the brain damage often makes it impossible for us to know how we've changed. And we're not just missing the little things. There have been cases of TBI patients who can't register that they've lost sight in one eye because their brain is too damaged to process that information.

The point of this rambling missive is that you may not be in the best position to access your strengths and weaknesses. You need competent neuro-psychologists and occupational neurologists to test you and help you make realistic decisions.

Good Luck

Mark, from what you say you would definitely be a candidate for Mensa. They accept anyone with an IQ in the top 2% of the population. If you are interested it would a good time to join. They are waiving the $40 prior evidence fee for the month of February if you want to have your prior tests sent in rather than taking their test.

Hopefully things will start to get taken care of a little better soon. After my surgery I will have a new PMR (physical medicine and rehab) physician. They are transferring me to a doctor who works with people who have the baclofen pump. My new doc is a wheelchair bound paraplegic due to a car accident when his was 17 yrs old. The nurses say he is wonderful. My former PMR doc says that he is really good as well. I'm hoping that talking to someone who *knows* what I'm saying will make a difference.

As far as the sign language. Yes there is some use for SEE (most deaf just call it signed English). It really depends on if the person was deaf prelingually (before acquiring speech) or after gaining some knowledge of speech as to their views on it. Some deaf schools or teachers within deaf schools use the signed English method. It's really up to what the person has been exposed to most that affects their preferences. Either way most court settings require you to translate exact words or quotes when asking questions or when quoting back what the client is saying in order for everything to be legal and assure no liberties are taken. If you ask me, it just causes confusion on the part of the client and the bystanders as well because the sentence structure of ASL is not the same as English.

Sorry this is so long. I hope I answered all of your questions.

Hockey, as I was saying to Mark I have a new PMR physician whom I have not met but have heard wonderful things about. I'm hoping that he will think that it would be beneficial to see a neuropsych. I'm thinking he will be more understanding of my situation because he is a wheelchair bound paraplegic since age 17 due to a car accident.

Honestly, the fact that I haven't had an evaluation is my fault as well. I have been terrified at the thought. Right now I still have the illusion that I'm not affected too dramatically mentally or intellectually. When I have the test I could very well lose that illusion. It would kind be like the proverbial "opening your mouth and removing all doubt". I think I have just now gotten to the point that I'm ready to know what the real deal is. Before now, I really could not hear anything except that my motor cortex was damaged, I couldn't walk, and was left with severe spasms. Really just the things that couldn't be ignored.

BTW, you asked what kind of profession could you do where you are oblivious to glaring errors? After I thought about it and the fact that you wanted to be an accountant I came up with the perfect profession. You could work for the US treasury department.

I also wanted to thank you Hockey for being so good about always responding to me. You and Mark have been God-sends for me. I appreciate that.

Dear Phyxius,

I understand your apprehension about the neuro-psych.

I think it's especially hard for those of us who've lost a great deal physically, to learn that our intellect has not escaped unscathed. Let's face it, damage to our cognition strikes at the very core of who we have been. Compound this with the personality changes wrought be frontal lobe damage, and it strikes at the very heart of who we are.

My brain injury has forced me to think a lot about the big questions, like identity and good and evil. Are we all just a bunch of axons? With severe frontal lobe damage, I'm in the process of trying to rebuild some sort of meaningful identity. It's not easy - but it's easier than continuing the vain struggle to be the old me.

Here's some info about neuro-psych testing I posted for another member a few months ago I thought might be helpful. I would add that you should make sure that the person doing the test has loads of experience and is an actual neuro-psychologist. This is not a job for a GP or regular psychologist.

The neuro-psych is painless, but exhausting.

You'll meet with your neuro-psychologist and do a series of tests (verbal, written, visual, motor skills) that are designed to see how your brain is actually functioning.

In advance of your appointment, he/she will want all of your medical records, educational transcripts and letters from employers and friends to try and get a clear picture of pre-morbid you that can serve as a baseline and determine which tests would be most appropriate.

You will also have a long pre-interview where the neuro-psychologist will ask you questions about yourself, your injury, etc... They like also to talk to a close family member or friend to help get a more complete picture. (For example, I had no idea that I constantly repeated myself until my husband said it and all my friends mentioned it in their letters.)

The testing is usually done over the course of one long day. However, they can break it up if that proves too tiring for you.

Most of the time you will get your results in about two weeks. The neuro-psychologist will call you and a family member (if you want) in for a long discussion about your results and make any treatment suggestions. You will also get a written report.

I understand your fear about getting neuro-psych feedback. However, it's not as bad as you might imagine. Frankly, it's not that you don't know something is wrong. During the testing, you may find, as I did, that there are tasks you can't do at all. And, of course, you've seen your MRI and live with your deficits every day. So, in short, while the specifics and extent might surprise you, the news that you have brain damage isn't news at all.

In a funny way, listening to my neuro-psych was a relief. Finally someone understood how I was thinking and feeling and behaving and could explain to me exactly why I was thinking, feeling and behaving that way. Before that, I thought I was going nuts.

The neuro-psych also helped target my cognitive therapy and got me access to some of the support services I obviously needed.

I'm not going to bull you here, Phyxius: you're at the start of a long and difficult process to fashion a new and meaningful identity from what you've got left. I can't stress enough the importance of finding a good psychologist. To say it isn't going to be easy is the understatement of the year. Those with high IQs suffer the most because they are most keenly aware of what they've lost. However, your intellect is still keener than most and it is your greatest tool as you rebuild. Well, that and understanding friends. As we're forced to walk down this bumpy and sometimes dark path, I'll hold your hand if you'll hold mine.


By the way, don't lament missing out on MENSA. I joined as part of a drunken college bet. My local chapter turned out to be a lot of old Russian guys playing chess. BORING!!!!!!!

Cheers

Phyxius,

Good line about working for the U.S. Treasury Department. I think Hockey is a Canadian. Besides, our Treasury Dept already has enough brain damaged people using fuzzy math to balance the books.

As Hockey said, knowing is much better than not knowing. The simple understanding that you are not imagining these symptoms is a load lifter. It helps you get directed at skills to help with brain-injury moments, as Dr Schutz calls them.

Hockey,

I have been thinking of trying to get a SIG (Special Interest Group) going at MENSA for the brain injured. It could be quite a benefit to the injured and those who try to diagnose, treat and care for them.

Together, we probably have more knowledge about PCS that all but a few of the top specialists.

What do you think?

First, I'd have to get tested. I have >99% in a number of IQ scales but have not had a Stanford Benet in decades. I routinely score >140 in online IQ tests. I never liked the egg head type of MENSAns. They get too stuck on themselves. Most are great at knowledge but weak at complex thought, except for the Chess types. My past neurologist is a MENSAn. His offhand analysis of me is that I am in the high MENSA level.

Hockey and Mark,
I wrote an argument for a class last semester, there was a quote in it by Hans Jonas (late philosopher). It kind of sums up how I have up to this point approached my chosen ignorance. I thought you guys may-- or may not-- find it interesting.

"That there can be (and mostly is) too little knowledge has always been realized; that there can be too much of it stands suddenly before us in a blinding light. ...The ethical command here entering the enlarged stage of our power is: never to violate the right to that ignorance which is a condition for the possibility of authentic action; to respect the right of each human life to find a way to be a surprise to itself."
I know Jonas was talking about genetic testing here. My ignorance made me act upon the situation with blind hope that I don't think I would have had otherwise. I think that if I had been told earlier on how bad things were going to be-- especially with the sheer lack of support that I had, I would have never made the tremendous progress that I have.

Life has brought me to the point now that I have made enough progress and the need is there to know the extent of what I'm dealing with. I hope I'm ready now.

BTW, Hockey I was active in MENSA a few years in Florida before the mishap. I didn't find it to be tremendously fun. My chapter was just a lot of fogies that wanted to do touristy Florida stuff (transplants). Then there was the ones who did nothing but play games-- puzzle games, word games, math games, you name it. ICK. I joined the pig SIG, just what it sounds like. You go out to different restaurants all the time to eat. I was born in FL. So, I didn't enjoy. Everyone there was older than me at the time. I didn't renew my membership. I could now but I feel that I really wouldn't belong now and I have a hard time being around a lot of people. Not worth the membership fee.