Hey guys,

It's been too long since I checked in and read the threads. With baseball season now in full swing, I have found a new love of the game based on its level, even, slow and steady pace. So I have spent a lot more time watching baseball and a lot less reading about PCS.

So I am 6 months post-accident, 4 months post-diagnosis, and 3 months on disability leave. Medication has helped reduce the headaches significantly. We are still working with meds to deal with the anxiety and depression. The brain fog comes and goes, there are good days and there are bad.

Now for a couple months, maybe longer, I have been experiencing what I termed "brain blanks." I saw my psychiatrist today and she believes they are "disassociative episodes." Let me describe a couple examples and please tell me if anyone can relate and what you have heard about it:

Example 1: I am watching TV with my wife. In the middle of a show I grab the remote and just start fast forwarding w/out realizing what I am doing.

Example 2: I go through fast food drive thru and WANT to order, say, the #1 meal but order something entirely different. I get home and find I don't have what I wanted, my wife confirms is is what I ordered. I don't recall ordering it.

Example 3: I am on a ladder and start coming down. I suddenly think I am at the bottom when I am actually still 3ft above the ground and step off, landing and spraining my knee. (I know! No more ladders!!)

Each of these times happened when I was tired, typically at the end of a long "good day," i.e., one where Inhave had the energy to get out with the family, or go shopping, or work around the house.

Any ideas??? Thanks!!!

Hi Lawyer1732,

No more ladders for sure! It sounds like your perception is off. Same here @ 6 months as well. Have you had specific vision testing? It's not exactly comforting, but relevant documentation re: work LOA.

Your example #2 mimics my 2-3 weeks post-injury, ( maybe longer), but I would definitely escalate that concern.

Sounds as though you may be pushing too hard & inviting setbacks. Maybe record the baseball games instead of staying up to watch?

Keep us posted,
Grace

In my experience, I would not call these disassociative episodes. I would call them 'loss of focus.' Going down the ladder, you lost focus on need to be aware of where the last rung was. I have done this many times. Usually only one rung to high so no serious issue. The TV situation could be, You brain has lost focus on what you are watching and is distracted. Think of it as a loss of continuity. Maintaining continuity is often a challenge with PCS. Your brain goes from following the program to 'I wonder what is on TV.'

At the drive through, you have your choice in mind but as you start to speak it, your brain sees the other things on the menu and erroneously substitutes something else. There is a neuro psych test that tests this. I think it is the Stroop Test. They show you the names of colors in varying colors. You need to either say the color or say what the word says. It can be difficult to say purple when the word is 'yellow' in purple print or the word is 'purple' in yellow print. I think it is a test of executive functioning.

The idea is to see how well your brain handles conflicting images.

Once you understand what is happening and you have accepted it as a real symptom of your injury, you should be able to develop coping mechanisms. Ignoring these 'brain farts' will likely cause them to continue to be repeated. Acknowledging them will give you pause when the situation arises so you can use your work-arounds or coping mechanisms. The drive thru could be handled by not looking at the menu as you place your order.

I have not found a work-around for the ladder issue. I think it may be made worse by visual perception weaknesses.

Oh yeah, part of the TV remote thing is just a guy thing. For some reason, guys tend to channel surf when they lose focus. Women complain about us doing this all the time.

My best to you.

Hi Lawyer,
Good to see you.

I recall you were taking some medications when you first posted here. You don't think these 'brain blanks' as you call them are related to any medications you're on or medication changes you had around the time they began?

Thanks for the replies!

Mark, the test you described was administered on me during my Neuropsych eval. I don't know how I performed on it specifically; if I knew at one time, I can't recall!

I do remember the Neuropsych said my executive functioning was grossly intact BUT my attentional skills, concentration, and focus was impaired. That is where I got confused because I thought the concentration skills were part of executive functioning.

(He relied heavily on the test with 4 pictures where you have to figure out the patterns and pick which other picture should be included. You get feedback from the administrator. And there are several sets with varying patterns. I had a very high score on that and he said that showed my executive functioning was still good).

Otherwise, Mark, you are just as apt to be right as my psychiatrist! The part I forgot to mention is when I try to remember the episodes, I feel detached from involvement in what was happening.... Do you get that too?

Lara, I have Nooooo idea on whether meds could be the issue. I have been very studious to keep a type written list of all my meds and keep it updated for all my docs, including my psychiatrist. No one has associated it with any meds.

On the other hand, I did start fluvoxamine at 50mg about that time I think but don't recall of the episodes started before that or after.

Thanks again!

I don't know what they are called but I have the same problems. A lot, it's like you become detached from what you are doing. It's a memory lapse but it feels different. Like your thinking brain cuts out. The food thing I do as well, or sometimes I'll drive to the wrong place and kick back in when I get stopped and think why the hell did I end up here.

I think some of it is concentrating and fatigue coming together to mess you up. I have to effort myself to stay aware. This probably isn't that helpful but know that what you say is something I deal with a lot too! Some days not at all some days are like an out of body experience all day

When I have had these events, I have tried to look back to what I was consciously doing during or prior to the event. Often, I let my mind get side-tracked into another train of though. The challenge we face is the PCS brain does not multi-task very well, if at all. In the past, we could have the primary activity in mind and add another thought without 'dumping' the primary thought. We could then easily switch between the primary though and the secondary thought.

Instead, now we use the same thought patterns of being able to mutlitask in our mind and when we take on the second thought, the primary thought completely disappears. Sometimes, we can resurrect that primary thought but other times, it is lost and will require a focused restart to get back on that primary train of thought.

Sometimes, it is something as simple as subconsciously climbing down a ladder that gets interrupted with 'I need to get the putty knife to scrape the pealing paint.' and voila' , we are no longer subconsciously following our progress as we climb down the ladder.

These events can be made more problematic by fatigue or sensory stimulations and distractions.

I have learned that there are some things I just do not do unless my brain is at the top of its game. I have learned to grade how well my brain is functioning so I have a better idea of when I can take on specific tasks.

For example, I would never try to order at the drive thru window with the radio on or with somebody talking in the car. I can almost guaranty I will mess up the order or get frustrated trying to keep things straight.

The important lesson in this regard is the brain is not designed for multi-tasking. Science shows that multi-tasking is stressful on the brain. When we learn to reduce our tendency to multi-task, these events will become less.

Hi again,

No history of seizures, Lawyer?

Regarding multitasking and stress - there must be a very large population of stressed out mothers and fathers out there. How does one parent and not multitask? How does one do anything and not multitask?

Multitasking takes its toll. Many people end up on antidepressants because of the burnout from multitasking. There is not such thing as a supper mom or supper parent. They are just hard working parents headed for a crash. Something has to give somewhere.

Actually, there are ways to learn to avoid multitasking. Studies show that multitasking does not get any more work done. Finishing a task before starting the next task is just as productive as multitasking, in some cases, more productive as the quality of the result can be better.

This does not mean one never switches between tasks. The point is to find a stopping point for one unfinished task before moving to the other task, finishing it then returning to the first task. The concept of having multiple tasks being juggled in the mind is counter to good results.