I disagree with the level of pushing. Instead, my suggestion is to learn to recognize those early signs that you are approaching your limit. Needing to reread a line of text, struggling to focus, and a myriad of other signs of fatigue are signals to take a short break. Just a few minutes break can make a big difference. Your brain does not heal/recover when it is needing to recover from pushing just a bit too hard. The goal is to maintain that level just shy of pushing too hard and as soon as you notice the tipping point, stop and take a break.

If your job is cognitively demanding, you will desperately need these skills when you return to work.

I have caffeine tablets in the cabinet. I occasionally need 1/2 of an 80 mg tablet to break through the slow processing. What stimulant did they suggest ? Are you taking it ? Many suggest limited use of stimulants, just to get started.

Your NPA show problems similar to mine. Did it say whether your memory issues are more visual or auditory or both ? How did those functions compare to your intellectual abilities ?

I am not surprised to hear the neuro thinks you may have had a pre-existing injury that got aggravated by your impact. I thought so too but was hesitant to make such a suggestion.

You might want to consider whether a cold hard return to work is best compared to a measured slower return to work. I take issue with those who set dates far in advance of evidence to support such dates. Goals are great but setting timelines without qualifying factors along the way tend to be problematic.

My original neurologist suggest Adderall and my current physiatrist prescribed Ritalin, which I have been reluctant to start taking. He prescribed a very low dose, 5mg, to start.

As far as my NPA, my auditory memory is better than visual, but both are considered poor for my education level and premorbid functioning, which was rated in the superior range. My divided attention is particularly bad.

I should have been more explicit regarding my return to work. I will be coming back part time (25 hours/week). My employer (consulting firm) has been understanding so far and I am hoping that they will be able to accommodate me with reduced hours if my output quality starts to suffer. Unfortunately, being client-based, we are always working around other peoples' schedules and don't often have the luxury of setting our own.

What do you think of Ritalin? I've been prescribed it for daily use.

Personally, I would not touch Ritalin. Forcing the brain to do something it is not ready to do is not good in my opinion. But, there are many doctors who claim to use Ritalin successfully.

Does you job require meeting with multiple people at the same time ? You may find you get easily overloaded when there are multiple voice in a conversation. You should look for opportunities of such conversations to see how you do.