[Aelfaba]

Hi all,

I thought I'd post an update -

I saw the neuro about a month ago - she prescribed Atacand for an off-label use treating headaches. This seems to have helped since now I only get headaches when I've overdone it.
Also taking Alertec for concentration and that was working, but now I'm not sure. I'm struggling.

The ringing in my ears is still terrible, and now sometimes gets really really loud.

I'm seeing a psychologist to help me with some coping strategies at home and work - this has helped.

I've been working full time for 3 weeks now - and this is my struggle. I'm pretty good at my job for a couple of hours, then okay at it for a couple of hours, then not as good as usual for the rest of the day. I also get dizzy, and spaced out part way through the day. everyone is understanding, but eventually I need to be fully functional.

My question - is this expected, or is this a sign I should talk to my doctor about going off work again?

[Mark in Idaho]

The Alertec may be stimulating your brain to a fatigue level. The brain slows because it is fatigued. If you need the Alertec, you brain may not be ready to push that hard. Maybe you need to try a 3 to 4 hour day then rest. Or, work 2 hours, take an hour off and rest before returning to work, maybe for 2 hours, rest an hour then work again.

A study on brain fatigue suggested that the brain does better with more frequent breaks rather than pushing the fatigue level to a crash point before resting.

[Aelfaba]

Thanks, Mark.

I am lucky to have a great team of doctors. I know others don't have this experience, but there are good doctors who have some understanding of PCS.

My psychologist looked at my agenda with me to identify the tasks that caused fatigue, strain and issues and why some days I'm ok (not good, but ok is an improvement) and why some days I am very bad.

Mostly activities requiring negotiation, persuasion, explaining things or managing groups are hard on me. Analysis seems to be a bit better, surprisingly. Decision making and asserting myself is hard.

Unfortunately, taking long breaks, or part time work are not options.

She wants me to take another few weeks off, before I end up with depression.

This is hard for me to accept - I feel I have failed. My very supportive husband reminds me that no one runs a marathon after breaking a leg and I just need time. i still don't look forward to the chat with my boss.

Thanks for your support. It helps to be understood.

[Mark in Idaho]

Personally, I think you need to find a way to change your work environment and duties. I don't think a few weeks rest will be enough to heal. That takes months if not years. Studies show that those with the best long term outcomes have accepted their limitations as the new 'me' and learned to moderate their activities to levels that do not cause a return of symptoms.

If you take a few weeks off, I suspect that you will be right back to your current condition within a week or two of returning to work.

[Bud]

Aelfaba,

I have a difficult time at work with decisions.

I am self employed and have been doing this for years and this year you would think I am brand new at the job. I have to rely on my family whom I work with quite heavily for some decisions. I have always been a confident go getter u afraid to try things and now I have very little confidence in myself. It must have got knocked out of me when the anchor hit my head!

It is coming back slowly and with struggle.

I think reading what you wrote that it seems anything involving decisions at work is a stressor. I know decisions are what really stress me now.

Bud

[Mark in Idaho]

Bud and Aelfaba,

I suggest you try something when you need to make a decision. Write down all of the issues you need to consider. The fixed issues and the variables. Then prioritize each and connect them to the different decisions you can make.

The problem with decision making is the need to juggle so much information in our minds. If we do not have a good digit span, we struggle to process more than 2 or 3 issues in the decision making process. By writing them down, we can avoid that mental juggling.

btw, Digit span is the number of items the brain can process (juggle) at the same time as it thinks through a decision. It matches age in years until age 8. Some develop a digit span greater than 8 but most stabilize at 8.

We often have digit spans that have regressed to the 2 or 3 level. This does not mean we are not intelligent. Just that we are limited in the information we can process at the same time.

My digit spans sucks. Usually 2 to 4, depending on my stress load. Ambient stimulations (sounds, lights, etc) can reduce my digit span. For example, I used to be able to drive my truck, listen to the radio, eat something while scanning a map to find a customers address. Now, I ride shotgun and try to use the map. My wife will need to turn off the radio, maybe turn the a/c off, and sometimes even stop the car so i can process the information on a map.

There are a few sayings to go with this.
The first is:

We need to STOP to think.

Second:

We can only do (think about) one thing at a time.

Once we accept this limitation, we can develop decision making environments that work for us. If we try to juggle everything in our head, we will likely make poor decisions and overload and crash.

btw, I often need to close my eyes so I can focus better on the issues at hand.

Hope this helps.

[Bud]

Mark,

Thanks. i will put writing into effect.

I could never have guessed how much a knock to the noggin affects things and am really amazed at what the brain does and learns so silently and in the background as we grow up. You aren't really aware of its skill till your life is interrupted.

Bud

[Aelfaba]

Bud, it is always reassuring to hear that others have similar issues. I keep questioning myself - are these real symptoms? Maybe I've always been this irritable. My hubby assures me I'm not my usual self.

Mark, I appreciate your opinions. Changing my work is a major step that I'm nowhere near ready to take. Too many years of education and career building at stake, and I used to like what I do. Frankly, my job is to take tough projects, in a fast paced environment and provide advice, analysis and oversight to get stuff done.
I need hope that my recovery continues. I am only 3 month in.

That being said, your comments on digit span make a lot of sense. I used to listen to music when in my home office. I can't do that now, it is distracting. Likely this also hinders me with my actual work - and explains why I struggle to follow a meeting with multiple people and viewpoints.

I used to juggle everything in my head. Now I take notes with crayons markers - the colours help my recall and help me keep track of multiple items at once. I will try to app,y to decision making when I have the luxury of time.

i hope I will adapt t and be stronger than ever - I just have to be patient.

Thank you- I sincerely appreciate your insight

[Mark in Idaho]

Aelfaba,

If you can, see if you can delay you answers and decisions. Taking the time pressure off the decision making can make a big difference. Even if you gather the information and return to your office to sort things out and make a decision half a hour later. The last thing you want is for your decisions to start to fall below par to what is expected of you. Some time to think may help you stay on top of your game.