I have not posted much here, but I do read the posts and responses. Many folks talk about relapses....and why they are relapsing. I know I should be positive that I will get better completely but, after almost two years and some improvements I am starting to understand that learning to live with the symptoms and adjusting to the changes is a must.

Accepting it, recognizing the triggers and relishing the good days is how I move forward. Don't get me wrong I know there can be continued improvements into the future just not at a rampant speed.

So when I read about relapses is that based on 100% recovery and then relapsing or is it based on many good days and falling backwards. It is all too confusing to me. Maybe someone can help me understand.

Many will relapse from a less that full recovery.

Full recovery is a broad term. Many try to say a full recovery is to a condition with all the functions that existed prior to the injury, no matter what the situation. Those with a better understanding consider a full recover means regaining full function in life in normal situations. It is not uncommon to experience struggles during times of stress.

A relapse can happen at any point in the recovery.

What many do not understand is that good days are not necessarily recovery days. They are more likely days that, when linked together, can lead to more improvements. Real improvements happen best during this good days. Anything that can be done to increase the frequency and duration of these good days usually leads to further improvement. The same gods for sleep. Improvement happens best when quality, restorative sleep becomes the normal situation.

You are doing well since you have come to the realization that you do better by living with your current condition rather than fighting against it.

Good for you.

Thanks for your response Mark. Wise words...

My physiatrist was talking to me about the concept of "recovery" today. He said that with TBI, it's important to remember that the brain will never go back exactly to the way it was before the injury, analogous to when a person has a stroke. However, in the majority of people who have had a mildTBI/concussion, new pathways around the injured part of the brain are created to compensate. That takes time, and while we may regain function, it won't be achieved the same way as before.

It's partly because of this that we are more acutely aware of how we feel and how we are doing -- so many parts of our lives had become "automatic," and now they are less so, as we make those new pathways. Once those pathways are better established, chances are these functions will become more automatic, too.

This psychiatrist is only partially correct. The 'new' pathways are really existing pathways that are reassigned to new tasks. Since concussions have minimal focal injuries compared to a stroke or penetrating injury, a broader area of minor injury that does not necessarily lead to cell death is common. This often results in struggling cells due to out of control neurofibrillary tangles. Some people's brains correct this issue better than others. Treatments are being sought to correct this but they look to be expensive and years away. There are other broadly based non-cell death issues that can arise, too.

As you say, the challenge is to learn to make up for automatic processes with newer learned processes. We often call these work-arounds and accommodations. Accepting the new person is the start to learning these work-arounds. Trying to force or struggle through to use past processes can be highly stressful.