I think I found the word that describes best one the main symptoms I am dealing with (other than dizziness, nausea, headaches,...): cognitive stamina.

I can solve a well defined task, sometimes better than a lot of people (I used to have high IQ) but I cannot work on a project. The latter usually involve many steps of thinking, gathering and multitasking and a lot of stamina.

For example I had to pay lawyers 10K to do some paperwork for my GC that anyone could have done on their own given the time (and I have plenty of time being off work).

At the same time, I was able to solve a 15 mins maths problem better than my smart brother. So I know that among other things it is a stamina issue.

Here is the issue: one of my neuros I am pretty sure thinks I am malingering. She asked for a neuropsych test, which I think she will use to evaluate my sick leave.

Sure the test will reflect some stamina issue, but is not equivalent to a project in complexity. Rather a series of tasks. So I might Ace the test while and confirm the suspicion of my neuro.

This is not mentioning the fact that I have major vision/convergence issues that make it impossible for me to work until my convergence is normalized...

A Neuro Psych Assessment has specific tests that identify malingering.

I suspect that you are trying to work the way you did pre-injury. Most with high IQ's struggle to work at a simpler level.

I had to compose reams of documents for my disability hearing. I did it with dual screens on my primary computer plus a second computer for doing online research. I needed to keep all windows/documents open or I would lose track of what I was doing. I could not toggle between windows. Out of sight, definitely out of mind.

I also used 3 hole binders with post-it notes as index markers. The 3 hole binders were important because it kept my notes in order so I could not have too many notes open at once.

I started documents by just typing out ideas and cutting and pasting information. Then, I would sort and organize them. Then, I would edit and format them adding any more specific issues.

I had to do this without trying to use working memory since mine is horrible. If I push my working memory, I cognitively collapse.

If I started to struggle to focus or had to reread a line of text, it meant I needed to take a break.

I have had 3 NPA's over 12 years. They all reported the same problems at very similar levels of impairment. All three Neuro Psych docs were confounded that my IQ could test so high but my memory and executive functions were so poor. Two even tried to claim I was malingering even though I scored near perfect on the validity/malingering scales (48 and 49 out of 50, 37 or lower indicates malingering).

The neuro cannot test objectively for your cognitive problems. Only an NPA can do that.

Think of a complex task like juggling 5 balls. Think of the air as your memory. You used to be able to do it with all 5 balls/ideas/data points in the air/your memory. You can't track them in memory now. But, it you put the balls on the desk(written notes) and work on them one at a time and arrange them as needed, you can get the task done.

I used post-it notes on documents. You can get a post-it notes like app for the computer. I think it is built into MS Office apps.

A rehab neuropsych explained it this way. The injured brain brain cannot use the short cuts we developed over years of education and maturing. We have to go old school with notes and diagrams and arrows between them.

My father was a rocket engineer who died from slow onset dementia. While slowing losing cognitive capacity, he carried a stack of 3x5 cards in his pocket. He made notes and organized those notes as he took on the tasks of the day.

I don't believe you problem is a simple stamina problem. If you simplify the process, I bet your stamina is great. If you trying to keep too many balls in the air, your stamina will be very short.

The NPA may not fully define your stamina issues but it will identify many issues that you have not yet understood, like verbal processing, visual memory, auditory memory, motor speed, reaction time, digit span (ball in the air), etc. There is an old test called PASAT (Paced Auditory Serial Addition Test) that is very good at identifying concussion dysfunctions. Modern versions are often in an NPA battery.

The only challenge with an NPA is tester bias. An attorney who handles subtle brain injury cases may have a recommendation of the good unbiased neuro psych docs. Neuro rehab hospitals are often a good place to find unbiased neuro psych docs. The neuro psychs who work at our two local neuro rehab hospitals and clinics are very good.

My best to you.

The juggling analogy sure makes sense to me...not all tasks do I have to place the balls on the desk, but some most decently require that approach.

The problem I face with such things is I do not always immediately recognize why I am frustrated over things...sometimes the pot gets boiling some before I recognize the need to prioritize and separate tasks.

@Mark Has your working memory improved?

"I have had 3 NPA's over 12 years. They all reported the same problems at very similar levels of impairment. All three Neuro Psych docs were confounded that my IQ could test so high but my memory and executive functions were so poor."

Nothing has changed except I keep learning and using various tricks and disciplines to overcome my limitations.