The Forrest for the Trees.

 One summer when I was in my early twenties I nannied two boys. One was 5 and the other 2 almost 3. The two year old boy was almost as tall as his 5 year old brother. He was a fun, sweet, energetic and intelligent 2 year old. 

I enjoyed taking the boys places. Especially the 2 year old. However, on these outings, I noticed something that bothered me a bit. For some reason people were not as warm and friendly to my 2 year old client as they were to his 5 year old brother. It was especially curious to me because the 2 year old was, baseline personality wise, much nicer than his brother. In fact, (and I almost hate to admit this because, especially with kids, this happens very rarely with me) his brother often rubbed me the wrong way. He was kind of sneaky and conniving by nature. He was often moody and brooding and not super pleasant to be around and often he would do things to intentionally hurt his younger brother. He was much harder to deal with and yet when we were out, people would dote on him much more than they would his younger brother. 

It was a strange phenomenon to me so I started really paying attention and I am fairly certain I figured out the discrepancy. Younger brother was tall and broad in a very athletic looking way and if you didn't know he was only two you would think he was much closer in age to his thin and average height brother than he was. People seemed to think he was older than he was, so when he would talk or act like a two-year-old they were immediately be put off by his actions. 

 I have since observed this phenomenon and similar happening with other children. My own daughter was not tall when she was 3 but she was very articulate and highly intelligent, to the point that one of her baby-sitters thought she was 5 or 6. In this scenario people would extra dote because of her high intelligence but the flip side is when she would act her age it was harder to be patient with her and even I would often expect her to understand things better than her physiological development would allow her. 

I have a nephew who is prodigy level intelligent, -he knew his numbers up to 20, his colors better than most adults, like magenta, indigo, etc, all of his letters by name, sight, and sound, and much more all by age 2- he knew all his states and a significant number of countries by name, shape, and their capitols by age 4. Egypt was his favorite which is what he decided to be for Halloween that year. He even knew more about the country than most adults, like who it's ruler was and what type or government he ruled in. Now he is big into elements, but he is also still just a little boy who has tons of energy and behaves in ways that are developmentally normal and appropriate for his age. However, because of his ridiculous capacity to learn and understand significantly above what is normal at that age he is often perceived as manipulative and deviant. Which to some extent is accurate but may simply be due to his very advanced intellect being stuck in a now 6 year old body. He is not developmentally capable of the expectations people have of him while he far exceeds others. 

Kids like this confuse people. 

And this is kind of how both TBI and "mental illnesses" can be. I have noticed that the more intelligent, resourceful, adaptive, and even attractive a person is, it seems they are less likely to get accurate diagnosis. Or even diagnosis at all. 

Couple that with symptoms that are considered shameful, inappropriate, embarrassing, etc and those who really do need help have been conditioned to hide the very symptoms that would alert providers to their need for help and medical intervention. 

It is hurting my heart seeing how common this is and how deep the stigmas go. 

I hardly ever used to talk about my TBI. Very off and on would I ever talk about things like depression and anxiety. I rarely would admit the hypomania. But I did learn how to navigate them and manage all of it. I had it so well managed I had even forgot some pretty significant parts of my life. 

But the second hit to my head made me realize just how profoundly that first TBI had effected me and even how I was perceived by others. 

I confuse people. 

I even used to confuse myself. But knowledge is power and so is accurate diagnosis. 

Now I talk about TBI all the time. I talk about what happened to me at and because of the Neuroscience Institute. I share far too much far too soon and I know this is risky because people will often judge. They usually have some form of prejudice, preconceived notions, and fallacies of thinking toward my conditions and people with my conditions. It is a huge societal problem. 

Which is exactly why I do talk about it too much too soon now.

 In so doing I have found surprising forms of validation, especially in finding how much more common some of the TBI problems I have had are. AND I have been able to help so many people already, sometimes in small ways and other times in big and meaningful ways. Last week a girl I had a conversation with in the park over and year ago and some followup text conversations, sent me an out of the blue thank you for a simple tip that has helped her significantly. I am so grateful for moments like that. I want to keep helping people who are struggling with problems that can be often rather easily treated if we, as a society, would shift our thinking, expectations and how we treat people who are struggling with very real physical health problems that effect behavior. 

TBI is being treated far too carelessly and unfairly and it is far too misunderstood even, and maybe especially, by the medical providers. 

People with mental illnesses or behavior problems are being treated with far too much skepticism, pessimism, and distrust which ultimately feeds those traits in the person who is struggling (Zootopia illustrates this nicely) and people far too often have nowhere truly constructive to turn to. Tests are not being done by providers, to often simply labeled, medicated and released. So when I talk if it happens to be a person who has or has had a friend or family member in one of my boats or similar, even if they will label and judge me, they usually find some solace, validation, and/or informational/educational value to our conversation. Those who find none of that usually at least find some entertainment value and even that, to me, is a bonus I am willing to give. 

So I'll keep compromising myself and keep talking and I'll keep hoping...

And now that this off my chest maybe I can settle on just one topic for my psy 3500 research project... 

Gestalt psychology; It's only partially true.

 "In perception, the whole may exceed the sum of its parts," say Gestalt psychologists according to my textbook.

The perception of the whole may exceed the sum of its parts...  I know this. It sounds like mania and situations interpreted when one is manic. 

It sounds like suspected perception errors that I was asking for help correcting. 

It also sounds like ignorance of providers and thinking errors on their parts. 

They wanted to Occam's razor me- simplify it into mere attraction and/or obsession?  And then use that to justify and excuse their not looking further into things that were affecting my health, safety, moods and behavior maybe believing that the whole of me was exceeding the sum of my broken parts.

But their job is to look. Their job is to first do no harm and their job is to be thorough.

They needed to look at the parts and add them up. They needed to check for alternative explanations. 

They needed to LOOK.

The sum of my broken parts, so far have far exceeded the perception of the whole.... What is the term for that? 

Consciousness? Neuroplasticity? Discipline? Success? Intelligence? Toughness? Misunderstood? Discredited? 

We interpret things based on our own experience, perception, depth, complexity... Their whole may be exceeding the sum of their parts... They project a whole that definitely exceeds the sum of their parts. If you have heard any IHC advertisement, especially those about how they care about individuals, then you know what I am talking about. 

And Dr. He, Dr. Concusion, and Patient Advocate too? Are they simply more ignorant, and narrow/small-minded than I am capable of believing them to be? 

Linear thinkers who dare not wander beyond the paths they have been conditioned and trained to think on. Prone to error simply because they cannot see beyond the paths and boxes they are confined to but that we are not? 

"In perception, the whole may exceed the sum of its parts." Degrees and the Prestige we tie to them just may be another example of this, because, after all, an ability to conform and do as told is a very large part of gaining that Prestige. 

And today, during class, one student asked a question. Some bias was sensed in the way she stated it. But is the bias in the student asking the question or is it in the in the person trying to perceive the question? 

...and as I study, determined to solve and fix the systems that break the people they are supposed to be fixing AND in doing so may be breaking the fixers themselves, I often wish to send him links to the scholarly articles of research... the profound madness of his very profession. I think I already have it very well solved, but how to quantify and qualify, that is the challenge. 

I am sorry dear friend that your profession must end at least in the form that it is. 

Love in the therapeutic relationship is both simple and profound and the perceptions of the whole are greater than the sum of its parts while quite the opposite at the exact same time and when the love is real it is twisted too much and lost may be all that he was. 

Lost with me and lost in me, a lost soul myself, who had thought she had finally found home.

Fantasies of Fair and Ethical treatment

 the hardest and most frustrating part... the isolation and ostracizing one feels when one has been through things similar to mine (things like mania, TBI, malpractice, and mistreatment from a psychologist)...

It is lonely. 

And also immensely frustrating because you are a victim but there is nothing you can do and nobody who can change things to stop the victimizing of you and others is listening. 

Very likely part of why they are not listening are the exact same reasons you are the prime target for victimization which then keeps you repressed, voiceless and powerless...

My heart aches for the victims of child abuse and neglect, and victims of rape, sexual assault and domestic violence. It brings tears to my eyes knowing how hopeless their plight must feel and in reality be, when mine, so obvious and from those that things like this should never happen with and that supposedly have many systems in place to protect me, has been completely disregarded and impossible to find help or even justice for. 

Money talks and victims don't usually have enough of that... at least not enough to stand up to their perpetrators. And mine, IHC, I definitely don't have the resources to fight. 

"I believe people are fundamentally fair," says Glen Beck who happens to be on the radio when I get into the car.

After seeing what I have and experiencing what I have, after how family and friends have handled and treated me, I beg to differ. It is easy to believe that people are fundamentally fair when you have money, power, and prestige. You will feel an innate drive to believe that just to justify your own hypocrisies of your unfair treatment of others, like your employees who work just as hard, and often much harder, but make less than a tenth of what you do. Is that fair? By the most basic definitions of fair the answer is no, but your money and power will justify your delusions of what is fair and equitable payment.

IHC will justify their delusions of fair and ethical treatment. 

Anyway... Sad and angry as I learn more and understand better, and as I still know the reality of the impossible tasks of competing for fair and ethical treatment... 

People are not fundamentally fair, they are fundamentally self-centered and delusional about their fairness and it seem to me the more power, influence, and money one has the more self-centered and delusional  they are about their own fairness. 

To be or not to be; so studious and as boring as a tree *

 I am really liking my psychology classes. They are full of fascinating hardly new information. The research class is surprisingly more engaging but probably just because we actually have scheduled class times... so even though it is online, at least I get to interact with real people!

But sometimes I read and I am like: just more blah blah bull shit only with the added pretentiousness of elitist academia and scientific sanctities. Wait, that later is not a possible combination right? And yet some how, maybe in Tau, it is.  

I probably need to be careful not to offend those sophisticated intellectuals... because I somehow have to convince them to invest their confidence in me and give me the chance to enter their prestigious PhD granting programs. 

A heathen and a commoner, the voice from the other side... And with brain damage and other indicators of inferiority

Insert green-faced-puking-emoji

puking at my plight and my empathetic feelings for how dull, monotonous and tedious those professionals' lives must become at times. Losing all sense of creativity, imagination and fun in their insatiable desire to advance perceptions of their very linear intellect and prestigious eliteness...

Yeah, sometimes the mood of the readings are bit heavy like that...

poor buggers. They should let me in just for the comedic relief of my plight if for nothing else!

*So to be or not to be; so studious and as boring as a tree? not that I think trees are boring. I find them very beautiful, majestic and interesting, but their very sedentary lives do seem rather boring. And it rhymes. 

Whose up to bat?

 4 for 4. Or is it 5 for 5? And then some added bonus findings.

Car accident of 2017 my 1st concern was my head. A possible concussion had me concerned. The first doctor I saw dismissed this concern with, "we don't do anything for concussion anyway." He did not test for it. 

Shoulder and left arm were x-rayed and found okay... So I suppose that may change it to 5 out of 6, because it hurt so bad I was certain something was broken... It was the only test ordered by a doctor to look inside immediately following the accident. 

The next test that looked inside was ordered shortly after the car accident by a chiropractor. He wanted to see the neck. MRI showed injury in the form of a hairline fracture in a vertebrae in the neck. Chiropractor is also the one who picked up on the concussion. At least they were concerned. 

Next was the ENT doctor, a few months after the accident. He ordered a CT scan because I kept getting sinus infections after the accident and my nose was runny a lot. That showed abnormalities but nothing in the sinuses that seemed to be accident related. I'd knock my average down on this because I was certain there was something wrong from the car accident that was causing these problems, but keep following and you will see why I'm still batting 5 of 6.

The next look inside was the ankle. It had been bugging me since the accident. 14 months after, when my head was starting to improve, I wondered why the heck I had not had the ankle looked at. It was only getting worse so I went to the orthopedic doctor. MRI; it needed surgery. Had it been caught when the injury had been sustained then it is possible surgery could have been avoided. This much later? No. But still 3 surgeons and a PA all impressed by my stability and strength considering the extent of the injury; especially once they got inside.

Ankle turning out to not be nothing coincided with the questionable #5 injury. Mania. Was that due to injury of car accident or insult of neuropsychologist? Not sure, but certainly mania and not so much a transference- countertransference issue.  That would have resolved much quicker and easier and would have followed a much more linear path of healing.. (or maybe not. That relationship is intense. Others I know have also been significantly injured by the mishandling of countertransference.) But mania, was a definite yes and I was right about it... Too bad I, like they, really did not want that to be what it was. Too bad they are governed more by their fear and/or egos than by honesty, integrity, medical knowledge, and logic. 

After ankle and knowing I was broken more than was previously thought -something I had tried to tell many doctors already but was shy and timid, not assertive, when they failed to listen- I decide to have the 2 other things that had been bothering me looked into: my hip and my wrist. 

The hip doctor decided to take the conservative approach and it was hypothesized the discomfort there was linked to my gate being off from the ankle. Which turned out not to be the case. But then it was supposed that it was the back and not the hip... Which turned out it was the back; MRI showed a bulging disk. Another injury I had not even thought to mention because I was associating the back pain and troubles to the hip. Physical therapy helped the back. 

But not the hip. 

Back to MRI and, yep the hip was also injured. Progressed or lit up by car accident, that much I know because prior to the car accident it had never bothered me. Not once. This injury has taken the longest to find, because we were being conservative in an effort to avoid chalking up unnecessary expenses... which, in reality, turned out to be chalking up a lot of unnecessary expenses and wasted time. I go in for surgery next week. This should prevent a full hip replacement down the road. 

So ankle, hip, back, mania, all initially missed... oh and the wrist.

Orthopedic found nothing wrong with the wrist. But there was clearly a tremor. "You might want to see a neurologist about it" says he. And Dr. Reddy, she suggests that too, but fails to refer and of course I want to believe that this means it is nothing. 

...but I know better... deep inside I know better. I had the whole time.

Finally, after the mania and that nonsense is actually being treated, I follow the directions of new psychiatric PA and I get into a neurologist. She wants me to go for head injury, I only want to see what this tremor might be tied to... But I already know. I did not have it before and I knew it as soon as wrist orthopedic mentioned it with concern all over his face. 

Yep. MRI shows TBI. Not concussion at all... so maybe I am batting lower because I first thought concussion and it was actually worse.... but truthfully, "I think I might be manifesting better than I am," said to at least 3 providers who diagnosed concussion, reminds me, that I knew... Deep down inside, I knew this was another TBI. It is why I woke up so quickly, I knew I could not let anyone move me and risk greater injury to my brain the it had been with the first TBI. After that snow tubing collision with a tree I had been loaded into a sled and bounced unconscious across a field... So the second time, something deep in my psyche or biology knew I had to walk up. 

But I wanted to believe those providers who were the experts ... experts who were very wrong. I wanted to believe their wrong diagnosis's too. 

Mania. That is what the result of believing misdiagnosis can lead to... Or was that mania from the pituitary tumor the MRI also found? We don't know, and may never know, because it was not diagnosed appropriately at the height of it or for months after amidst the chaotic cycling that ensued and I will do all I can to prevent another manic episode.

But we could have known, had those whose care I was under, when the mania presented, taken it for the evidence it was -that more was in fact going on with my brain- and ordered the tests to be done then. 

And today I am glad and sad

Sad about the insanity of the journey and the mess that it has been 

Sad that my experience is being shunned and shushed instead of used to help others (and me)

Others who are also being shunned and shushed and treated badly inside and out of the medical institutions that should know and behave better.

Glad that I have the husband I do and we have made the progress we have. I have support here.

Glad that I have been fortunate to get the medical help I need even if it took far longer than it should have and the journey was not a direct route. 

...and nervous 

because today I just scheduled surgery for the hip. I will get it fixed next week. 

nervous... but also glad

glad that I will finally be done with the finding and diagnosing of injuries from the car accident of 2017. 

TBI has compounding effects. It leads to behaviors and symptoms that can look quite different than what is expected. And for those of us that are coming in with a second TBI, providers need to be aware of the effects of years of conditioning to hide and be ashamed of our symptoms and associated problems. Providers need to not add to the shame, shunning, isolation and ostracism. It even effects our ANS: https://www.researchgate.net/publication/324431877_Concussion_and_the_autonomic_nervous_system_An_introduction_to_the_field_and_the_results_of_a_systematic_review 

(yes, that article by my ex-neuropsychologist, is about concussion, but I am fairly certain more severe TBI's are likely to effect the autonomic nervous system as well... but that is just a guess) 

So in the end what am I batting here? I lost track... and I'll leave it that.

Cognitive Dissonance

 Cognitive dissonance. It's a theory. And a condition?

basically it says if your thoughts/beliefs and behaviors (what you think/believe and what you do) are not in alignment with each other you will experience dissonance "a tension or clash resulting from the combination of two disharmonious or unsuitable elements" within your cognition.. 

So like, if you feel morally obligated to report something but it is emotionally challenging to do so and you have a stupid (or intelligent, not sure which it really is) brain that considers far too many possibilities far too much, then your are going to be in a state of imbalance until you bring those conflicting variables into some sort of alignment with each other...

Stupid human experience.

Actually it is not and it is possible I am not so dissonant as I might be making it sound, rather just a tad annoyed with myself for letting my day get away from me once again in avoidance of continued attempts to straighten things out. Procrastination, distractibility, even loss of memory all seem to increase dramatically when I decide I am going to again work to tackle those rotten issues that day... 

Why?

Porque? 

It is so very annoying and now I feel bad at having wasted my day and I may even feel a tad guilty for coming here to process and confess... Oooh lovely blogger.com, my confessional and my redeemer...

Blasphemy! now what am I up to? 😬 delightful irreverent distractions of minimal comedic/artistic value... 

But why the dissonance of belief, knowledge and action? 

because we are creatures of habit?

and even when we know it is the right thing to do we still seek community over isolation and we hate to have our value, insight, and experiences invalidated ...again and again...

Hopeless?

No. I still don't and won't believe it and if that is stubborn then, in this situation, I will accept the label.

and my confessional, tipped over, turns into my soapbox...

Now off box and off to work I go to 

try and catch some portion of my day that got away...

To solve or not to solve... there really is no question

 To solve?

Or not to solve?

That is the question.

And yet I think I lack the ability to to not to and probably that stems from the silly little fact that I would not have survived if I had chosen not to. 

Too much is happening in a brain that is damaged and whose chemistry is so far out of whack and I am confident that, if what I was experiencing was bipolar, than bipolar is terminal if left untreated. 

Your body just cannot sustain.

and I am so very curious about it now and curious about how it ties to TBI. So curious about what was happening to me because something very strange was happening that I am certain science has got to be able to account for. 

by-the-way

So far I have been correct on that and here is some further evidence form Oxford Academics, Brain; A Journal on Neurology: "Manic changes are related to changes in the frontal cortex"  

I will confess I have not read the entire study but I read enough to know that they found a of reduction in grey brain matter in the prefrontal cortex of patients who had experienced manic episode(s) in comparison to those who had not. All patients tested had been diagnosed with bipolar and they did an initial MRI and then one somewhere around 6 years later. Some had had manic episodes and some had not. The reduction in grey matter was only observed in patients who had had manic episodes. It was not observed in those who had not. 

Hmmm, maybe this is why Psychiatric PA said mania is hard on your brain? 

And here is the very important, fascinating and also devastatingly sad part of this: Dr. Sweet (new neurologist) reviewed my MRI image with me at my last appointment I had with her a couple of weeks ago and the area we were looking at that had a decrease in grey matter matches the area/images of that study... The biggest difference, to my understanding, is that the patients in the study had it more uniform across the two hemispheres, right and left lobe. 

Now we do know that correlation does not equate to causation so it could mean something like mania in these patient caused the damage/changes. Or it could mean something like some forms of bipolar are degenerative and lead to a decrease/deterioration of the brain in that specific area which then leads to more manic episodes. Or their could be alternative explanations and other variables causing or contributing, some that I considered (ie. medication) the study factored in and suggests are highly unlikely to be the cause. But what we do know: mania can be positively tied to damage in that portion of the brain. That same portion that I have damage to. 

So what does this suggest to you? 

To me it suggests that initial insult was likely due to auto accident injury, and that location of injury made me much more susceptible to have a manic reaction/episode... I am also fairly certain that some the intense fight flight surging of chemicals that go along with mania are linked to the limbic and nervous systems- specifically the ANS. We also know the stress and other factors can trigger a manic episode. Thus it is evidently conclusive (to me) that my trying to solve really was literally necessary to save my brain and in turn my life from the harm that was (if not caused at very least) perpetuated and very likely worsened and exacerbated by the negligent and indifferent Intermountain Neuroscience Institute who absolutely should have caught and treated these injuries and ailments. They are, after all, The Neuroscience Institute. 

And even Dr. Reddy suggested it had been a "perfect storm" scenario. 

They could and probably should be utilizing me as a case study 

but alas doctors sure do hate when their patients turn out to be smarter than they are. ESPECIALLY when they have brain damage. 

...Is that possibly all this boils down to, they can't handle being wrong to, and corrected, by a person with brain damage?

Ah, living the glorious life of a TBI survivor. When we need people the most we are ostracized the most and when we manage well we are discredited, bullied and shamed by those who claim to be the experts. Tautology; the ever-present naysayer dictating our diagnosis, prognosis, and relationships. 

Even still

Dear Intermountain Neuroscience Institute,

 The offer is still on the table: use me as a case study because if you are what you profess to be. I could help you help so many people. Because that is what really matters and that is what is really important. 

.... insert sad sigh from the fading hope of the altruist in me.