Search This Blog

Thursday, September 24, 2020

Surgery, What a Rush!

I had this kind of fun today

and now I have one of these! Yay

Waking up from surgery was really weird this time. They did not put whatever happy drugs into my IV as the ankle doctors did. That was a happy fun waking up.
This time I was so shaky and not because I was cold. My emotions were unstable. I needed to know everything. I tried to relax my mind but it was misfiring all over the place and I 'd shake and cry...
But the interesting and kind of cool thing was I knew exactly why. 
"my right prefrontal cortex is damaged and that's what is happening" I told the nurse. 
"My Autonomic Nervous System is all out of whack and firing fight flight signals." I ask her if it is normal for people to get shaky like this. She says it is. But I know something about this is not normal or okay. It is uncontrollable and I feel like my body is experiencing a form of shock. I am telling the nurse what the prefrontal cortex does and why my reactions are related to that. 
And even though I have a spinal block I can feel that my very low damaged disk in my back is unhappy. It usually gets that way if I lie flat on my back for too long.  The nurse leaves for a moment. I have to adjust my body position to settle that disk, knowing that could help settle some of the nervous system stuff that is firing like crazy.
When the nurse returns she tells me I need to get back on my back and she helps me do that but also makes sure I have a pillow to support and she adjusts my bed to sit me up more. 
I tell the nurse my brain is not handling this well and that we need to get it to settle down. The crying and shaking is out of control and it is scary. I try to calm it, and while that works on my psyche it just seems to send new shock waves through my physiological systems. I need something to calm it. My impulse control and mouth not up to par, I actually tell her this mess of my body is due to "jackass Dr. He" and "stupid Dr. Concussion" I feel this because they potentially caused more harm to the locations of my damaged brain by ignoring and denying what was happening and thus perpetually feeding these very responses, things similar to what is happening now; a broken system that is struggling to regulate, especially under stress. And they kept it going for far too long...* (see end note)  I think I may have used the "f" word once or twice. But at least I did not rip out any IV's or try to get out of bed. 
 Nice Nurse gives me some sort of sedative, maybe Diprivan. She starts with a half dose. But has me take the second half about 10-15 minutes later as my bodies response is starting to look more and more like shock or a full blown panic attack. I keep asking questions. She tells me she will go over it later because I won't remember now.  
But I remember. Second dose in, she allows me time to settle. The medication starts to work it's magic and my body and emotions start to come back to center. I'm leveling and when she thought I was sleeping, I was mostly not. I was settling and allowing the medication to work and allowing my body to settle. Your brain is part of your body too. 
These mind altering medications are absolutely fascinating. And this was another rather fascinating experience. 
I tell the nurse, "I really should be a case study."
I am not in a drugged like state after the medication. I am not sedated. I am simply settled, and back to the more accurate version of me. I am stable again and my nervous systems are settled. My mind is able to work in a calm and rational way again. 
Home now, my husband observes once again, "You are so alert and fine." After both of his surgeries he was groggy and out of it. For days.
I don't seem to work that way. Even after giving birth to my two kids I was like, "okay, when can I go home," while my husband was wiped out- asleep in my hospital bed with the baby.
I am guessing I will get tired and my emotions will start to get to me again. But this little incident, so heightened and bizarre, yet I knew what was happening, I was able to identify it, communicate it, and I knew what I needed. The medication, amazing, brought me back to level rather quickly. Not sedated, but level.
I am so grateful for a nurse that listened and cared. 
...I suppose it is not too surprising to find out that she has a daughter that suffered a stroke at age 18 and has endured some similar effects due to the lasting effects of the damage it caused. 
...So once again, this is why I talk about it. :)

*A little later I ask her to send a report of this to the Neuroscience Institute, even though I know it is highly unlikely she will. But I want her to because of how it correlates with what I had tried to tell them and even with their own research -which according to them somehow did not apply to me, probably because they had opted to make me taboo instead.
Another note on this: while I am certain many may think, and I do to, "just get over it, quite tying it back to them."  I sometimes can and I sometimes do, however, I live with the realities they denied everyday. I live with the rejection from the one place in the world where I really do belong and really could be a valuable asset. While I know, "the one place in the world" is not entirely true -there are others- they have actually done enough harm and sufficiently tainted my name and my records enough that I am now, something like blacklisted by other institutions and organizations that could otherwise easily be home to me. 
The lady from the BIAU conference last year, -the one who claimed my attempts to converse with her, in ways that could help me understand were unethical- she is on the board. My attempts at conversation with her were not unethical, rather, to her, it was taboo. Which, we all know, is what is truly unethical. But no matter, she holds the power and all the cards and I am irrationally "unsafe" to her and the off vibes I have caught from others who have connections to her, my intuition suggests are related. I could be wrong, and I keep trying. But over the years I have gotten rather good at knowing when people are talking about me behind my back
... And I can tell you, it sure makes them uncomfortable when you try to address it directly with them. Which to me seems most reasonable, logical, and mature. But somehow, even if you think you have it cleared up, very often you don't. They even like to use the fact that you brought it up to further fuel fires... sheesh, I thought we were supposed to move past this kind of communication after junior and high school... but even the most elite among us can't handle it, heck they may even be the worst at it.. Or is it just doctors and educators? The most schooled among us. hmmm...That actually makes some sense since elementary and secondary schools seems to be where these problems would mostly lie and are rather developmentally appropriate,  and most teachers go straight from high school into college, coming from highly flawed systems which they were successful in. Thus, they are very likely to repeat the same patterns. While doctors also usually go straight from high school to college and then stay in these education systems for many years being educated by educators who have never actually survived outside of these systems...
hmmm...

 

Wednesday, September 23, 2020

When the person becomes the Taboo

It's so hard to channel my thoughts right now. To limit to one area of research. I want to know and understand everything. 

Like Taboos

I am pretty sure therapists developing certain feelings for their clients is pretty taboo for them. 

And as I am reading about taboos I am realizing that the aforementioned often results in the actual object of affection, who is also coincidentally a person, becoming the taboo. 

I am a taboo. 

It's not my problems or conditions that are taboo. It is not how I behaved or even the misdiagnosis that is the taboo. It is me. I am the taboo and I have become a taboo for a bunch of people. They even want me to taboo myself. I'm not supposed to talk about it. 

It is not unethical for me to talk to people about my experience and yet I have been told it is. But ethics is not why they don't want to talk to me about it. In fact if it were about ethics the opposite would be happening. They would be talking to me about it. It is not a matter of ethics at all. It is a matter of taboo. And I am the taboo... 

No wonder I feel so powerless. Even thinking about me is wrong and forbidden and punishable. Especially thinking of me with any kind of positive regard. 

And I am unjustly and unfairly put into the same category as things like: incest, so many sins against children, cannidbolism, and all sorts of other terrible things that are so taboo I don't even want to mention them. 

 https://www.psychologytoday.com/us/articles/199801/dont-even-think-about-it

It's an old article, and long so I did not read it in its entirety, but it is interesting. I just wish someone would cover the very taboo topic of how some, often irrational, taboos are turning victims into taboos. 

I know others who are also taboo. Voiceless, powerless, vulnerable and broken by the very people who were supposed to be protecting them. The people that were supposed to be loving and nurturing them. Their abusers are not taboo. They still have plenty of life and voice and people are aloud to talk then and about them. They are allowed to accept them and even love them. But that is not how the victim is treated. They, and most who knew the person who is actually the victim, will not talk to them and won't even allow themselves to think about them. And if you try to talk about them to get them help, you will quickly see what I am talking about here. 

If you try to file a complaint on my behalf or try to talk to anyone at the Neuroscience Institute about me, or others who have made the "it's unethical for me to talk about this" claims, or if you try to contact a lawyer on my behalf or the media -and I both give permission and encourage you to do so- you will quickly see just how taboo I am. 

"Anyone who has violated a taboo becomes taboo himself because he possesses the dangerous quality of tempting others to follow his example."
-Sigmund Frued form: Totem and Taboo:Some Points of Agreement between the Mental Lives of Savages and Neurotics

Heaven forbid others may follow my example of wanting to talk about problems, address them, and work to correct them in ways that are fair to all parties and could even benefit many more people to come and even their own business. Heaven forbid we treat people with TBI and mental health issues as intelligent, respectable, and equally human. Sheesh, what a horrible heathen I am!

...and have you ever dared read studies related to any condition you have? You find yourself being equated to mice and your condition the biomarker of you as a human... or something like that. It is not so easy. They rhetoric is very one-sided and dehumanizing. And I think my brain is starting to shut down because of it...

anger. sadness. fatigue. all rearing their UR's (unconditioned responses) to a CS (conditioned stimulus).

Or would my reactions be considered conditioned because they are directly related to effects of TBI and the hopelessness I have been conditioned to feel? 

And maybe the real reason I am struggling to decide and stick to one research topic is because they are all quite painful to study... It's hard to be reduced to statistics and structural abnormalities. It's hard to be the empty and missing voice, all words relating to you and those claiming to represent you and account for your voice coming from the same type of professionals that have used and abused you, refused to listen, and/or discriminated against you... It's hard to be reduced to mere representation by the side that has assaulted you. And made you taboo.



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... 

Monday, September 21, 2020

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.


Sunday, September 20, 2020

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. 

Saturday, September 19, 2020

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. 

Wednesday, September 16, 2020

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.