Getting Back On the Horse

A year and a half ago, I rode my bike for the first time since the fall.

I fell.

Yes, again. No, not on my head, nor from 4m above concrete.

But, I fell.

Instantly recalling the old adage from my youth, if you fall off the horse, get back on. So, I promptly picked myself back up and rode it again.

But I drew the line at the motorcycle. I most certainly didn’t have the physical coordination or psychological confidence to take the risk. I decided that I’d leave the Wee Star parked — safely garaged — and on her own wheels for however long was needed to return to riding.

Fast-forward 18 months to today:

  • 63F, clear, and windless.
  • I ran 8km as the sun rose.
  • Had an appliance repair I had to tend to.
  • I took care of the batteries in the one outlier smoke detector in the house.

Then thought there was something else — something more — that I needed to tend to before the weather quickly turns rather cold…

A safety-check on the Wee Star, started it up, and donned my helmet to give it another go.

Yes, U-turns were a bit shaky. I need to spend some time practicing them far more and get back to the 3.5m diameter idle U-turns. It was a rather quick spin around the neighborhood. A bit of quick-stop practice. And she still remained on her tires and quite unblemished. I’m rather happy about that.

I’m extraordinarily pleased that I had opted to garage the Wee Star until confidence had returned.

Sometimes, getting back on the horse will take some time.

Also, I still refuse to let the Wee Star show up at a home on a trailer. She’ll be ridden there under her own power.

Grrr…

I’ve complained before about noise. Ambient noise, white noise, just noise. It seems somewhat common from what I’ve read to be sensitive–sometimes very sensitive–to noise with the TBI. But it’s honestly freaking tiring.

Here I am, nearly two years on–today, doing a bit of simplistic home-improvement, and generating a bit of noise in the process–and I’m exhausted. Completely and totally mentally spent.

Then again, recent events may have also contributed.

Nah, it’s totally my ability to perceive audio. It will, like all things, change with time. Continuously imperceptible to me, and, in time, it will change–or I’ll become more accepting of my own perception of it.

I wonder if I should start using some mild-strength earplugs to help dampen or take the edge off of sounds on the left side.

Worth Giving a Try…

I’ve gone on a few times about some of the struggles with which I’ve contended around hearing. I’ll summarize the summaries:

Sound is a problem.

Too summarized?

Okay: sounds are familiar, but something’s not “right”.

I’ve recently started to wonder if part of the challenge is actually something of a hypersensitivity to sound. Apart from going through a period of deafness, so to speak, I wonder if that deafness was something of a neurological attenuation of sounds trying to bring them to appropriate levels for comprehension. Perhaps the initial concern that I’d made — that sounds felt effectively overdriven — may have been an accurate interpretation.

Now I find myself wondering if some mild-grade earplugs with a low NRR could be somewhat beneficial. I don’t need (nor want) a 32 dB NRR solution, which would be ideal for motorcycling or shooting sports. But it’s certainly worth giving something mild a go to see how it will impact my perception.

Permanent? I can also see that it would be as long-lived as my need for a cane has been. I found it inconvenient.

Hitting Rock Bottom?

Go have watch, and listen, and resonate:

…or a Shattered Assumption of the kind that blindsides you at 4PM… on a Friday… right before a holiday weekend… with family arriving to lazily and quite happily spend the week with you… while at the same moment, ambulances rush to take your broken body and very shattered life to a trauma center where dozens or hundreds of people work hard to save you. And you don’t have that realization until that groggy, amnesic period after awakening from the prolonged coma.

Oh… wait… sorry.

You know, a few years before that happened, I’d come to the conclusion that the best way to grow would be to step outside of your comfort-zone. Far beyond your comfort zone.

Detach yourself from any of the comforts one might enjoy in their daily life: restaurants, work, your home, people you know — even the city or nation that you know.

Thoughts on the Neuro-Psychology Exam

[Alternate title, “Ritalin: It’s not what you think.”]

It’s now been about a year or so since I did the post-TBI Neurology/Psychology battery of tests — the Neuro/Psych exam. I think I’d said before that these things were often performed prior to returning to work, but because I’m so determined (and somewhat narrow-minded) and was chomping at the bit to get back to the people I knew, I just resumed work as best I could then worried about the Neuro/Psych tests later.

Last March, I’d shared, very vaguely, the way Neuro/Psych exams are performed. I’d also used the abbreviation “PSE” and I frankly have no idea how or why I’d used that, so… meh. Jump back there for a read of the very generalized review of how the Neuro/Psych exam works.

The intention was, of course, to baseline the patient and compare his performance to — a big question mark. There is, of course, nothing to compare the patient’s current mental state to his pre-TBI mental state, so it’s instead very much working in averages based upon the statistics and trends of other people in the same age- and education-range.

I’d made it rather clear at the off that I have limitations and they’re almost entirely mental focus-related. Sure, there were other issues — gross neurological-related.

Ultimately, the report from the psychologist said…

…nothing that I didn’t already know.

I’d never read it, and it was relayed to me by the neurologist. He suggested, “I think we should try Ritalin.”

Ritalin? Well, Methylphenidate, actually — Ritalin is, of course, a trade-name.

So, sure. It doesn’t hurt to give it a go. A couple of concerns with it, but they have nothing at all to do with the social, dosage, or cost.

We’ll take those in reverse order:

Cost: trivial. In fact, I’d wager that somebody could shuffle around in the couch cushions to find enough to cover a three-month supply. I think it was US$3 or $4.

Dosage: it’s actually the smallest possible dosage. 5 mg. We’ll do it once per day and see if there is any impact.

Social: ADHD. This isn’t. I suppose that Ritalin is often thought to be a sedative to calm down hyperactive children. It doesn’t do what you think, nor is it anywhere near the dosage level that people would assume. It’s actually a stimulant, not a sedative.

“You’re giving stimulants to hyperactive children?!? What kind of monster are you!?!”

hammy the squirrel

“The last thing you need is caffeine.”

As much as you’d think caffeine will make a hyperactive child more hyperactive (mega-active?), it actually won’t. What you consider to be “hyper-activity” is actually the result of boredom coupled with rapid, unfocused task-switching.

Also, as long as I’ve been on it, I’ve not had any psychological awareness of stimulation (or addictiveness) — but it does help improve task focus.

So, where’s the problem?

It’s inconvenient.

You’ll need

  1. an actual printed prescription, and
  2. only a 90-day supply, and
  3. there are no refills.

That’s somewhat inconvenient. Methylphenidate is on the Schedule II controlled-substance list and laws. Other things like Hydrocodone, Opium, and Morphine (among others) are on the list! No wonder there are such strong social beliefs about being in a culture that drugs children. And, yet, Methylphnidate is nowhere nearly as physiologically (or socially) impactful as those substances are.

So, every three months, I’ll need to get a printed prescription from the doctor who is 110 miles away. I suppose I should investigate having a local doctor here in Moses Lake do the needful rather than a neurologist or physiologist in Spokane.

Are there alternatives? Well, caffeine, at an appropriate level, will help provide the additional mental focus, but it has several other rather unwelcome side effects: tremors, elevated blood pressure and heart-rate, digestive issues, insomnia.

Ritalin is far more agreeable. Inconvenient, yes. But far more agreeable by not incurring any of those other side effects.

Right, so where are we one-year on?

I’d say that now there’s something more realistic to compare last year’s exam to. Rather than compare to the global averages of people at the rough age and education level, it’s going to be more meaningful to compare my current state to the previous state.