Monday, May 28, 2012

Sleep As An Droid Android App Review


I'm always looking for ways to objectify the information I report about my recovery, since symptoms of brain injury can affect perception of those symptoms. I recently found an android application that interprets sounds I make as I sleep and graphs sleep cycles. I have learned two things from these graphs:

1) I'm not getting as much night-time sleep each as I imagined.
2) Only when I am very well rested, do "standard" 2½ hour sleep cycles emerge.





The review gets a couple of details wrong. The software does provide comparisons of sleep data. It can optionally record when you snore or talk in your sleep. The description I read says the app uses a combination of motion and sound to produce its data, since not all android phones have identical capabilities, the method employed by the app to gather its data will vary from phone to phone.


Thursday, May 17, 2012

Brainstorming About Ideas I'm Considering

As I recover from a moderate traumatic brain injury, working through understanding new limitations, and looking for ways to cultivate positive outcomes from a negative event, I plan to post resources for recovery as I discover them.

Soon, I intend to link a set of static pages with the kinds of resources the title of this blog suggests. I also intend to post a description of the accident (to the best of my ability) that caused my brain injury. That description may take the form of a "first" blog entry. I have written about the accident on a number of occasions, so I have notes I can use to put together something rather quickly. One issue that concerns me about describing the accident is my continuing amnesia surrounding the event, and the discrepancies between what I think I remember and what others reported at the time. I still haven't resolved what I really think about the accident in my own mind. It is safer to say I don't remember, and to report what others have said, than it is to report my own disconnected set of mental images that are inconsistent with each other, and don't fit the observations of others.

I started writing this morning with the intention of discussing the value of brainstorming to overcome limitations with short-term memory, but as I prepared, I found my thoughts are too disorganized to write coherently about a single topic today. Instead, I'll do some brainstorming here, and mention some of the ideas I'm considering.

As I have considered my own situation I have become fascinated by the relationship between problems with the inner ear and a range of cognitive difficulties that are traditionally associated with the cerebellum. Specifically, I am intrigued with the suggestion that inner-ear difficulties that cause vertigo can overwhelm the cerebellum with conflicting data, slowing down its function, and causing a variety of difficulties which fit the general pattern of symptoms I have experienced.


mindmap created using http://www.mindmeister.com

The idea that vertigo and cognitive and sleep issues could be related is exciting to me because it would imply that exercises and meds that are effective in treating vertigo may also be effective in helping my recovery.

References:

Schmahmann, J.D. (2004). Disorders of the cerebellum: Ataxia, dysmetria of thought, and the
          cerebellar cognitive affective syndrome. The Journal of Neuropsychiatry and Clinical
          Neurosciences, 16, 367-378.
 






Monday, May 14, 2012

As I recover... (first entry)

While this May 14th entry was my first blog entry, I intend to create additional prior entries from other notes I created on those days to provide a sequential perspective to my thoughts.

As I recover from a moderate traumatic brain injury, working through understanding new limitations, and looking for ways to cultivate positive outcomes from a negative event, I plan to post resources for recovery and accommodation as I discover them.

One of my new limitations is a tendency to think ahead of my speech, making comments that are out-of-context for those who cannot read my thoughts as I think them. Sometimes entire sentences and words that I believe I have spoken, were not spoken. More often, I speak parts of words, dropping prefixes or suffixes 
as I speak, or even single letters of the alphabet as I write. I have discovered I make word substitutions such as "necrology" instead of "neurology." Since my accident, dropped words are now common in my speech and writing.


Social resources 

One of the most humbling aspects of a long-term recovery is the need to accept the help of others, and to show appreciation for "help" when it goes beyond what was wanted or needed. As I work on this website, expect to see changes as people make comments to help me improve the site and make it more useful.

I depend on others to help me overcome these difficulties with my speech. If others do not make me aware I have said something that makes no sense, then I assume they have understood me. Depending on others to help me recognize errors requires me to contribute to the process by accepting others' misguided attempts to help with a sincerely appreciative attitude. 



Software resources

Just as I depend on others to tell me when my spoken words have not made sense, I depend on software to help me express myself clearly and consisely in writing.

MS Word's document review feature can identify misspelled words and grammatical errors. However, MS Word can be tedious for checking single paragraphs that are common in online posts. SpellCheckPlus.com is free to use, and does a great job of identifying grammatical errors. In a recent email to the company, I wrote:

... I tried using the grammar checker in Word, but word seemed more concerned about use of passive voice than it was in nonsensical word choices. Your software catches my errors, and it enables me to write intelligibly....


Resources:

Nadasdi, T. & Sinclair, S. (2012). Spell check plus. Nadaclair Language Technologies.
          Retrieved from http://Spellcheckplus.com.


Neurology. (2012). Dictionary.com unabridged. Retrieved from
          http://dictionary.reference.com/browse/neurology

.








Friday, May 11, 2012

Something strange just happened.


(Posted 5-23-2012, this note was taken from my journal entry for 5-11-2012 as-written, including some dropped (missing) words which I left to illustrate my on-going difficulty. I did see the error, and I chose not to correct it.

Please be warned the post is about a nose bleed. I delayed going to bed to write a description in the hope that the released pressure would trigger an improvement that I would want to document. Sadly, the day-to-day variance in my symptoms over-shadows any small improvement that the released pressure might have brought about.

I removed the ''
things to discuss with my doctors" link to my medical information that was in the original post. I also re-ordered words in the next sentence for aesthetic reasons.)
Blood in the bathroom sink
(there is no actual blood in this photo)


Ever since my accident, I've been bothered with more sinus pressure than usual, and difficulty with sinus-related headaches. I have suggested to my neurologist repeatedly that I think sinus pressure could be related to the neurological symptoms, but he has repeatedly assured me nothing serious is going on up there. As I taking drinking my bedtime water and thinking about taking some Nyquil for cough and sinus pressure, suddenly one of my sinuses on the left side of my head behind and under my eye released pressure, dumping a large (1/8 cup) quantity of bright red fluid. The fluid had enough blood in it to look very disturbing. I wonder whether this is something serious?



Written Saturday Morning, 5-12-2012
Last night just before bed, my sinuses behind and under my left eye suddenly released a large quantity of bright red fluid too thin to have been all blood. I estimated the quantity to have been more than two tablespoons. I had not been doing anything that could have caused the bleeding. I had been doing some loud forced guttural sounds trying to loosen heavy mucus high in my throat (at least that's were I perceive the location of the pressure that makes me gag if I don't continually work at getting it to clear). Normally several times of doing that will loosen chucks of mucus I can spit. This effect of causing a large quantity of liquid that also contains bright red blood is entirely new.

I debated about whether the incident was serious enough to require an immediate call to a doctor. I decided since there was not actual bleeding, just a single gush of bloody fluid, that I was OK. I should probably maintain a list of things to discuss with my doctors, though.

Thursday, March 15, 2012

Symptoms


(This journal entry was written 3-15-2012 but posted to this blog on 5-28-2012. In spite of the glaring errors, I attempted to catch errors at the time. Hopefully my ability to see those errors now is evidence of improvement. There is a strong temptation to fix the missing or substituted words and the resulting improper grammar, but I think allowing the reader to see the kinds of mistakes I was making may be helpful to understanding this condition. For writing comparison, look at my other blogs such as Big Bad Ideas where I allowed myself to get a little crazy with miscellaneous posts, or Recharge Point which was used to post my thoughts as I worked toward my master's degree in Instructional Design and Technology--specifically designing online courses.)
Sometimes I report symptoms very differently than at other times, because these symptoms bother me to varying degrees from time to time. Some of these symptoms may not be specifically related to TBI, but are associated with my experience after the bicycle accident and head injury. Also, some symptoms are difficult to track, because the symptoms affect my perception of the symptoms. 

Amnesia is a good example of a symptom that hides itself. To be aware of the problem, I have to be confronted with external evidence that I don't recall something I once knew. Examples of evidence I have encountered involve tasks I started only to discover I had already completed the task, such as the work involved in concluding my last week of class after the accident, and two weeks later suddenly panicking because I could not recall completing the previous course. Fortunately, it was a simple matter to look up the work I did, because one of the assignments was posted online. In the first several weeks after the accident, evidence of amnesia was one of my most troubling symptoms. 

Some of my symptoms are difficult to name. Since the accident, I have been confronted with evidence that I never did a task I believe I remember doing. It is my impression that I'm recalling an incomplete thought process in which I started a task with the intention of finishing, but was momentarily distracted. Later, when I review my task list, I mark the item done, believing it was done. I have learned that when facts don't agree with my recollection, that I usually recall a specific image of working on that task, which is the basis of my belief it was completed, but if I try to recall the entire scene, I cannot recall it, because it was interrupted and left unfinished. While this problem may sound potentially serious, I'm not terribly concerned because I can test my own memory and know instantly whether I have a complete recollection of the entire task. If I can't recall every step of finishing, and someone else says I did not finish, then I did not finish. If I do have a complete recollection, then I treat the issue the same way anyone else would, by presenting evidence that supports what I am saying.

Fortunately, most people are flexible enough that an occastional moment of personal reality adjustment is not terribly upsetting to them, and if they aren't upset, then neither am I (to a point).  

Prior to the accident of 6/23/2011, I never experienced episodes in which I discovered I had done work I did not remember doing. amnesia. 

Vertigo is an example of a symptom that comes and goes, and can be disabling at times, but usually is not noticeable. Vertigo can be dangerous because it can cause accidents, especially if it comes on while driving a car. Prior

Sunday, February 26, 2012

Tales from the void: "I'll take slightly crazy over slightly dead any day"

To put a lighter spin on an otherwise darker time in my life, I have labeled it "the void."
Copied from Facebook:

alt
David Lloyd
Feeling Stronger

(Actually, I don't feel that great at all. I have unaccountable muscle pain all over, which would be good if I had been working out yesterday, and I may be coming down with bronchitis, but that's not the point of this post.)

For the first time in a long time, I woke up with what I consider my "normal" morning attitude, which is positive, "strong," and capable. For a long time since my head injury last June, I have privately wondered whether I would be going to bed by nighttime, or if I would awaken in a hospital or worse....

I also woke with a set of epiphanies about various topics I had been considering the previous day, which is also normal to me, but not recently.

I had a thought about how sophisticated user-level cloud-based file sharing, in which the creator of an individual file, and the people designated as collaborators with various levels of access is replacing traditional computer network security. I wondered whether the IT community had fully grasped the implications of this phenomenon to their monolithic security structures. I resolved to review the various IT blogs in my reader software to check what others are thinking.

I had a thought about a new paradigm about mental health in which health is evaluated across multiple spectrums, rather than the current nonsense of equating the ability to name a set of symptoms with a "diagnosis," which I discounted about ten years ago as nonsense. If you have a label, you do not really know any more about yourself than you did, but you also no longer feel "normal," nor do you tend to feel capable, regardless of the label. But if instead, we reported simplistic scores on a sliding scale across four dimensions, we not only could understand ourselves better, but we would see ourselves and our potential in a much healthier way in terms of taking charge of our own mental health.

To grasp my paradigm, suspend your private views of what constitute "reality," and assume (as I do) that our perceptions of reality have more importance to us individually, than the objective reality around us that none of us are capable of fully grasping. My paradigm accepts a relativistic view while affirming a "solid" external reality also. An individual's grasp of reality then, can be evaluated based on how well that person connects with others, and on how "profitable" their view is to their own success; however each person individually defines success. For example, whether or not "they" are out to get me, it is likely "they" have enough concerns in their own lives to have little energy left to focus on my life. Chances are that if my interactions with them are honest, positive, and co-beneficial, that they will drop their "conspiracy" and become my allies. Not all beliefs about reality are useful to me. A little "honest" self-deception about my outlook can go a long way toward improving my actual prognosis.

So, back to dimensions of mental health (Needs expansion and consolidation):

Alertness and awareness
Confidence and optimism
Connectedness (the extent to which my "reality" derives from my connections with others and with God)
Happiness and pain

Sub-dimensions:
Empathy (the extent to which I understand others)
Confidence (my willingness to take risks)
Optimism (beliefs chosen for profitability AND truth)
Sympathy (the extent to which I exist to serve others)

Instead of fixing depression, drop the label, and focus on how the score across these four (or more) dimensions, compares with what the individual would consider ideal.

Instead of fixing severe symptoms of altered reality, focus instead on general physical health factors that may be influencing fear responses and general awareness. I suspect all phenomena we label as altered reality, "voices," or hallucinations, are part of the awareness spectrum, but also influenced by the connectedness spectrum. Essentially, the schizophrenic is experiencing a feedback loop in which dreams perceived as reality excite fear which the dreaming mind attempts to interpret and explain.

Just attempting to break the cycle by artificially lowering dopamine levels may make the patient more comfortable and more manageable, but may actually strengthen the problem of wakeful dreaming, because low dopamine levels contribute to less awareness. A better approach may be to help the "dreamer" understand the process of wakeful dreaming in a safe environment, while verifying no marginal health issues such as low but "normal" thyroid levels are affecting wakefulness.
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    • alt
      David Lloyd Wow. This seemed so insightful this morning when I wrote it.
      It must be the drugs.
    • alt
      David Lloyd Note to self: After the doctor adjusts meds, save "brilliant" essays at least 12 hours before posting them...
    • alt
      David Lloyd Regardless, I'll take slightly crazy over slightly dead any day.
    • alt
      David Lloyd Last night, Audra assured me that my ideas are not crazy, just insufferably dull. Then she scolded me for the self-critical comments, gave me a hug, and she went to bed.
    • alt
      David Lloyd Betty and I have the best kids ever.

Thursday, February 9, 2012

Tales from THE VOID: Clueless

(see THE VOID)


I originally posted this comment on Facebook on February 9th, 2012, a day within a span of about three months from the end of December through the beginning of March for which I have almost no recollection. I averaged 20 hours of sleep per day during those months, and even the time I was "awake," no meaningful work was accomplished, and I have almost no memories from that period of time. Those months seemed like a span of a week or two. I purposely did not attempt to answer mail during that period because I knew I was not capable, and because I had a distorted impression of the amount of time going by. I never considered that I could be missing important deadlines. When the period was over, I became overwhelmed with bills that had not been paid, and official Government deadlines that had not been met. I also flunked the capstone course in a Master's Degree program in which I had been maintaining a high "A" average. My projected final GPA at the time was 3.95. (10-13-2012)

In the midst of that terrible period, I wrote this comment (which did NOT prove helpful*):
Today I made a discovery about my symptoms that make me hopeful I will be able to proceed with my school work (and other endeavors) at a stronger pace. I took a strong dose of ibuprofen around 2:00 pm because of extreme neck pain, and within a half-hour, the neck pain was bearable, and I was feeling alert and able to work. I have long suspected that my head injury had caused swelling that was the cause for my extreme sleepiness, but it never occurred to me that something as simple as ibuprofen could fix the problem. I'll be taking another stiff dose of ibuprofen tomorrow morning, and hopefully I'll have a productive day tomorrow! (and, of course, I'll be discussing this discovery with my doctors, if tomorrow goes as well as this afternoon)
 * (written 6/19/2013) I struck out the comment "which did NOT prove helpful" because I may have been premature in that assessment. I thought I had ruled out Ibuprofen's possible benefit for memory because continued use did not provide continued benefits, but in hindsight I realize the problem may have been with the amount of Ibuprofen I was taking. Recent studies have shown a previously unsuspected link between brain inflammation and diffused axonal damage, which is the most common cause of continued decline in "mild" TBI cases. Ibuprofen is probably not going to prove to be a preferred choice for TBI patients, because the dose required to bring about improvement is too high for most people to tolerate, but some other anti-inflammatory drug, one that can pass the blood-brain barrier like ibuprofen can, may be useful.