Cognitive Rehabilitation

[rhondalea]

The site going down was a blessing for me, because I realized just how much I rely on its existence. All my attempts to post since Denise died have ended in failure, but I did my best to keep up with what was going on. (So even though some of you don't know me, I've met you, and I think of you and hope the best for you.)

I still have a hard time writing. I can manage Facebook because shares don't take thought, but everything else that has anything to do with stringing words together to make sentences--oral or written--has not gone well. Not at all.

Two paragraphs, and I've still not gotten to the point. That's one of many problems I'm facing--I can't keep my train of thought on its track, so I babble.

So...

I had my first cognitive rehab session yesterday. The purpose was intake, so there wasn't a whole lot of therapy going on, but boy, was it an eye-opener.

All those brain games? They probably make chemobrain worse. In fact, nearly everything I did to try to make chemobrain better had the effect of making it worse.

It turns out that what an injured brain needs is the same thing any other injured body part needs--rest. Time to heal. The example the neuropsychologist gave me was a runner with a leg injury--even if she was running 10 miles a day before the injury, an attempt at 5 miles after the injury will only delay healing. Baby steps. It's all about baby steps.

I've been instructed that I've been pushing myself to hard, and I am to take breaks.

-Reading is not a break (and in fact, she told me I should probably only read for 15 minutes before I take a break).

-Playing a game of solitaire is not a break.

-I'm not sure about housework, but cooking probably isn't a break.

-I don't watch TV, but if I did...you guessed it: it doesn't qualify as a break.

-Posting here and reading here (or anywhere else online) is not a break.

-In other words, nearly everything I consider relaxing...isn't. At least, not for my injured brain.

She told me to "think primitive." Firelight, not electricity. I can go for a walk. I can sit on the porch and drink a cup of tea. Well, okay, electricity isn't totally out, because I can listen to music. I suppose I can daydream, but I can't sit and let my thoughts grind about the things I need to do. If I could remember how to knit, it might be okay, but the relearning process would not count as a break. Grooming the kitties is acceptable, but I'm absolutely certain that sorting my piles in the basement is out. P.S. Running errands today didn't feel like a break because the wheels were turning in my brain the entire time.

A long time ago, I signed up for notifications from calm.com so that I would know when their Android app was released. Then it was released, and I ignored it. Yesterday, I downloaded the app to my phone, and I added the site to the task bar on my computer. I've used it today, and I think it, too, may qualify as a break. It features new age-y (very soothing) music and a serene scene to watch, unless you use the guided meditation feature. For that, you close your eyes and listen and relax. I managed two minutes the first time, but I've since worked up to five at a time. Seems to help, because I felt a lot better afterward.

Googling for clues about resting the brain after an injury, I came upon the tidbit that blinking rests the brain. Here's a link:

http://articles.latimes.com/2012/dec...-rest-20121227

Today, I have practiced blinking. It's quite a lot of work to remember and then do it, but it does help me feel more clear-headed. Long ago, I remember reading (and then noticing) that part of the problem with computers is that people blink less than normal when looking at the screen. Remembering to blink helps the brain and the eyes.

Now the bad news. Most insurance seems not to pay for cognitive rehab. The program I'm enrolled in offers charity care, so I would guess that other facilities have similar ways of covering care for those who are not covered by insurance. (I am, but they thought I wasn't, which is how I learned the option was available.) It seems downright sinful to me that this service isn't routinely offered to individuals with cognitive deficits on account of cancer, because just one session has made a huge difference for me.

About that difference... I have a lot of doctors. All but one wanted--desperately--for me to be depressed, so that they might write a prescription and send me on my way. I kept saying, "I've been been depressed. I know what depression feels like. This isn't depression." For some reason, though, the medical establishment has a default setting: "If we don't know how to fix it, it must be in your head." To tell the truth, I started to fear that I would become depressed because of how dismissively I was treated and because there were so many really stupid roadblocks in the way of my getting the appropriate care.

Well, they can all bite me. In a single session with this neuropsychologist, it became clear that everything I was experiencing is so common to brain injury as to be pathetically pedestrian. As I sat there with my jaw dropping, she told me what was happening to me--it was as if she'd been watching me go about my daily life for months on end rather than just meeting me minutes earlier. All those doctors I mentioned above? They're about to be on the wrong end of an earful.

I encourage anyone who is having any cognitive problems at all to have a neuropsychological evaluation. If nothing else, the validation is life-altering. The coping tools offered afterward the diagnosis are just the icing on the cake.

P.S. In case I don't get my sig fixed right away, I am no longer on Aricept. It helped a little in the beginning--which may only have been a placebo effect--and then it seemed to make everything worse.