CONSERVING OUR OWN ENERGY

    Conserving energy is a timely subject for me on this particular evening.  It's Friday - the end of a two week run of an over booked Day Timer and now I am planning the next week with the 'less is more' mindset.  

     The temporary madness started 4 days before the Oscars (just a little over two weeks ago).  I was preparing for an Oscar Party of 6 friends.   To most, that number of guests doesn't make a party but to someone with a brain injury that is a 'huge' party!  In the last 9 years I have learned well to pace myself by following a schedule a week before the event of making a prop or one food item each day.  The food is frozen until the day of and by Saturday - the night before the Oscars - I was quite proud of myself.  Everything was ready to go for my party, the props were up and all I had to do next day was heat up the food and serve it.

     Sunday morning I was feeling a tad weary from the steady preparations but naively, I felt I had made it.  I could have a crash tomorrow and spend the day lying down, but it would be accomplished and I would be proud of success.  I took the 2 loaves of bread out to thaw for the dips to be baked later on.  I put together my one star offering - Gateau Basque - a decadent french pastry.  I had prepared the pastry and refridgerated it a couple days before and I had made the pastry cream and chilled it as well.  I had even marinated the black cherries and simply had to assemble and then bake it.  So far, so good.
     All of the cheese, crudites and sliced meats were cut and just had to be arranged on the serving plate, covered and chilled.  I had made lasagna rolls, laid them out in the baking pan and frozen them a week ahead.  Now I removed them from the freezer to thaw and I had sliced fresh mushrooms and cubed mozzarella in preparation to top each one before going under the broiler just before dinner was served.
     Finally I put the precooked and marinated chicken wings in the oven to bake slowly over the next couple of hours.  And oh yes!  The quinoa salad had to be put together. 
     Time to rest.
     It was 2:00 when I put my feet up in the recliner.  I made myself recline for one full hour but my brain kept on racing around in circles.  I did not feel rested when I got into the shower but I had to move on.  I dried my hair and styled my hair.  Back in the kitchen, I checked the wings and they looked like they needed a few more minutes so I moved on to another task.  I was sitting down much more frequently now as my mind started to turn to a thickening, gelatinous state.
     My guests were expected just after 6:00 and it was already 4:30.  I started to rearrange the loveseat and the arm chairs so that they faced the television for viewing the Oscars.  I took wine glasses out for the guest and started to bring out silverware and serving utensils.  I suddenly smelled something burning... I took the lid off the pan of wings to discover little blackened morsels of dryness.  So I had to order wings from a pizza outlet. 
     I was still in my housecoat when the doorbell rang.  It couldn't be guests yet - it was only 5:30 - so I opened the door expecting the delivery of my chicken wings.  But there were 3 of my guests and of course, disheveled in appearance, I panicked.  They were close friends and I wasted no time thanking God that they appeared early.  Bonnie grabbed a broom to sweep the kitchen, vacuumed and helped me set up the buffet table with cloths, stacks of china, napkins and silver. 

    The pizza guy showed up with the wings and I set to work keeping the food warm and making the final preparations.  Bonnie ordered me to go and get dressed before the rest arrived over the next hour.  I did.  She got everything else ready and I sat. As I sat there, questions of where this went or 'what would you like to do with this' were getting increasingly difficult.  I was starting to stare and tried to force my gray matter to function.
     When dinner was served my thinking had decreased to a sludgy, slow motion.  I didn't carry on conversation as that requires thought processing (which was coming to a stand still).  I was now relying entirely on Bonnie to carry the rest of my little gathering.   At 8:00 we retired to the front room and turned the TV on where the Red Carpet activities were underway.
     In the recliner again, muscles started pulling every which way.  The ability to chat socially disappeared and my neck muscles had become so tight that I could not look down.  At 9:00, I knew I absolutely had to go and lie down in my darkened room.  The awards were being given out now but to who and for what, I had no idea.  I dreaded telling my friends that their hostess was abandoning them but I had little choice.  They were understanding.  I retreated to the soothing darkness.  I couldn't shut off my brain and did get up for the last hour of the awards.  I also saw my guests off and sitting there in a silent room, I felt what I can only describe as disappointment and the feeling of having let my guests down.     
    I slept all that night and into the next afternoon.  It was Wednesday before I was able to take down the decorations and clean up.  I went through my date book and had to cancel many of the appointments I had scheduled in order to try to rest up for another big occasion on Saturday.  That event was an annual gala that was to be put on by the Brain Injury Association of London.   The Oscar party and the Gala were like parentheses on a week blurred by the fog of an over stimulated brain.
     I am now awakening from an exhausting, drawn out dream.  The few friends I keep close are very important to me and I am still struggling with the ability to entertain.   I have never been one to be interested in going out for expensive meals or listening to loud music in bars but rather I liked to host murder mystery dinners or small gatherings.  As a single parent, my social life had to be affordable and usually included my daughters. 

     It had worked so well before. It's not working so well now. 

     What am I prepared to give up now for my brain injury? 

     And what can I keep?

     

OVERCOMING LONELINESS

OVERCOMING LONELINESS

     "What happened to all those people who visited me in hospital?"  

     "Why doesn't Joanna ever phone anymore...?"

     "You'd think by the way that Vince has been avoiding me that he doesn't want to be my boyfriend anymore."

     "I wonder if my wife really will leave one day.  She threatens to all the time."

     After a brain injury, loss of friendships, relationships or closeness with family may very well be one of the greatest difficulties for survivors.  That an ABI causes medical and physical problems is expected but having one can change the way you relate and act toward others.  Understanding this is important.  From that realization we can move on to discover ways to hang onto and even improve old relationships.  It's also a starting point to learn how best to create new ones.  

     It's inevitable that we will lose some important relationships but the ones that endure says much about the people they are.  Our peers, family or work mates react uniquely to illness or change in us and those who don't disappear show us the strength and caring that they are capable of.  This is a good situation to remember that old adage, 'We find out who our friends are!' 

     

     While members of our ABI group were being interviewed for a video, I heard many answers to this question:  "What do you appreciate about this weekly social group?"  Many talked about the trust, companionship and involvement in fun outings or events in our meeting place.

     But the ones that stood out most this week were those that created some stark imagery for me.  The answers went something like this,"I can be among people instead of staring at my four walls and the TV."  or "It's an escape from arguing with my mother all the time."  "Sometimes I feel so alone and seeing my friends here once a week is something I look forward to."

     Loneliness...  It's everywhere among the group of us.  Thankfully for myself, I have always been somewhat of a loner, painting at my easel, reading and writing.  I seem to function well on 4 or 5 visits each week whether here at home or in someone else's space.  It's important to remember that I no longer work so that former 8 hours each day is now spent in my own company and admittedly, I kind of enjoy the quiet.   I choose to stay in quite a lot but like to go to a movie once in a while or maybe visit a gallery or an event with a friend.  I prefer to shop alone and in the old days I needed the alone time I had while hiking.  However, if it's much more often than those 4 or 5 visits each week, I tend to get overwhelmed and fatigued.  The same goes for not getting enough people time, though.  Then I tend to feel a bit down until getting a 'fix' of a good chat.

     Now back to those who are more social and extroverted than I am.  Many of these folks worked in the public eye or attended school with many fellow students.  They enjoyed daily lunches with coworkers, attended board meetings or laid on crowded beaches with friends many weekends.  I call them social butterflies (very unlike me).   They may have lost those everyday social skills we take for granted.  Possibly, they anger more easily and frighten those who knew them in their calmer years.  Or like me, they may have become much more self conscious and awkward.  Certainly fatigue, so common in brain injury, changes the socialization process for so many.  One can simply lose relationships when they find they can't keep up with their peers anymore.  Weekend trips or weekday evening get-togethers become so difficult when one needs to rest frequently, is sensitive to noise or the chaos of several people talking at once.  Focus is such a common loss and a stereo or TV playing, friends talking with us and then a phone ringing are now distractions.  Before an ABI, this was seen as the normal chaos of life.  Now it's something overwhelming to be avoided or tempered in the best way possible.

     I would like to see more social groups spring up across this country, offering survivors a place to fit in and enjoy the company of others.   I am fortunate to have a few good friends and enjoy my family but within our own social group, I have met some fascinating and cherished friends.  

     And very simply, it is one day of the week that I don't have to explain things.  I can just be myself.

KINDNESS, ONTARIO

      I consider myself a very blessed and fortunate survivor.  I moved here from a larger city in the beautiful west to this little piece of heaven 4 years ago.  For the sake of privacy let's nickname my little city here 'Kindness'.  If a vote were taken in this country for the top 10 friendliest places, Kindness would be among them!

      I've always been somewhat of a loner - painting, writing and reading my evenings and weekends away.  Now with a disability, I'm missing that human contact from the office or a workplace in general so I have to push myself out the door sometimes to shop with my daughter, go to a movie or visit with friends. 

     I guess I would consider myself a bit of a clumsy and artistic oddball at times, however, I'm told that I am likable and I know that I worry about everyone (to a fault).   But it's also important to have friends and family that look out for you.  We need to feel cared for and appreciated for the good things we do and are.  These are the people we have deep talks with, laugh with and trust to hold us safely in their hearts. 

      I have family here and have made good friends as well as many wonderful acquaintances.  We are very blessed to live in a peaceful country and it is up to each of us to weed out those who might pessimistic, judgemental or simply non-affirming toward us or our fellow human beings.   Kindness, compassion, good will toward others - such necessities for the smooth humming of life.

      In September, a childhood friend visited.  We have gone lengths of 10 years without seeing each other and that is certainly because of distance, but as human beings we have our own families, move around the world and make lives of our own.  That week was as if time hadn't elapsed at all.  She still had the same, crazy sense of humour, we still shed tears over the ups and downs in our lives and we truly listened to each other..... and oh, the memories!  

      Other friends and family from the prairies, from other parts of this province and from the southern U.S. are also greatly missed.  But they are accessible by email and Facebook.  So we make do and communicate in whatever ways we can.

      In Sept of 2010 we started a local social group for survivors of brain injury.  We meet one afternoon a week for coffee, engage in discussions, play board games or contribute to potluck luncheons.  On outings we might go bowling, to the park for picnics or to a pottery studio.  We boast a baker or two, a former rugby player, university student and hockey player. There are two artists in the group and we have taken in galleries and projects they've been involved with.  Currently we are creating a video to be used at an ABI Conference and one of our group members who has acting experience has been of invaluable assistance in the making of it.  Among a group of about15 members, we are all vastly different people and uniquely affected by our injuries. 

      Of great importance though, is how much we are all alike.  We share similarities that range from adversity to interests to hopes and wants.  Everyone deserves community and friendship and as survivors we find that here.

       I am not my brain injury.  I do have one, though.  My friends understand the difference and that is why I love them so.  Ah, Kindness!  What a lovely little city!

What is Brain Injury?

WHAT IS BRAIN INJURY?

LIFE HAPPENS:

     We may be driving our children to day care, grabbing groceries on the way home from work or driving up to the lake for a much needed vacation when a collision occurs or someone simply rear ends our vehicle.  Your preteen might be racing on his bicycle trying to make it to a science class before the bell rings when he swerves to miss an animal scurrying across his path.  The crash that results sends him to hospital.

      Or possibly, you have head x-rays to determine why head aches persist, only to find there are numerous tumours that must be removed.  Surgery is invasive and the brain is delicate ground.

BRAIN INJURY HAPPENS:

There are hundreds of ways injury happens and they happen in an instant.  No two ABI survivors will be affected in the same way as there are so many areas of the brain that control different parts of the human body and its functions.  Symptoms are more consistent among those with MS, cancer or diabetes for example.  Maybe one day, science will name brain injury specifically for the part of the brain which is affected but there are dozens of areas so we will be looking at many different names when that does happen.

 There are 6 lobes in the brain.  Notice how many functions each lobe covers.  Think of throwing a dart at a map of the world to determine your next destination.  Doing the same to a map of the brain is not much different.

WHAT  DO WE SEE?

Brain injury is often called the 'invisible' illness.  Not being able to remember a face 15 minutes later,  process thoughts or organize an event are not visible signs of illness.   Often, folks will brush such things off as 'not being interested or focused' and demand that they see physical signs of disability.   I've always thought I might have to use a rollator walker when I became elderly but I was 44 when it became necessary to use one to keep my balance.  I still feel too young to be hunched over one but I do accept it now.  It at least lets people know that something is wrong but my survivor friends who can drive a vehicle or walk without aids face much more unfair judgement from the public. 

     The effects of brain injury are like a fingerprint.  Each survivor is different, which makes it difficult for others to understand.  "Why doesn't David hold down a job?  He is so lazy!"  "Why do Mary's children receive so much more care from their father?  What kind of mother would slack on parenting tasks?  No wonder kids nowadays have so many problems!"  

     Brain injury may or may not make drastic changes to mobility or coordination but if it does, it is quite plain to the eye.  When it affects our personality, memory or cognitive thinking, the human race is not so understanding.  The brain is one of the great puzzles of our time and we see negative reactions to its illness time and time again.  Those with schizophrenia, phobias or depression, for example, have long experienced the stigmas associated with mental illness and some of the time, brain injury may cause similar symptoms.

     Most survivors will tell you that what they miss most is the person they 'used to be'.  You may have been a high school teacher who had the uncanny ability to make teenagers laugh (challenging at times!)  After a brain injury, it would be unlikely that you could teach more than a couple hours at a time as brain fatigue is very common.  You also may have lost that wicked sense of humour, taking on a more grumpy persona.

     When speaking of emotional changes we often think of increased crying, angry outbursts or withdrawals into depression but often the opposite may occur.  For many years, I lost the ability to cry.  In fact, I was almost unusually optimistic and cheerful.  

     A perfect example was my first daughter's wedding 4 1/2 years ago.  As much as I loved that day, and the preparations leading up to it, I simply didn't feel the emotion that brings us to tears on such special occasions.  I had always been a soft, doting mom and I am actually disappointed that I shed not a tear as she walked down the aisle.

     Fatigue!  Oh fatigue!  You know how a job such as mowing the lawn and spending a couple hours weeding and hauling away bags of leaves leaves you tired.  This feeling is how I would describe the brain fatigue of a thoughtful 2 hour discussion.  Talking on the phone can force me to lie down and rest for an hour afterward.  Having a two hour meeting in the morning dictates the need for a lie down in a darkened room immediately afterward.  I try not to book more than one two hour visit or appointment in a day as my cognitive functioning shuts down quite quickly.  If I rest long enough, I can continue to do other things but it is so important to pace myself.  

     I often answer the phone and draw a blank if a question is asked.  If the caller is a friend, I am quite often okay to talk but if it is a business I can be at a loss for words.   Sometime I know that I do not have the energy required to carry on even a simple conversation and at those times I allow the answering machine to take a message for me.  

     It takes time and patience to find the pacing and routine that is right for you.  When you do, though, it does make life much easier.  More will get done and fatigue can often be avoided.  

     Writing this blog must be broken up into hour long sessions with long rests in between.  I am feeling myself shutting down now, so I must call it a night!

A FEELING OF SELF-WORTH

     Among survivors of brain injury, there is a broad range of disabilities which affect how dependent we actually become and the differences are more diverse and on a longer scale range than many other medical conditions.  My own injury was rated as 'severe' at that time after repeated impact injuries to the head and then having a stroke during surgery to repair a ruptured aorta.  I know that my recovery was much more advanced than anyone expected.  I am grateful and humbled for being able to manage certain things that give so many other survivors of an ABI great difficulty.

     I am able to live in a house I love with modifications and hired assistance.  I am able to phone for a taxi and go to the places that I need, perform limited housekeeping and keep filing in partial order(!)    I also keep up a social life although not a dazzling, social butterfly type.  I never was exceptionally social and certainly limits have been added now, but I still visit with friends & family, cook meals with them, play board games, watch movies together and have great discussions.  I even make rare appearances at parties.  I also sneak off alone on my scooter for some much appreciated 'me' time, enjoying the sights of this pretty town or I can just sit at my easel and paint.  It really is about quality and not quantity, making the best with less.

     I was 43 when I was injured badly enough to render me dependent on the medical field, my friends & family.  I still have some dependency issues but I have long since hired most of the assistance needed for my disabilities.  The line for friends & family generosity and goodwill is a fine one that I respect highly.  

     Many of you know what it's like to become suddenly dependent for those things once taken for granted.   Most consider having a career, driving a vehicle, managing personal bookkeeping, taking care of our home and having a social life as rights.  So having to give up any of those things permanently has a huge impact on self.

     My self esteem still isn't the greatest but with age it has improved significantly.  I consider myself a born nurturer and always will be but I no longer allow myself to be drawn into ongoing activities or a dreaded event  in order to keep a friend company through it.  However, when in a shop I will likely look for things for my family or friends before finding something for myself.  Whether I make and decorate cookies with my beloved grandsons or cook for friends, I do try to send the extras home with them (partly so that it isn't beckoning to me when I am alone and vulnerable!) but I love showering goodies on people I love.  And I'm not even Italian!
     Would it be that hard to just treat myself sometimes?!  I fix my hair and dress well to go to some gatherings but it's the quick trips to the store or library that I neglect how I present myself.
     Two weeks ago my daughter showed up at my door saying,"Mom, throw something else on and come to Les Mis with me.  Oh, and it starts in 15 minutes!"  I was sitting at my easel painting, dressed in a pair of worn jeans and a smock, both absolutely covered in paint.  So I changed into clean jeans and pulled a sweater over the smock.  I brushed my hair and put it back into the pony tail it's always in.  As my daughter is swinging her car keys at the door, I pull on my coat, step into my shoes and grab both canes - not presentable but I never see anyone I know in the movie theatre.
     Upon exiting Les Mis when it was over I was stunned to see one of the best dressed couples I know standing in front of me.  I was so embarrassed and so nervous that I'm not really sure what we even said to each other but I sure high-tailed it to the car when the exchanges were over.  I realized that I was wearing odd socks that showed; my sweater didn't completely cover the painting smock (the splotched tails were sticking out the bottom) and I knew what my hair looked like!
     I can't remember when I last made a New Year's resolution but I'm not sure if the promise I made to myself this year isn't just a necessary lifestyle change.  It went something like this...  Always caring about others before myself needs to change a bit.  This year and always, I need to start paying more attention to 'me'.

1.   What do I want?  Is there something special I could do for myself?  A trip?  Spa time or a great      concert?  What can you do for yourself?  And don't make excuses like I have.  There is a way around almost anything!

2.    I think the last time I wore makeup was at an Aloette cosmetics party several years ago!  In fact,
I still have the untouched compacts in my bathroom cabinet.  I've never been a big user of it but starting this year I will use a little.  And no more pulling my hair back into a pony tail!  It has to 'look 'done'.

3.    I used to love clothes.  So out with the stuff that doesn't fit, is worn or out of style.  For those of
us who need to watch our pennies, thrift stores are blessings in disguise.  You don't need to buy things at retail if they are in excellent shape and superior quality.  I tagged along with someone going to Goodwill last winter and happened to find a lovely, double breasted camel hair coat in my size for $15.  It looks like a $1,000 coat and it makes me feel good.

4.    And finally, but most importantly, is my physical health.  This is a big one for me as after my        accident I  suddenly have health 'concerns'.  My heart had some damage so I have been militant with food ever since, keeping my blood pressure and cholesterol down.   However, my fitness has taken a fall due to my vestibular disorder which in turn has me carrying some excess weight, complicating things all around!   Movement makes me more unstable and light headed than I already am so for the past 9 years I have been sedentary trying not to move.  That is also coming to a halt.  I will become fit again by hiking (true, with a walker this time).  But I plan to hang on and hike through that constant dizziness.  It thinks it owns me and so it is time to turn the tables on it!
    
       My happiness rests on doing what I am able to - with the disabilities that I have.  I've always dreamed of living in a century home and by purchasing a tiny, affordable one with everything for my own living on the main floor I achieved that dream.  I'm in a quiet, neighbourhood that is pure joy to live in.  Unless I install a stair lift one day, the only ones who ever go upstairs are my guests and the friend who cleans for me.  I've rarely been able to go upstairs unless someone is with me. My ensuite bath, walk in tub, laundry, kitchen and MBR are all on the main floor.  
      Your life should also include some of those things that give you contentment.  Where you live is a basis.  If it isn't the condo you dreamed of, fix it up like one.  Just some paint makes a big difference.  Then choose something amazing for it.  If you are a stereo hound, an astrology or movie buff - choose the best equipment that you can afford to partake in those activities.   For many, nothing is 'affordable' and if that's the case, then take advantage of activities that are free or subsidized.  Some of the best years of my life were lived while raising 2 kids alone with one clerical income!  And then set your mind to being proud and happy with your life.  I know well that that is easier said than done but positivity is something that does not happen over night.  It surely needs to be worked at.

       Go for happiness!  You are worth it and you deserve it!

MY NEED TO HIKE AGAIN!

MY NEED TO HIKE AGAIN 

    

          I miss solo hiking.  

          My daily meditation happened then.  The smell of the outdoors and the warmth of the sun on my face was simply intoxicating.  That feeling of purpose and striking out at a fast pace, arms moving freely, gave me the feeling of strength and that natural high that the physically active talk about.  Yes, I miss it...

        My brain injury came with a vestibular disorder and it seems to be here to stay nine years later.  These disorders are caused by complications in the vestibular area of the head and symptoms can include all or some of the following.  Dizziness.  Loss of balance.  Vertigo (spinning).  Motion sickness.   On Dec 15 it will be 10 years since the car accident that changed my life but on that anniversary I want to have succeeded in meeting the goals I've set for myself.  Maybe I'll have a party to celebrate!

GOALS FOR DEC 15, 2013:

1.     To be able to walk around the river trail.  (probably an hour's hike with the walker)
2.     To be able to discontinue three of the meds directly linked to my former sedentary lifestyle.
3.     To feel good about myself again.

      To meet these goals there are steps that need to be taken.  I started in September to walk around my neighbourhood with the use of my constant companion - my rollator walker.  Now that it is winter I am using an elliptical trainer and a Nordicycle to increase my cardio endurance and to strengthen muscle.  In the spring when the sidewalks are clear I will return to walking outdoors.  At that time I will reward myself for this long winter's exercise doldrums with an all terrain Active walker.  For a walker it's pretty sleek - ha,ha!  Who would have thought?

      Nowadays, I move pretty carefully, trying not to look up or down or turn my head quickly.   I don't swing my arms freely anymore as I have to keep my hands on the walker's handles so that I can keep my balance.   I often walk these days with someone beside me and it is difficult to carry on conversation without turning my face toward them periodically.  It's funny how we can take that for granted until we just can't do it anymore.

     The photo I've posted here was taken in the final years of my hiking days when I was a young lass of 38 - almost 15 years ago!   (that is my 15 year old daughter you can see a sliver of where she stood beside me in front of a yacht club on Lake Ontario.) 

     I will never be 38 again but I do aim to stand again with some of that confidence.  I doubt I'll ever see the walker disappear but with better muscle strength and endurance, I will have better alignment and posture.

     I'll be updating my hiking progress periodically but will continue to blog mostly about the concerns that come with an acquired brain injury.   The struggles that ABI survivors live with from day to day.
   
     So wish me luck in the year ahead.

     And walk beside me!

    

A LOSS OF SELF

 

     Of concern to any survivor of a brain injury is the loss of the person they had been.

     As humans we carve out our own identity in life.   We do this by our choices in education, career, lifestyle, friends and family.  So let's just create a mock life - it could be anyone's but we'll call him Josh.
     Josh is quite a jock in high school, has always loved sports and made many friends from his hockey team.  He graduates with the marks needed to study physiotherapy at university and upon further completion of that program he's ready to start his career.
     He finds work in a clinic that specializes in therapy for sports injuries.  Josh is in his element there and makes many more friends among his colleagues at the clinic and has even taken on a client from an NHL team in his province.   He continues to play hockey with a local team and between friends, his family nearby and his beloved career, he feels like a lucky man.
     His life takes another positive step when he meets Kim.  Kim is also a physiotherapist at the General Hospital not far from the clinic where Josh works and they hit it off well.  She spends many evenings in the various arenas where Josh's team is playing and he in turn cheers her on in the amateur theatre she is involved with.
     We all know what comes next, right?  The huge rock on her left hand and the wedding date is set for May.  They buy a house that winter and anticipate the approaching date with a great deal of excitement...yay!
     One evening in February, Kim sits in the stands as Josh's team heads into yet another game.  Kim cheers on her feet at every goal they make but jumps up and down ecstatically, pumping her fists when it is Josh who sends the puck home.  At intermission he rushes over to the concession stand where she waits for coffee ordered.  He hugs her hard and gushes excitedly about how the game is progressing.  He chugs down his coffee and heads back to the ice.
     It's in that next period that things quickly go wrong.  Josh is racing down the sidelines when a player from the opposing teams ploughs into him, sending him crashing into the boards.  Josh collapses to the ice where he lies motionless.  Kim races through the stands and makes her way through the players standing around him.  The sudden hush is deafening as she holds him waiting for medics to come and transport him to Emergency at the General.
    A week later, he is diagnosed with a severe brain injury.  2 cervical discs were fractured in his neck
and the blow to the head caused swelling that had to be relieved with removing a portion of the cranium for several weeks.  They then replaced the boney segment when the edema had receded.

     What follows starts with a postponed wedding to make way for the urgency of the best possible recovery for Josh.  Rehabilitation as an in-patient takes place 5 days a week for 8 months before he is finally able to leave the hospital but he still needs to continue 3 times a week as an outpatient.
      It is fortunate that their recently purchased home is newly built as the electrical wiring, plumbing and general carpentry was completed with an eye for all the new building codes.  But more importantly maybe, everything including 3 bedrooms and the den were on the main floor.   Kim had started to have it modified for Josh's ambulatory and living needs several months before his discharge, so when he came home again there was an outdoor ramp for the walker he would need to use for at least the coming months, a therapeutic gym complete with a treadmill, walking rails and various other equipment necessary to his rehab.
     Upon his settling back into their home, Kim is enthusiastic to begin the work required to return Josh as close as possible to his former self.  She is a physiotherapist after all and between the two of them much hard work would be necessary.
     A personal support worker was hired to be with Josh throughout the day until Kim returned home at 4:00 from the hospital.  At that time she put her feet up for a half hour to just chat with Josh about his day.  He had trouble speaking and it took some time to understand his new voice.
     At 4:30, they moved to the kitchen where she prepared dinner and he relearned, very slowly at first, how to work along side Kim.  The first few weeks were spent just setting the table.  Each Sunday she dressed the table up and lit candles.  On one of those Sundays, Kim had dashed out to the kitchen for a forgotten item when Josh accidentally knocked over a lit candle.  He tried to shout for her to come back while he clumsily attempted to right it but unable to throw his voice for her to hear, the table cloth started to burn.  Slowly, he made his way into the kitchen to alert her.  Although much of the table surface was charred, she managed to extinguish it before it spread to the rest of the room.  After getting Josh off to bed, Kim sat at the island and sobbed.  That night would be the first of many like it, frustration at the realization that many things would never be as they were before.
     A year later, much improvement was seen.  Josh walked now with just the use of a cane (slowly albeit but steady).  He could fix a simple meal for himself but was encouraged to avoid using the stove yet.  He still could not drive but as the passenger he was able to get around with the use of the cane.  His voice had improved greatly but his speech slurred when he became fatigued.  That first year he cut down his napping to once or twice a day.
     It was in the 3rd year that folks noticed that many of the initial symptoms had faded.  But what Kim saw was much more subtle - like the repetition in conversation, the forgetfulness and the obvious disconnect in his thought process.  He might tell her that he was going to go and get a glass of water but upon reaching the half way point to the kitchen he would stop and wonder what he had been about to do.  Of course, this happens to just about anyone, but for Josh it happened several times in a day. 
     He was no longer able to keep his balance on skates so hockey was out of the question.  He was still unable to return to work due to the cognitive change in his thought processes.  With Kim's help and regular sessions with an Occupational Therapist, he was able to write legibly and perform other simple tasks in the office.  What he could not do was multitask.   He couldn't write out a treatment plan for physiotherapy as he had done hourly for so many years.   He could not figure out how to answer a ringing phone while filling out a simple form.  Kim was unable to say to him, 'Okay Josh, just fill out that form, stuff it into an envelope, address it and put a stamp on it.  The stamps are in the second drawer on the far right."  By the time she tells him where to find the stamps, he has forgotten the 3 previous instructions.
     Josh had tested that 3rd year for driving ability but was not granted a license.    Just shifting, steering, braking and managing the mechanics of driving were somewhat like riding a bicycle in his case.  Never forgotten.  The impairment was seen in his reaction time and his slowed thought processing.   Remembering to look for the light at intersections or just understanding that red meant he had to stop were problematic for him to obey without cruising through that red light.  Thankfully, it was not on a busy street, but a computerized screen that he was running red lights!
     The two of them had never married and Kim eventually did meet someone else.  She continued to drop in at the house they used to share just to visit but now a Personal Support Worker lived in to assist Josh in all things day to day.
     So much had changed...  10 years later, Josh works 2 hours a day in the office of his former clinic helping the receptionist.  He naps, he gets up again to take part in light gardening, housework and some sedentary activities.   His work as a physiotherapist is over.  Playing hockey, too.  Driving a vehicle will never happen.  And Kim was gone.
     The hopes and dreams of parent hood, traveling with his wife and owning a cottage - all have disappeared.
     Brain injury... loss of self.