Hot or Mild? or, Everything I Didn't Know

"Aristotle was famous for knowing everything. He taught that the brain exists merely to cool the blood and is not involved in the process of thinking. This is true only of certain persons." Will Cuppy


Before the accident, I never even knew there was such a thing as Mild Traumatic Brain Injury. Like most people I thought you were either brain damaged or not. The words "brain damaged" always spoken in a whisper, the way cancer used to be.

Brain damage was, in my mind, right up there with "the big 'C'". It was something that happened to other people. It was something from which you did not recover, at least not completely. And it was something that usually left those unlucky enough to suffer it, either paralyzed or drooling or hooked up to ventilators waiting to die.

I had no idea there existed an almost infinite continuum of brain damage, ranging from imperceptible to substantial, and that's just in the "Mild" brain injury category. There are thousands if not millions of people out there right now walking around with mild traumatic brain injuries who don't know it. There are thousands of people walking around out there with MTBIs who know there's something wrong, maybe really wrong, but who won't ever get a diagnosis or the help and support they need because they and their doctors aren't aware of, or aren't considering, MTBI.

MTBI can occur with a seemingly innocent bump on the head. It can occur without loss of consciousness. Adolescent and child athletes are especially susceptible to head injuries, with girls even more susceptible than boys. Mild concussions occurring within a short period of time can have exponentially worse outcomes. Two sound knocks on the head during one sports season can have profoundly detrimental effects on a growing brain, but that's a topic for greater exploration in another post.



Most people don't realize that a seemingly innocent bump on the head can cause:





Memory Problems This can be forming new memories, retrieving old memories, and, or short term memory lapses and everything in between.


Emotional Changes Mood swings can be an issues, and can come just as easily from dealing with the injury as from the injury itself. Difficulty controlling emotions can also be a symptom. Emotional outbursts are common. Some people experience fairly profound personality changes which can be as distressing for the injured, as it is for their friends and family.


Hearing Loss or Change This can range from out and out hearing loss to difficulty discriminating voices to changes in the way sound is perceived.



Speech Problems Difficulty forming words, processing sounds, retrieving words, remembering names, are all common. This can also extend to the written word and cause problems with reading (perceiving) words or actually writing words.


Eye Problems Persistent double vision is not uncommon, as is difficulty focusing, trouble reading, and increased eye fatigue.


Dizziness Vertigo or dizziness can be caused by neurological damage or by problems in the ear canal (more on that later). It can also be caused by vision problems and needs to be assessed by professional both to understand the cause and address the symptoms. Dizziness is one of the problems that can be an "easy" fix so it is definitely worth exploring with a trusted doctor.


Loss of Executive Function This is basically the part of your brain that controls everything else. It's the part of you that makes decisions and organizes both your belongings and information, as well as the function that allows you to multi-task and divide your attention. It is a complex and interesting set of skills that also deserves a more in depth discussion.



Changes in Taste and Smell Loss of taste or smell can happen but it is also possible to have changes in the way taste and smell are perceived. This can lead to other issues like not wanting to eat, and a loss of enjoyment in eating.



Fatigue Post injury fatigue can be overwhelming at times. The effects and symptoms of brain injury can be very subtle but pervasive. Sometimes it can seem like almost everything, all "activities of daily living" are more difficult, and, consequently take much more energy. The result is fatigue. It IS harder to think, to see, to hear, to make decisions, to move, etc. and all the extra energy it takes to process the information your brain takes in every day leaves little remaining at the end of the day.



Loss of Enjoyment This can range from enjoyment of hobbies and interests, to your sense of humor, to loss of enjoyment of sex. Causes are just as varied and can be depression, or distractability, or loss of energy, or simply a change in the way your brain processes.



Depression/Anxiety Brain injuries can cause a number of distressing "mental health" symptoms which can often lead sufferers to seek treatment. These are not symptoms to be ashamed of, they are merely manifestations of the injury and the resulting frustration.



Lack of Tolerance This could easily be lumped under Emotional Changes or possibly even Executive Functioning, but I think it deserves special consideration. A "shortened fuse" is an extremely common result of brain injury and, when you think about all the other symptoms that can and often do go along with it, it is much easier to understand. Frustration is a constant when dealing with this type of injury. Fatigue goes hand in hand with that. Consider how you, yourself respond to difficulties when extremely frustrated and fatigued and you will understand how it's like for MTBI folks, except with a brain injury you exist in that place most of the time.





These are just some of the possible symptoms resulting from a MILD Traumatic Brain Injury. We're not even talking about severe brain injuries. But this list gives a brief overview of all the things we normally take for granted that can be affected by a head injury.



MTBI is subtle. It is, as I like to call it, an invisible injury. It's possible to look normal and seem normal and face difficulty completing what most people would consider a basic task like calling to order take-out. Although they look the same on the outside, many brain injury patients feel like completely different people on the inside. But don't beat yourself up if you had no idea MTBI existed, I had no idea either.



I used to wonder about disease outreach. You always see people working on fundraising campaigns for cancer and diabetes and MS and a host of other diseases, and often the spokespeople, when not asking for money, are talking about awareness. I always find myself thinking, "Who doesn't know about cancer? Who hasn't heard of diabetes?" But I suppose the reason these diseases are so entrenched in the public consciousness is because of these awareness programs. Perhaps it is time for a Mild Traumatic Brain Injury awareness campaign.



Maybe I need to design some "Got Mild?" t-shirts and sell them on this site. I could include a list of possible symptoms on the back. At least it would get the information out there. I think I'll work my way up to the telethon.