Psychology

  1.  The neuropsychologist

People with crap memory get tests to monitor their progress.

On Friday 8th June Mrs. Culshaw of 3, Pelican Place took Jim, her twenty-one year old pet zebra for a walk.   When she got home she put him into his stable and went shopping for carrots, and then returned to the stable to give him one as a treat.  She unlocked the stable door, which was bolted, and looked in to find him gone.

This is read three times and then it’s my turn:

Some time in June Mrs Culshaw of Pelican Place takes a zebra for a walk.  It’s called Jim.  She puts him away and goes somewhere and when she comes back he’s gone.

….and again after she’s distracted me with something else:

A lady has a zebra called Jim and he goes missing.  Carrots.  Gone.  Or was it a pelican?

The tests continue.  Recreating line-drawings and repeating back ten-digit numbers.  Thinking of nouns beginning with the letter S.  And what happened to Jim in the first test?

I blink.  Who was Jim again?

In the end I score no better than I scored a few months previously.

Thwack.  That’s the sound of hard news hitting, not a zebra kicking down a stable door.  I don’t want to be like this forever.

 

2.  The Parenting Psychologist

I arrive alone.  Hubby doesn’t want to come (turns out later he’s assumed ‘psychologist’ means ‘private’).  I don’t actually know what we’re here to discuss, but it turns out to be parenting.

Which throws me:  I’m not prepared.  I’m finding the kids harder, sure, and we argue.  But off the top of my forgetful head I can’t pluck out an example.  The guy asks what time they go to bed.  I don’t even know that.

I remember that meal-times are difficult.  The kids are never hungry at dinner-time;  they’re only ever hungry ten minutes after washing-up.  Or sometimes when we’re about to go out.

I can see the psychologists weariness.  He says that kids need routines.  They have to have a bed time.  And they shouldn’t have pudding until they’ve finished their main.

’So you’re suggesting I use pudding to reward them for eating food they don’t want to eat?’

‘Well, yes.’

I probably look incredulous.

‘I thought that was really wrong, from a psychological perspective?’  I can’t remember why.  ‘Eating disorders, and stuff?’

’Well, I did it with my kids.’

Anyway, he says, I need boundaries.  Kids respond to the sort of boundaries and routines that I don’t have.  He mutters the term lassizfaire under his breath.  It doesn’t describe my parenting, but perhaps he thinks I won’t understand what he means.

I stomp home and seek out the prejudice-confirming world of Facebook.  Various replies remind me why using food as a reward made me cringe.  If my kids’ bodies are not prompting them to seek fuel, why bribe them to eat using sugar?  Surely withholding tasty foods makes them more desirable, and also labels them ‘bad?’

I email what I’ve remembered and click send.  I’m not sure that my rant will completely change his opinion, but I certainly feel better.

A few kind Facebook friends take the trouble to explain that routines work really well for them.  Some of these are parents I respect.  It occurs to me now that a stable script to follow might not be a bad thing, particularly given how forgetful I am.  Perhaps my kids are not the only ones who need routines.

I send a second email.  In balance I’m happy to meet him again – to listen.  Then I spoil the effect.  Talking of boundaries, I refuse to use sweet bribes to make my children eat food they don’t want.

I press send.

 

3.  My friends

Thank goodness.  Bank holiday.  My friends arrive.  No psychology appointments for days.

Somebody compliments me on my children.  Perhaps they feel they have to.  But if my kids behaviour was worse than my declining garden, surely they’d compliment the garden instead?

And then, my friend Chris, who was there when all this started, asks what we did today.

And I tell him.

‘You know,’ says Chris, ‘a few months ago, you wouldn’t have been able to remember.’

‘Really?’

And suddenly I remember what else the neuropsychologist said about her test.  It’s not that I haven’t improved.  It’s that I haven’t improved that they can measure.

But maybe positive, tiny, unquantifiable improvements are happening under the radar.  Perhaps a big, measurable thing will happen all at once, like when people with paralysed legs suddenly stand.  People who haven’t seen me for a while are already noticing differences.  Perhaps, because memory is so intangible, things are actually better than she thinks….

Next appointment, she will probably shake her head about that;  point out that neurological improvements slow down as time goes on.  That the more time passes without quantifiable improvement, the lower the expectation of a miracle.

Right now, that doesn’t matter.  Chris can see an improvement!  Not to mention that my kids are enjoying the unstructured late-evening BBQ food, and one of them is gorging on lettuce.

 

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Hormonal

frog-macro-amphibian-green-70083.jpeg

This will be ok;  I am a strong, confident woman.

The GP is grey-haired, eloquent and calm.  And middle-aged and male, obviously.

And did I mention calm?

So I say, as confidently as I can, ‘Did you see the notes about my memory problems?’

The doctor doesn’t even twitch.

‘Anyway, I haven’t had a period for ages – well I can’t remember how long, but definitely not three months now.  I think that’s too long.’

It is too long.  The doctor asks if I might be pregnant.

’I’m pretty sure not….’

‘Pretty sure’ is not enough.  The doctor needs to be very sure.  I have to do a test.

‘Also,’ he says, ‘has anything stressful happened to you in the last few months?’

I knew it.  He hasn’t seen my notes.   I look back at him.

’Losing your memory’s pretty stressful.’

’No – I mean, really stressful.’

Just to be clear.  I got through my veterinary finals, a horrid unsupportive first job, a fabulous wedding, being diagnosed diabetic, my mother’s death, two pregnancies, having my own business and two small kids, and have never encountered anything nearly as stressful as losing my memory.

’No,’ I say.  ‘Nothing really stressful, I suppose.’

*

 

Hold the stick directly into the urine stream for five seconds or dip into a collected sample for twenty seconds.

I guess the stick is exposed to more urine in a moving stream.

Tiddler Toddles in.  ‘What’s that, Mummy?’

’Don’t worry.  I’m not pregnant but I have to check for the doctor.’

Two minutes can take a very long time.

’Do you need the toilet, Tiddler?’

Tiddler goes to the toilet.  He toddles out again.

I wonder about names for a third baby.

Tiddler reappears.  ‘Mummy, your alarms going off.’

Oh, yeah.

Negative.

*

 

The doctor wants a blood test.  I go through my usual routine of pretending to be terrified and biting a finger while they stick the needle in.

’Thats different,’ the nurse says, watching.

‘It’s certainly different from my patients’, I think, darkly.  ‘They’d have bitten you.’

 

*

‘Mummy,’ Tiddlers been thinking, ‘How do people get pregnant?’

I explain.

‘You know, Mummy,’ he says.  ‘Some people say it’s actually to do with storks.’

*

And then… nothing.  Everyone knows that when you tell someone you’re missing your period, not to mention start writing a blog post about it, the bloody thing turns up at the most inconvenient moment imaginable.   But…… no.

*

And then a phone call.  The doctors receptionist:  please can I come for a blood test?

Sure.  What happened to the results of the last one?

One of the levels was outside the normal range.

Oh really?  Which one?

The TSH

I grab a pen and start scribbling.  ‘How many milimoles per litre was that?’

The receptionist clams up.

*

I remember it saying in one of my veterinary lecture notes that human doctors say that hypothyroidism gives people a frog-like appearance.

I ask Tiddler whether I’m looking like a frog.

Tiddler nods, grinning.

Who needs blood tests anyway?

 

 

 

 

 

 

 

 

 

 

 

the awkwardness of Amnesia

tortoise

Image nicked from: http://lifeoftwosokools.blogspot.co.uk/2012/04/please-pardon-awkwardness.html

 

Do you know that ‘I’ve got it on the top of my tongue’ feeling?   Perhaps you associate it with pub quizzes, when you’re desperately trying to remember name of the actor who played Charlie Fairhead in casualty in the 90s.  Or perhaps your TV trivia is so innate that you only get it watching Mastermind.

Since my brain injury, I get it all the time.  I get it when I try to remember what I had for breakfast, or who I talked to yesterday.  I get it when I try to recall what’s just happened in the novel I’m reading (if the bookmark falls out, I’m screwed).  I even have it when I’m trying to remember what I just read with each child.

On the other hand, I know for a fact that Toddler’s reading book is awesome.  I can’t begin to describe its events or characters, yet my gut is certain that it’s amusing, and that I heartily approve.

My general feelings about a thing are more memorable than the detail, you see.  I know how I feel about a person before I’ve remembered who they are.  This is bad because sometimes I take against people without actually knowing why.  Did they do anything to deserve it?  With retrospective skills like mine, it’s hard to know.

I always worry that I’m inadvertently doing something cringeworthy (I mean, other than posting about my illnesses on the internet).  Recently I ate out with a friend and there was something about her expression when the food arrived.  We were quite far on with our respective meals before she admitted that she didn’t like hers – and I still suspect that I’d forgotten what I had ordered and simply accepted her choice from the waiter.

I didn’t rack my brains any harder on that occasion.  After all, I had already eaten it.  But I was sufficiently embarrassed that the incident is a memory I’ve retained.

Things that I’ve forgotten do sometimes come back later.  Don’t quiz answers always come back to you once the quiz sheet has been handed in?  I try not to let it keep me awake at night, because forgetting, remembering and beating myself up is a mentally knackering business, which mostly seems to happen when I’m supposed to go to sleep.  When I mentioned it to the medical team, they said that I might have fatigue.

So now I attend Fatigue Group.  Fatigue Group!  – I kid you not.  We meet in a centre and sit around on chairs with cups of coffee and a biscuit.  I can’t tell you too much because it’s confidential (‘the first rule of fatigue club is there’s no such thing as fatigue club’) but something about the format makes me think of alcoholics anonymous (Hi.  My name’s Liz and I suffer from fatigue).

Who knew that fatigue group would turn out to be so useful, though?  Despite being mortified to go there, I enjoy meeting other people whose brains fail them too – they help to normalise it and they teach me ways to cope.

Energy levels, I have learned, are a zig-zag graph – up one minute, down the next m.  Its probably the same for anyone.  In neurological repair however, the troughs can get extremely low.  The point is to ‘stop and rest’ before you reach the peak of your activity, to reduce the steep rebound slump that’s bound to follow …..

What interested me most was that, the boom-bust diagram on the worksheet draws exactly the same graph as my typical blood sugar trace.   I might wake with too high sugar, take some insulin – it doesn’t work immediately, so take some more – and some more – and suddenly my sugar’s low.

Or else the graph might look headed for sinkage, so I eat (sinkage makes one hungry), and before I know it I’ve scoffed too much – and before I know it, I’m too high again.

Of course, I need to knock these zig-zag graphs out of my life.  STOP EATING after correcting a hypo.  DONT KNOCK blood sugars down with insulin if they just need time to come down on their own.

The same goes for fatigue:  anticipate it.  Rest before the crash.  Rocket science it’s not, but the hardest bit is doing it.  Remembering to be moderate when the moments in it’s heat.

Not my forte.  Which is awkward.  But I’m working on it.   And I’m lucky, because……

Hang on, I’ve forgotten.  Why am I lucky? It was on the top of my tongue….

Oh yes.  I am lucky.  Because I’m loved and supported.  Because there’s still an NHS and I’ve got fatigue club.

Because my wee brain will improve and I will practice until I master it, and all this awkwardness will pass.

Of Nuns and Confused Resolutions

 

SisterMonicaJoan

 

So…… have you broken any New Years Resolutions yet?

Perhaps you are too clever to make them.  I, on the other hand, am self-absorbed and big on self-improvement:  I make some every single year.

And break them, because it’s traditional.  And there’s so much decent food, drink, TV and good company around in January that it would arguably be rude not to.  Which is a shame, because I love the idea of a new, fresh year.  It’s like a field of perfect snow awaiting a single neat line of perfect footprints……

 

snow

 

I would have preferred, here, to find a stock photo showing the footprints disappearing into a massive, concealed pond.  On the other side of the pond would be a muddy mess where I climbed out – with clod-hopping, muddy, bloody footprints limping away.

Familiar TV is easiest on my poor brain, hence I’m watching the DVDs of Call The Midwife.  To my horror, the character I most identify with is suddenly Sister Monica Joan.  If you don’t watch, she’s the senile elderly nun.  When there are biscuits involved she’s remarkably astute, but often she’s away with the fairies.

I don’t want to identify with Monica-Joan, but I don’t have much in common with Trixie:

 

trixie

 

Trixie wouldn’t go to people’s houses and say:  ‘Have we come here for dinner or are we supposed to be going home?’

She wouldn’t ask after people who’ve died, or avoid asking after people in case they’ve died, which I do now.  I worry about calling people by the wrong name and wince when I ask questions in case they’ve already told me the answer.  I’ve occasionally voiced opinions only to realize half-way through that they haven’t  actually been my opinions for years.  I’ve disagreed with plans that five minutes before, I had been enthusiastically advocating.

However, unlike Sister Monica-Joan, my prognosis is good and I’m fast improving.  A few months ago I would not have remembered the events in the previous paragraph, but now it’s surprising what comes back, with rumination.  Lost memories suddenly pop into my head from nowhere, like answers to cryptic crossword clues…….

I wish (about cryptic crossword clues).  But anyway, I had a train of thought going.

Resolutions.  Tracks in 2018s snow-field.

I’m won’t be aiming for perfect footprints.  Think, mud and slush, and a lot of doubling back.  The odd mess in the snow where I fall over, forget what I’m doing and make a snow-angel.

Had I resolved to leave perfect footprints, the resolution would be broken by now.  There have been days when I haven’t managed to leave the house;  a run where I completely forgot to take hypo-sweets and another where I forgot I was running to a set place to meet my family, and went on a different run instead.

But I knew in advance not to pick anything too results-focused.  The tracks might suddenly run up to a brick wall;  that’s got to be okay.  They can always come to a complete stop, double back on themselves and run at the wall again, and get over it this time, and into another field.

But what metaphorical wall or snow-field to choose?  What direction did I want to go?  It’s hard to know what  to focus on when you feel useless and have poor memory.  How the hell should I go about making resolutions?

There were so many ways in which I wanted to be better.  I flitted about like an untrained springer spaniel amongst pheasants, undecided which one to chase until all of them had got away.

It’s my leading characteristic, you see.  I’m the sort of person who likes to juggle lots of balls in the air, rather than throwing any particular ball very high.   Yet I needed to choose just one ball and build up…..

A few days in, I picked exercise.  When I’m working, I always moan that I don’t get enough.  I spent January prioritizing running and yoga.  I’m getting fitter and that’s nice.

But my blood sugar keeps ballsing up, so that’s February taken care of:  exercise with better blood sugars.  Except that I’m sick to the back teeth of yelling at the kids – i don’t believe in it and it’s making me miserable.  And I keep changing my mind as to which one is most important (good blood sugar equals better mood with the kids, you see).  Perhpas I’ll try both at the same time.

SO that’s February and March:  continue the exercise, and conquer sugar and shouting.  Focus on both of them together.

As for April…..

…….Oh, bugger April.

One or two muddy footprints at a time.

 

midwise2

 

 

Actually all Around

Image result for love actually
picture pinched from:  Love Actually

Modern medicine (and the NHS) enable many survivors of brain injury and psychological disease to lead surprisingly normal lives.  The doctors sound cautiously positive about mine.

But meanwhile it’s hard, as I told everyone over Christmas.  And I do mean everyone: extended family, friends (I can’t thank you guys enough),  teachers at school, innocents out for a jog, the pub waiter, a librarian…

I’m trying out new labels, you see.  I’ve stepped outside the satisfying ‘good veterinary surgeon’ box, outside the ‘contributing family member’ box and occasionally outside the ‘good parent’ one.  And given that the confusion isn’t going to improve overnight or kill me, ‘confused’ and ‘ill’ are suddenly my identity.

How insulting!  Because I’m not ill!  Other patients in hospital needed frames to walk or ate only mushy food, but not me!

An older guy in neuro rehab explained  that he wasn’t an ‘ill person’ either, although he looked it from where I sat.  We talked about our respective careers;  he was a scientist and his research sounded – clever.  And lifesaving.

The mother in the next bed (post car-crash) was a nurse.  And even the nurses on duty had lives outside that place.  And two of them were Type 1 diabetic.

Nobody is just an ‘ill person,’ or a ‘nurse’ or a ‘relative,’ you see.  Nobody is just here to be an extra in a two-dimensional film of my diabetic life.  Ill people have lives and achievements;  hospital staff get ill;  at the time this was an epiphany.

Then came epiphany number two – that a lot of the useful, active ‘normal’ people I know in real life are actually ill-people too.  I’ve lost count of how many friends and family reminded me that they are struggling with something;  illnesses such as chronic fatigue, depression, arthritis, diabetes, anorexia, heart disease; cancer.  But we are not our illness any more than we are our sexuality or nationality or race;  we are people.

Which brings me to one person in particular;  a family friend, known in our household for her sharp wit, wry observations, formidable intelligence and good advice.  She says that she can only recommend endurance and sends me knitting materials;  I don’t know if she’d heard about the trouble I’ve had knitting an elephant, but the wool is beautiful and the note accompanying it recommends that I start with scarves.

She is pleased when I tell her that I’d forgotten she was ill;  like me, she doesn’t want her illness to be her defining characteristic.

But neither does she trivialise it:  survivors of illness aren’t just the superficial feel-good stories you find in crappy newspapers:  ‘I beat such-a-disease, by being positive every day.’   Illness and disability can be isolating and difficult;  frustrating and maddening to live with, as at least some people reading this will know.  It’s ridiculous to expect anyone – but most of all ourselves – to be high achieving, super-strong and invincible in such situations.

I’m afraid I cant remember her words, but I have taken inspiration.  Enjoy what you can do, and be nice to people;  I am enjoying knitting this scarf.  I am also running, doing yoga and watching DVDs.   My scarf is growing and I’ve seen Love Actually a record number of times this Christmas.  I cry for the wee boy at his mothers funeral every single time.

And that brings us nicely back to the subject of illness.  Illness is – actually – all around.  But the good news is, that so are tools to help us:  strength, humanity and…..

Love.

 

 

 

Bionic Liz

Two days ago, I went to the hospital with my glucometer, thus:

 

blood

http://www.health.com/health/gallery/0,,20469215,00.html

 

and walked out with a constant glucose monitor.  This magic device measures my blood sugar not five or six times a day, but all day long, every few minutes.  It also draws a graph:

 

dexcom

Image: http://www.mynewsdesk.com/uk/dexcom-europe/images/dexcom-g5-call-outs-mmol-465096

An alarm goes off if my sugar is about to go too high or too low, and when I check back I can see exactly when (and therefore why) it happened.

Even better, the electronics taped to my abdomen are conveniently small:

IMG_6479 (1)

 

It’s the technology, not the tummy, that’s up for discussion by the way.  The CGM (that checks my glucose all day) is on the left.  It has a short, palsticky tip that goes under my skin.  The tube on the right’s from the pump, that constantly puts insulin in.  I am a middle-woman between them – I check the trace and tell the pump what I’ve eaten (so that it can work out how fast to pump).  It helps to cut the guess-work:  rather than an isolated number (my blood sugar is 5.6) there’s a trend arrow on the phone app. (and stable / climbing slowly / falling fast).  Thus I can see what effect my activity and food are having in real-time and what to eat, or what insulin to take, to keep it stable.  Even if I’m not watching the trace (and why wouldn’t I be? – it’s fascinating) the alarms should minimize the chances of me hypoing ….

On one level this is very exciting.  On the down-side, it’s hard to shake off the idea that I no longer exist on my own.  I feel slightly like a lab-rat, wired up to lots of equipment, which I ‘need’;  if there was a big natural or political disaster, I’d be scrabbling to get hold of insulin, but also my pump, oodles more bits of specialised plastic and my phone.  The complexity of my requirements is ever increasing….. there is no doubt that I’d be dead in the natural world.

And then there is the more immediate problem:  remembering how to use the thing.  I can say, with my fingers tightly crossed, that the phone app. is intuitive.  I can only hope that I have instructions for changing the sensor extremely carefully written down…..

 

The Trouble with Humans

Sure, there are other species with impressive intelligence:  David Attenborough recently demonstrated an octopus using tools.

But not as clever as us:  the octopus couldn’t have made a film.  They don’t teach that in Octopus Elementary School.

Humans, you see, are unbelievably clever.  But we are undoubtedly stupid, too.  Our cleverest people can show, beyond reasonable doubt, that climate change is escalating.  We can use our technology to transmit this information around the world.  And yet….

(INTERRUPTION TO WHISPER: I’ll say something happy soon.

 Meanwhile, I DARE you not to go:  ‘Oh Gawd, climate change,’ and click the cross at the top of the screen.

Although, it’s tempting to click away, isn’t it?  I’ve taken to switching Blue Planet off before the end, so I miss the bit when Sir David makes me feel very sad.

Instead, I convince myself ‘it won’t really happen,’

Or ‘I can’t do anything about it’ (although,  if we got together, we could)

Or:  ‘My current life is more important,’ which is obviously bollocks too.  Because we can’t really live without Oxygen on Earth, can we…?

But wait! – I promised to change the subject.

To another splendid issue that no-one wants to talk about:  the decline of our own bodies.  More immediate than Climate Apocalypse (I hope so, anyway) and trickier to lay at the feet of Donald Trump.  Our bodies are as vital to our personal survival as the Earth, yet we are programmed to abuse those too.   

I blame Evolution, myself.  Evolution’s too damned slow.  We have evolved to seek high-energy food when the opposite would be more useful.  In fact, evolution is barely happening at all, thanks to our healthcare; folk like me with bodies that would naturally be incompatible with life (placenta previa, Type 1 diabetes), are managing to pass our (otherwise obviously awesome) genes on.

Our primitive brains still crave the old advantages: children, food, comfort, nice things and group status.  And though we are clever enough to understand intellectually that we are ruining our bodies / world if we keep doing what we’re doing, our primitive brain hasn’t managed to keep up.

We crave the good life so much that we don’t stop doing it. Is it a hopeless business?  If we won’t listen to the experts to override our instincts to improve the health of our own bodies, I wonder if we will ever listen about saving the Earth.

And that’s why climate deals are one of the most important issues in the world, you see:  individuals desperately need forcing to comply.

Solutions on a post-card, meanwhile normal, happy posts will resume in the New Year.

PLEASE do your personal best with both the climate and your personal health this Christmas.

A very bloody Merry One to You.

Image result for amazing christmas octopus

 

https://www.google.co.uk/search?q=amazing+christmas+octopus&safe=off&dcr=0&source=lnms&tbm=isch&sa=X&ved=0ahUKEwjroZi1w4XYAhWGDcAKHZ8YBbgQ_AUICigB&biw=1366&bih=613#imgrc=3mT7-VFqEShk3M: