Things anonymous people apparently want to ask about my Memory – and are scared to

1) What’s wrong with it? I had a brain injury, caused by a bad diabetic hypo that happened a few years ago, while I was sleeping. My brain was essentially deprived of food and various important brain-cells died. On the MRI scan, one area apparently looks a bit ‘fuzzy.’

2). What’s are the effects of that? My short- term memory is much slower to act than most people’s, and gets its wires crossed sometimes. You’ll be familiar with three types of memory:

Working memory – information you’re actively using. If you’re listening to a story, you remember who the characters are. Or if someone asks you a question, you remember the question while you answer it. A popular test of this is asking someone to count backwards (from 300, perhaps) in sevens; you have to remember the task and subtract the numbers at the same time. Mine is OK: I’m in the ‘intelligent’ quartile.

Long term memory – things that you’ve remembered for ages. Long time memories are resilient, which explains why old people often ‘remember that night from the distant past as if it were yesterday,’ but not what they did this morning.

Short-term memory – things you put into your head temporarily, expecting to need them again later. This is my problem area. So you make a new pin number, use it to access your bank account once and then – gone. You buy something on the internet; ten minutes later you can’t remember doing it. Somebody says ‘by the way, we’ve changed the plan for next week….’ just as you were about to walk out of the door. It’s understandable behaviour from them, but my brain doesn’t file things away without writing it down (in a place I will definitely find the bit of paper later). Somone tells you their Dad’s dying….. you use all your people-skills, your prior experience of your own father dying, to make what feels like all the right noises. Next time you see them, you will have no conception that their Dad is even ill.

3). But we all do things like that sometimes! – yes, you do. But this is extreme. More extreme, even, than what most people with ADHD do all the time.

4). But you are actually capable of learning things? Definitely. It just takes more repetitions. I’ve been teaching my son to recite the periodic elements in order and….. only added about seven to my childhood list in the time it’s taken Tiddler to draw level with me from Hydrogen (we’re now at Selenium).

5). But how come you remember some new things really vividly and not others? Isn’t that a little bit convenient? It would be, if I remembered the things that were useful or important to me. Some things are easier to remember because they link to something else, or follow the line in which your brain wants to think i.e. they match with your previous experiences. The things that don’t flow in the direction you were expecting are harder – if a hardcore carnivorous friend switched to veganism, for insteance. It’s unexpected, therefore takes more repetitions to get in.

But it’s not just that. Whether I remember things depends on how I was feeling at the time – whether I was distracted, mentally juggling, or whether I was tired. I forget things very quickly if there’s some strong negative emotion involved – if something’s hurtful, say. If I’m upset or preoccupied, new ideas are harder to deal with.

And also, if I’m trying to concentrate on something / remember something and you talk to me about something else, then it’s very hard to put the first thing on hold and switch to the second. If you tell me that the building is burning down while I’m playing a difficult piano peice, then its cognitively incredibly hard to stop playing and walk away from the piano. So if you’re trying to tell me something important, please make very sure that you definitely have my full attention.

6). Are you just making it up? No, sorry. It might surprise a lot of people, but there’s really nothing to gain from being like this. I used to like my job. And for heaven’s sake, I don’t want to fleece a drink out of anyone. If it’s my round and I haven’t realized, you can just tell me.

7). How many times do I have to tell you my name before you learn it? It depends on who you are, and how easy your name is for me to remember. And on whether or not your partner always calls you something different (yes- that has come up). Please don’t make it mean that I don’t like you or that I’m not trying. It’s just that I’m also trying to actively remember the names of every kid in my children’s class, all my SAVTE students, what I’m doing today, where I am spatially, what’s going on with each of my children, my husband, how I’m getting home…. and I might not have expected to talk to you this morning, and my capacity’s greatly reduced.

8). How does this impact day to day life? Less badly than it used to. There was a time when every other day seemed to be a write-off; I’d frequently forget to show up somewhere or got lost. I used to lose my keys; lock myself out; forget my children or their after-school activity; go home to the wrong house; invite people to visit and forget; offend people by assuming something different to what they’ve previously explained.

9). And relationships? I don’t think I’d have chosen to be my friend either, for the first 5 years of this. If you managed to make friends with me within that time, or if you’ve been my friend all along, then thank you. You’re special. The absolutely worst, most painful thing people can do – and it’s part of modern life now – is the posting of passive-aggressive messages about it online. Like most people whose brain doesn’t function normally (or even those whose brains do), I accidentally piss people off sometimes. But getting things right depends on openess; I have to risk being incredibly open, so I have limited patience for those of you who do passive-aggressive posting because you’re too two-faced to put your name to what you think.

10) Isn’t that a lack of regard to characters who are nervous of getting criticism back? I dunno- does that make it okay? Most people would rather a direct conversation starting ‘this is a bit awkward – if I get it wrong will you tell me?’ or ‘can you help me understand?’ rather than ‘I think (all these untrue things about you, usually) and I’m going to go on letting you know I think them and not give you a chance to explain that I’m wrong.’ What can you do with that?

11). How is the memory thing affecting things NOW? It’s still getting noticably better. Every time I (know that I) make a mistake, is an opportunity to put something into place to stop it from happening again. That does rely on people making me aware of the mistakes though – and sometimes working with me to find a way of doing things that works, at a time when I can give it my full attention.

12) Are there weeks when you don’t seem to forget anything? Yes. This mostly happens in term time, when life follows a convenient set pattern and most things are diarised, and someone plans with me the night before every day. But most weeks have something different about them – a changed venue here, a parents’ evening / school concert there, a hospital appointment…… and there is a base-level after which it gets tiring. Being away from home is harder, because of the extra cognition taken even to find the toilet. But we’re getting better (I saw we – we do it as a family) at that too.

13) It happened ages ago. Why haven’t you got over it yet? Some challenges are fences for getting over. Others challenges attach to your leg, and stick with you as you climb over yet other fences – and this is one of those. Honestly, people with chronic problems are criticised however they climb their fences – not least by people with other chronic problems, ironically. People who don’t choose to acknowledge how chronically their own challenges affect them, perhaps. People who don’t like to explain themselves. For me, there are always going to need to be adaptions – so If I want to progress, I am going to have to find better ways of explaining. Meanwhile, I’m getting better at reducing the effects. It’s still getting better year on year.

14) Getting better? Really? How much of the improvement is due to your memory getting better and how much to coping mechanisms? Who knows? There are objective ‘pure memory’ psycological tests, but the ‘jumps’ between the grading levels on the test I did, are quite big; you’d need a very significant change for it to be measurable. It also costs the NHS a lot to pay someone to ask you the test questions (they have to be asked in just the right tone of voice), so they don’t, unless it would change something.

15). Should I tell you if you forget something? Yes please. I’d encourage it, as long as your tone of voice doesn’t sound as if you’re speaking to a naughty toddler. Remember, the onus for this is on me, not you; if I balls something up and you tell me, I do appreciate that.

16) But don’t you realise that people are scared to talk about things they find awkward? I’m in no position to judge if you try your best but get it slightly wrong. I have tried my best to be a good person, and got it wrong for five years now, and made many social errors in that time. But like brain injury people right around the world, I have to get up and try again every day. And again. It’s quite awkward to write this, if you think about it.

17) Why DO you keep talking about it? Becuase it’s really hard to explain and I hate being misunderstood. People assume all sorts of bad things about you if you don’t explain….. but if you do explain, you’re too self-obsessed, or talking too much. It’s difficult to find a balance, and every situation’s balance is different……..

And yes, I am trying very hard not to judge the passive aggressive posters. After all, they want me to be different and I’m not. Never-the-less, we all get a better reception and understanding if we learn to communicate kindly and openly.

It’s complicated and difficult understanding other people, isn’t it?

Forgetfulness

Let’s talk about frustration

Most people reckon they can cope with frustration

Until the there comes a time when they put down their keys –

Just a moment ago –

And now they need them desperately.

And an hour later, they are still walking

From room to room

With their fists clenched.

For me it’s not just small objects on difficult days

It’s grasping the thoughts from my head

Although they left a sort of snail-trail, vagueing over my neurons

Which I’ve been trying to follow all day.

Eventually, it occurs to me

After I’ve stopped combing my brain

That I actually promised to meet someone somewhere…..

This morning.

And someone’s understandably upset

That they’ve been inconvenienced

And it’s really hard to say to them

‘You’ve really no ***ing idea

What it feels like to be inconvenienced by my memory.’

So instead, you say. ‘Oh my God I’m so sorry,

My coping mechanism / diary / person who reminds me things

Didn’t manage to catch that one.

I’m trying to understand why.’

But the worst is when some people take

Your forgetting things for granted

Which of course is stupid because.

Memory is far more complicated than that.

You remember the feeling you had about them

Even after you’ve forgotten the why

Not to mention the sense of frustration

That even though you know

That you went out of your way to explain

It’s obvious that you didn’t manage to convey,

How painfully, painfully hard you tried.

Novel Feedback – part one

The kids are reading my children’s novel. Picture the scene. Side-by-side at a lap-top, wide-eyed, staring. An hour later, they are still there! That’s when I work out that we might be onto something. And, sure enough, that something is You-Tube.

Now there is feedback in its own right, but you sometimes need something more helpful. Luckily, I stumbled upon the Sheffield Novelists, who used to meet in an ‘Old Man’s Pub.’ You know: bar-stools, beer-mats, dart-board, that sort of thing. Landlord who said ‘it’s nice to see you’ and invited last orders before shouting ‘Time!’ We swapped 3000-word submissions before the session and gave each other the sort of feedback we’d hopefully have liked to receive, which was nice.

Unfortuantely, there were two blows: losing our venue was less devastating than you’d think, because the awesome Anne, a Sheffield writer, moved the whole endeavor online. My second blow was when my memory failed. There are precious few advantages. One is that I can read someone’s second draft of a scene, as if I’m reading it for the first time. But then they say, ‘did you like that ending better than last month?’ – and you’ve no idea. Or worse, you agree to host an in-the-flesh meeting and then you completely forget that they’re coming…… and the toilet needs cleaning….. =

For quite a long time, I couldn’t remember what I’d read before meetings, let alone the names of other authors, characters, or the back-stories of the novels. I regularly forgot to submit things, or to read one or other of the pieces. Worse than that, one Guy – let’s call him guy – who rarely goes to meetings and has mostly an internet presence – has the same colour hair and the same first name as another guy we’ll call Guy, who does go to meetings but has no internet presence at all. I know one the second guy very well – and so do my kids – where as I have a vague idea that I offended the other guy once rather badly, when my memory was newly atrocious. You remember the feelings, but not the facts. Anyway, my stupid brain keeps refusing to split them into two separate people.

The Facebook Guy is publishing a book. I send encouraging messages and accept a ticket to the launch. I share a social-media post encouraging others to go along too. You might have seen this coming, but I did not: my social-media post liberally praised the previous writings of the other Guy. I got a very polite email putting me right, my heart dropped through my feet and I will be going to his launch with a bag on my head. I would try to tell the funny story to strangers I meet at the launch, but for some reason squirmy stories about your own memory difficulties are never a very good ice-breaker, and I think Guy might have been quite offended.

Anyway, last night was the Sheffield Novel-Slam. It’s a massive event, like Strictly Come Dancing for writers. You have to give your novel a name and a first line. Then you have to read a one-minute long pitch. After that, there’s a vote and the best few get to read a few pages. The judges give their feedback and then crown the winner.

But what’s notable about Strictly is that the contestants are already entertainers and public speakers, where as writers are generally people who can happily spend days alone with their laptop. So I arrived at the novel-slam and there was a small group of people who knew each other at every table. I took a deep breath, picked one with a few empty seats, went over and muttered something like ‘Hi – can I come and be friendly?’ – and the nearest woman said something all in a rush, along the lines of yes, you can sit here, but – erm politely and all that – I’m not all that friendly. Actually I’m really nervous so I’m sorry if I don’t talk to you.’

And some people might be offended by this, but I genuinely wasn’t. In fact, the first thing I thought was – thank f***.

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.

 

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.