Cognitive Complaints after Second Brain Injury

Cognitive Complaints: Elizabeth Part Six

Regardless of which of her two injuries has left her disabled, there is not doubt that she has been left with a long list of cognitive complaints. She explains:

With the way my injury ended, well I shouldn’t say ended, they never end, with the second one, all of those things together have gotten worse for me. It’s understanding things. I can ask my question four or five or six times before I understand his answer, my, my wonderful husband, and it’s the same question.

In our interview, many of her cognitive complaints weren’t apparent. She explained how in day-to-day function her cognitive complaints are worse, especially when someone else is doing the most of the talking.

The problem is since my accident not understanding, you can ask me the questions now and I can answer the best I am possible to answer, and with my injury, the second I walk out that door by the time we get home my husband will probably repeat one or two things you said or asked me and I won’t get them out of my head straight again.

Like other of our interview subjects, her memory, cognitive complaints and comfort levels are best when she is doing the talking. (See http://tbivoices.com/blog/uncategorized/uncontrolled-talking-after-tbi-logorrhea).

Talking gives me the attention with someone and it makes me be able to try to understand more and get it the right way instead of totally losing it.

This is going good (discussing our interview and her cognitive complaints and functioning during it). Wonderful things that I can think about that I understand and it’s easier this way where to like writing stuff down. Write a question down and I can look at it and it can take sometimes ten minutes, sometimes a half an hour, well what is the right thing to say to it or to, it’s like I forget. My, my understanding of things.

What makes listening harder than talking?

To make sure I understand it that’s the hardest part. To make sure I understand it right. That I, that I know what I need to answer correctly, what I, what I need think and what I need to say.

Memory can be broken up into a lot of different terms as a cognitive complaint, but in lay terms, it is most helpful to talk about the memory that’s lasts 30 seconds versus the memory that last five minutes versus the memory of events of yesterday. While all of those are types of short-term memory, they involve distinctly different functions. For Elizabeth, she didn’t demonstrate either the 30-second lapses or even the five minutes. When quizzed, she remembered parts of our conversation, even those parts where she wasn’t doing the talking for up to five minutes.

She explained that remembering what happened hours ago, or yesterday is where she has the most difficulty and one of her biggest cognitive complaints. Yet, as to be expected, something that was important to her (such as being interviewed for TBI Voices) and memories that had an emotional component to them, she remembered best. She explains:

A lot of it depends upon what it is. If it’s someone that you love is hurt or there’s an accident, someone that you care about (then I would remember better.) I have to write things down because if I don’t understand it the right way in my head and it, and I can’t connect with it and it comes out wrong, it can totally mess up everything and that’s the biggest, the biggest problem.

Her husband admits she is a bit scatterbrained.

She can be reading a book, get up, put it on the, the table next to the chair, and come back, sit down and she’ll go, well where did I put the book? And it’ll take her five minutes to find it and it’s sitting right there.

What time interval causes her the most cognitive complaint with her difficulty with memory?

I would say after half an hour, you know, where it’s, most of the time it’s like from one day to the next day. If she don’t write it down, forget it. You know, it’s, it’s gone. But I would say most of it is 20 minutes, half an hour, you know, after that you can really notice that.

Returning to some limited work is more difficult for her because she didn’t have a background in sedentary/office work before her injuries. The type of factory work in which she has a background would almost invariably involve far too much risk of further injury. She explains with her cognitive complaints that doing an office job would be too difficult:

I can’t. Say it had anything to do with a computer, I don’t understand them. I can look at one for eight hours and not get it. They can teach you how to type again and I think I – if you spell a word wrong the computer can fix it for you but the dizziness, the frustration part I think is the worst. Even though you’re looking at it and you’re trying to get it, if you’re trying to do it at an office and somebody wants it in 10, 15 minutes I can’t do it. My brain does not work that fast connected with that and other people too.

Next in Part Seven – Day in Life of the TBI Housewife.