Brain Injury Fatigue and Day to Day Functioning

Brain Injury Fatigue: DJ Part Fourteen

Brain injury fatigue is another common denominator about brain injury.  Its causes are multiple, including the draining of cognitive reserves from over-attending and stress, in combination with pain, depression and poor sleep all symptoms of brain injury fatigue.  See http:// http://www.subtlebraininjury.com/fatigue.php

“I’ve gotten up and ridden a bike 10 miles, in an around town and gone to the store and then take a nap until 6:00 in the afternoon.”

 

DJ Explains His Brain Injury Fatigue

What about brain injury fatigue?  You mentioned that you need to take naps and that tomorrow’s going to be a lousy day; and you know it’s going to be a lousy day and that’s because today’s a hard day.

I’ve very seldom done anything for 12 straight hours and I’m going to today.  I’m already, I can feel bags.  My chest is getting tight.

We’re going to, we’re only going to go for another 25 minutes or so.

Well, we still got a meeting at 5:00. (The TBI support group meeting.) And the stimulation with that’s going to be amazing because I haven’t seen these people for a year and a half.

So, we’ll try to get done to give you at least a 45-minute break before that meeting.

That could be good or bad.  So, you know, it could bring me down to the point –

If you feel like you are getting brain injury fatigue, we’ll turn off the lights and let you get a nap.

I could probably talk to you for six more hours.

Imagine  you being up on top of your mountain in Connecticut.

If I go up there, I’m going to sleep.

Tell me about your brain injury fatigue in a normal day.  This isn’t a normal day.  Tell me about brain injury fatigue in a normal day.

It is weird.  I can tell you that I’ve gotten up at say 8:30, most days I don’t just jump into the shower unless I have to go somewhere.  I go to dishes or something and try to warm up easily.  Medications, maybe shave, brush teeth, something like, you know, easy going.  A lot of days I don’t turn on the TV for a long time because of that mental stimulation thing but I have gotten up and taken a shower and gone back to sleep for three hours.  I’ve gotten up, walked to the mailbox and come back and taken a nap for three hours.    I’ve gotten up and ridden a bike 10 miles, in an around town and gone to the store and then take a nap until 6:00 in the afternoon.  There’s just no rhyme or reason and that’s what I’ve tried to explain to everybody and no doctor’s ever written that I’ve become so amazingly consistent.

If I were to say, “Today’s going to be a day where we’re going to take you shopping without your list.  Today is the day when you’re going to have to drive, as a passenger in a car for half an hour.  Today’s a day where you’re going to have to try to track the conversation of three or four people sitting around a table together.”  That wouldn’t guarantee a day of brain injury fatigue?

Oh it would, doing all of that in one day.

Is your fatigue related to how much you are asked to multi attend, how much you’re asked to concentrate?

No, sir.  It’s really not.  Like I said, I’ve gotten up and taken a shower and gone back to sleep for three hours.  I mean, a shower should not wear you out.

Have you had a sleep study?

No.

Another thing that workers’ comp doesn’t pay for?

It was never even mentioned.

Talk to me about a typical 24 hours. What time do you typically go to bed?

I can’t.  That’s been asked a lot.  There is no typical 24 hours.

Well, let’s start with yesterday.  What time did you go to bed last night?

I went to sleep at about 12:15 and I woke up about 1:30 and I could not go back to sleep and I haven’t been back to sleep since.

So you’re not only keyed up for this interview, you’re running on fumes right now.

I’m not doing well.  I’m hanging in there.

The day before.  What time did you go to bed?

It was the 4th of July.

Did you do fireworks?

I did.  I went downtown.  I watched fireworks and then, I’m glad you said that because this happens, too.  Is I’ll leave and if I’m, my heads not together and I’m not paying attention, I will walk around and just suddenly realize I’m very lost.  I just, I get on the phone and talk or I answer Facebook.  I’ve done it going to the store to get bread.  I’ve done it, you know, a lot of different facets and forms.  Believe me.  And, I get a little bit lost.  I called a cab and I came home.  So, I went to bed about 12:00.  I think I woke up around 6:00 or 7:00, which is as much sleep as I’ll ever get but I probably walked somewhere around 8 miles.

What  wakes you up?  Is it pain?  Is it just the light of the day?

Eyes open.  I don’t know. I don’t wake up to an alarm clock.  I mean, unless I have to.

How many times a week will you get up in the middle of the night?

Get up in the middle night like?

Say, you went to bed at midnight and somewhere in between midnight and 6:00, you were up.

I never, without getting lost or a day like today, never sleep more than three to five hours at a time.

Then how often do you take a nap because of your brain injury fatigue during the day?

I’ve slept from 9:00 to 11:00, been up from 11:00 to 2:00, slept from 2:00 to 5:00, been up from 5:00 to say like 9:00.  Slept from 9:00 to 1:00, been up from 1:00 to like 5:00.  It, it’s just, it’s all over the place.

Brain Injury Fatigue Evaluated by Sleep Study

Without question, DJ needs to have a sleep study done.  The lack of structure in his life and his role on Facebook invariably mean that his daily routine may always be a bit unpredictable. Still it is clear that despite the sleep medication that he is taking, he is not getting the restful sleep that gives him a fighting chance of consistent cognitive function. An example of the effects of brain injury fatigue.

Next in Part Fifteen  – Frontal Lobe Deficits in Planning for Interview

By Attorney Gordon Johnson

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