Saw Dr H on February 13th and Dr D on February 14th (a belated Happy Valentines shout out to you both!). I count myself extremely fortunate to have access to both of these health professionals. I owe each of them a huge debt, one that I doubt I can ever adequately describe, or fully repay.

During my visit with Dr H, she advised me on the need to identify priorities, those items on which I should focus my limited energy. Dr D introduced me to a very interesting paper on cognitive research. Reading this paper introduced me to a great deal more information, most of which has been added to my backlog of documents scheduled for review and study. I find I am very slow when it comes to processing complex text.

I just realized that I have spent the better part of three hours following the links in the article Dr D shared with me. My literature review has triggered three insights:

• Dr H’s suggestion that I identify priorities is critical. I need to identify those areas of focus most important to me, most relevant to my injury, and to the rehabilitation / job finding process.
• That my idea of using technology in the creation of peer to peer “wellness community” targeted to the needs of the mTBI community fits with a number of other initiatives which are also investigating the utilization of technology and social media in addressing health sector issues. The concept of a participatory “wellness community” overlaps with current academic interest in cognitive research and learning. So my ideas are not completely “out there” but rather represent current areas of  significant academic research interest.
• That my notion of “External Cognition” also appears to resonate with current initiatives in academic research.

This morning’s review led me to further research on the importance of fluid reasoning. Empirical research shows that fluid reasoning may be improved through avoiding arbitrary time pressures. This avoidance of arbitrary time pressure is reflected in my need to slow my activity down in order to allow myself adequate time for cognitive processing.

I have learned to allow extra time for the performance of all activities (arriving an hour ahead of time for doctor visits, providing an enlarged time budget for routine tasks etc). If I do not allow considerable slack in my time budgets then I inevitably encounter time constraints. These constraints manifest as immediate time pressure and my cognitive abilities degrade as I increase the tempo in an attempt to “beat the clock.” The more rapid the tempo, the more likely it is that I will exhibit performance error. My performance then becomes further burdened due to developing frustration with my own lack of capacity. Reflection on this “loss of capacity” results in a further self-imposed burden caused by feelings of hopelessness and despair. The experiential outcome is a tendency to retreat (see following URL for a formal expression of this retreat: Present Experience). Over time I suspect this form of social retreat will result in further skills atrophy leading the mTBI victim into a progressive downward spiral.

So my number one priority must be to get out into the world and engage more as a means to inhibit further skills atrophy.

It is noted that one of the core aspects of the TBI Proposal is to provide a community setting in which participants are afforded the opportunity for such engagement.